Neck Pain

About Neck Pain

We often refer to life’s challenges as a pain in the neck, and for good reason. Neck pain can be a nagging annoyance that interferes with your ability to focus mentally and perform physically. Neck pain can stem from a number of causes, and treating the symptoms alone is not enough. To get rid of your neck pain for good, you need to treat it at its source.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Neck Pain Specialist Dr. Lev Kalika

Dr. Lev Kalika’s mission is to change the way common conditions like neck pain are diagnosed and treated. The neck pain specialists at NYDNRehab leverage cutting edge technologies and innovative treatment methods that are rarely found in private PT clinics.

Patients with neck pain are often subjected to unnecessary surgeries or treated with pain medications, steroid injections and muscle relaxants that fail to resolve their condition. They often go from doctor to doctor without finding lasting relief for their pain and dysfunction.

Dr. Kalika uses diagnostic ultrasonography to accurately confirm his clinical assessment. He believes that accurate diagnosis is the ultimate key to successful treatment.

The neck pain specialists at NYDNRehab go beyond treating your symptoms, pulling out all the stops to get to the true source of your neck pain and correct it for good, so you can enjoy pain-free movement again.


Why Physical Therapy Alone May Not Resolve Your Condition

Physical therapy is a valuable and effective approach to resolving musculoskeletal pain and dysfunction, but in many cases, physical therapy does not provide a stand-alone solution. Prior to beginning physical therapy, patients often need to address underlying issues that contribute to their pain and disability.

Unfortunately, mainstream physical therapy clinics are often not adequately equipped or experienced to identify and treat complications that undermine the effectiveness of physical therapy. They often rely on one-size-fits-all treatment protocols that overlook the unique characteristics of the individual condition, opting to treat the symptoms and not the patient.

Issues that should be addressed prior to beginning physical therapy include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury
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Holistic Non-Invasive Diagnosis and Regenerative Therapy

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to do so can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

At NYDNRehab, we use a broad range of advanced technologies and innovative therapeutic approaches to resolve issues that can potentially undermine the success of physical therapy.

Our talented staff is certified in a diverse array of treatment methodologies, rarely found in run-of-the-mill physical therapy clinics. Our one-on-one sessions are personalized, based on the patient’s unique diagnostic profile.

Obstacles to physical therapy success include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

Why Treatment at NYDNRehab is Better than Conventional Neck Pain Physical Therapy

Conventional neck pain treatment focuses on the locus of pain without looking at the bigger picture. But your neck does not function independently of the rest of your body, and your pain could stem from issues anywhere along your body’s kinetic chain, from soles of your feet to the top of your head. In most cases, neck pain is only a symptom, not the cause itself.

Conventional neck pain treatment often includes:

  • Corticosteroid injections to reduce inflammation
  • Cervical nerve root block injections to relieve pain
  • Muscle relaxants to relieve tension
  • Narcotic pain medications
  • Ice and/or heat therapy to reduce inflammation and ease pain
  • Surgery to remove a disc that irritates a nerve root
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At NYDNRehab, we look at the whole person, not just the part that hurts. Only after we learn more about your activities, lifestyle, health history and other factors do we begin our diagnostic process. You may undergo ultrasound imaging, postural evaluation, gait analysis and other assessments until we pinpoint exactly what is going on.

Once we get to the source of your problem, we design a custom treatment plan especially for you, based on your unique patient profile.

Symptoms and Causes of Neck Pain


  • Stiff and sore neck muscles

  • Sharp pain in the neck

  • Tenderness in the neck region

  • Pain that radiates to the shoulder and arm

  • Tingling, numbness and weakness in the arm

  • Difficulty gripping objects

  • Headaches and migraines


  • Athletic injuries and trauma

  • Awkward sleeping position

  • Poor posture

  • Texting and computer use

  • Whiplash

  • Herniated or degenerative disc

  • Osteoarthritis and spinal stenosis

Risk Factors

  • Advanced age

  • Poor sleep habits

  • Excessive use of mobile devices

  • Poor sitting posture

  • Sedentary lifestyle

  • Overuse from sports and exercise

  • High-risk sports and activities

Awkward sleeping position that places short-term pressure on muscles and nerves, causing a “stiff” neck
Athletic injuries including falls, collisions and other trauma occurring while the body is in motion at rapid velocities
Postural misalignment caused by poor postural habits or physical overuse from work or sports. Poor posture anywhere along the kinetic chain, especially the upper body, can lead to neck pain.
Prolonged poor neck position from texting, talking on the phone, using a computer or other activities that put the head in a forward position
Whiplash caused from rapid deceleration or collision in a moving vehicle
Herniated disc, where a disc becomes compressed between two vertebrae
Degenerative disc disease, due to wear and tear over time
Osteoarthritis due to eroding cartilage and inflammation
Spinal stenosis, where degeneration leads to a narrowing of the spinal canal

Accurate Neck Diagnosis Means Successful Treatment

Because neck pain can originate from a number of different causes, accurate diagnosis of your condition is critical. Once the source of pain is identified, a treatment plan can be put in place to resolve it.

To diagnose your neck pain, your therapist will conduct a thorough exam that may include some or all
of the following:


Patient history

We review the description and location of your neck pain, your daily physical activities and lifestyle behaviors, your postural and sleep habits, and your past and recent injuries.

manual therapy

Physical exam

Your physical exam may include:

  • Postural evaluation
  • Range of motion assessment
  • Assessment of reflexes and sensations
  • Evaluation of muscle strength
  • Palpation of the affected area

Our Regenerative Therapies are Game-
Changers for Neck Pain

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

INDIBA CT9 Radiofrequency Device

INDIBA CT9 Radiofrequency Device

Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to lower back pain. Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Regenerative Ultrasound Guided Injection Therapies

Ultrasound Guided Injection

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.

Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)

Benefit from Our Innovative Non-Invasive Therapies

Surgery for neck pain should only be considered as a last resort. Most neck pain can be resolved with non-invasive conservative treatment. Your neck pain specialist will likely incorporate a combination of approaches in your customized treatment plan.

Some of the unique neck pain treatment approaches at NYDNRehab include:


Exercises for motor control of the upper quarter of the body


Range of motion exercises


Postural correction


Ergonomic workspace correction


Individualized home exercise program


Chiropractic care



More Treatment Options

Acute Neck Pain

Acute Neck Pain

  • Over the counter NSAID’s (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation

  • Acupuncture

  • Chiropractic care

  • Ultrasound guided dry needling (UGDN)

  • Steroid Injections

Chronic Neck Pain

Chronic Neck Pain

  • Physical therapy

  • Chiropractic care

  • EMTT (electromagnetic transduction therapy)

  • Ultrasound guided dry needling (UGDN)

Preventing Neck Pain

Staying in shape with regular exercise is the best way to prevent neck pain. You should also be aware of your posture, especially when using a computer or mobile device. Be sure to use protective gear when playing sports or engaging in high risk activities. Good sleep hygiene, including and appropriately firm mattress and pillow can help protect your neck while you sleep.

Preventing Neck Pain

Get Personalized Neck Pain Physical Therapy Designed Just for You

At NYDNRehab, we never take a cookie-cutter approach to patient care. The symptoms of neck pain vary from one patient to the next, each with their own causative mechanisms. We thoroughly examine each patient and base our treatment solutions on your unique diagnosis. We provide one-on-one Physical Therapy, custom-designed for the individual patient.

neck pain manual therapy nyc
neck pain dr kalika
neck pain manual therapy

Range of Available Unique Physical Therapy Treatments at Nydnrehab

Clinical Case Studies

Neck and Scapular Pain with Disc Bulges

Our patient presented with persistent neck and interscapular pain lasting more than five years, with a history of overhead sports and a prior car accident. The patient had been unsuccessfully treated elsewhere.

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Ultrasound Guided Dry Needling for Vertigo Treatment in Patient with Skull Trauma

Our patient is a 30 year-old male with head trauma, suffering from persistent vertigo and neck pain. Prior attempts to resolve his condition had been unsuccessful, primarily due to misdiagnosis and ineffective treatments.

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Neck and Shoulder Pain Diagnosis and Treatment with Ultrasound-Guided Dry Needling

Our patient was a 46 year-old male complaining of pain in his left shoulder and neck. During the clinical exam, it was revealed that two days prior, he had received an allergy injection in his left arm for asthma.

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Patient with Facial Pain and Complex Neurological Dysfunction Successfully Treated with Alternative Therapies

Our patient, a 28 year-old male, had been suffering for over two years with unexplained facial and upper body pain. He had seen two separate neurologists and undergone MRIs of his brain and cervical spine, with no concrete diagnosis.

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Get Neck Pain Treatment That Really Works!

TMJ pain can be relentless and debilitating, interfering with your ability to enjoy life to its fullest. Pain medications and surgeries fail to get to the root cause of neck pain, they only treat the symptoms without resolving their underlying causes.

At NYDNRehab, we make it our mission to get to the source of your pain and dysfunction and correct it, so you can move freely again and enjoy life to its fullest. Contact us today and make an appointment to get rid of your pain in the neck or good.

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    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Our Specialists

    Dr. Mikhail Bernshteyn MD (Internist)
    Dr. Michael Goynatsky DPT
    Dr. Daniela Escudero DPT
    Dr. Michelle Agyakwah DC
    Dr. Tatyana Kapustina L. Ac.
    Neck Pain
    Neck Pain Treatment NYC

    Nowadays there is significant increase in the amount of patients with neck pain. Clinical experience and scientific data shows that this recent increase is due to excessive usage of hand held devices, computers, excessive sitting and increased amounts of stress.

    SYMPTOMS of Neck Pain

    Many patients complain of the pain in the shoulder area where in fact what they are experiencing is lower neck pain. Muscles and joints of the lower neck are also known to refer pain into mid back or between the shoulder blades. Myofascial involvement occasionally may refer pain into the arm, elbow or even as far as the hand. The herniated disc in the cervical spine which compresses the nerve root will produce pain, numbness and tingling down the arm and into the hand. Although disc bulges, protrusions and herniations in the cervical spine are not uncommon, majority of people suffer from myofascial pain when it comes to the neck pain. The most consisted characteristic of the myofascial pain in the neck is that of the pain changing location.


    Bringing together the reported data from different studies, we can claim that pain in the neck has increased by 10.4% and 21.3% in the past five years. Prevalence in general population is higher in women compered to man, however a high peak of this type of pain is observed in sitting-workers of both genders.


    The cervical spine consists of seven vertebras interconnected by the discs, spinal joins and the ligaments. The top of the cervical spine is connected to the cranium (head) through intricate anatomically designed cranio-cervical junction. The muscle of the neck connect many anatomical areas together. In order to fulfill many different neuromuscular functions for mobility, stability and connection of the central nervous system to the neck the muscular and fascial system are ana


    Reasons for neck pain may vary from many disorders of different tissues within shoulder girdle and cervical spine. Here are some of the causes:

    • improper breathing
    • poor posture
    • breast implants
    • head injuries
    • trauma to the neck such as whiplash
    • hypermobility
    • poor muscles balance of shoulder girdle and cervical spine
    • falling asleep in an awkward position;
    • prolonged sitting position;
    • stress.
    • excessive computer work and excessive use of mobile devices
    • poor vision
    • improper exercise



    The protruded, bulged or herniated disc in the cervical spine are not uncommon however most of them go away with proper conservative care in a relatively short time. Surgery is rarely necessary. However when its warranted the healing is much faster and reoperations are very rare.


    Neck arthritis is not uncommon. It causes limitation in the movement of the neck and pain. However in the hands of experienced physical therapist or a chiropracor the pain can be eliminated and enough of the lost movement can be restored in order for the symptoms to subside.


    The cervico-cranial syndrome is characterized by the neck pain at the junction with the skull, headaches, occasional dizziness and blurry vision. Sometimes patient may have concomitant pain in the jaw. Depending on the symptom presentation this syndrome may be called as orofacial pain or TMJ (temporo-mandibular joint) pain syndrome. Irregardless of the name the etiology of this syndrome is within the musculoskeletal system and not the problem in the mouth or the nervous system.

    Neck pain TREATMENT NYC

    Pain in the cervical spine may be a symptom of more serious problems like degenerative disc disease, herniated disc, or a pinched nerve. Cervical facet joints are rare source of pain. Most of the pain experienced in the cervical spine outside disc disease is of myofascial character. In the absence of perpetuating factors myofascial pain responds well to variety of different manual therapies in combination with rehabilitative exercises , acupuncture and extracorporeal shockwave therapy.
    Preventive treatment for reducing the risks of this type of pain should include ergonomic work space arrangement, gentle stretching, postural exercises, Pilates specific neck and breathing exercises.
    Neck pain treatment should address all functionally interrelated body segments such as: whole upper extremity, shoulder girdle, rib cage, cervical spine, and even skull and TMJ. Movement dysfunction in any above described areas could affect biomechanics of the cervical spine through kinetic interlinking of muscular chains. Sitting postures, lifting, prehension, breathing as well as ergonomic conditions must be examined and addressed. The use of hand held devises must be minimized for the time of symptom duration because hand held devices perpetuate abnormal movement stereotypes affecting the upper quarter. Patient is recommended >to take short breaks with performance of brief remedial postural exercises for reduction of strain to the neck imposed by desk and computer work.


    At Dr. Kalika’s clinic neck pain treatment is conducted by a combination of DNS (dynamic neuromuscular stabilization) therapy, clinical Pilates, variety of manual myofascial and neuromuscular methods, acupuncture, extracorporeal shockwave therapy which concurrently address all interrelated tissues as well as motor control of the upper quarter of the human body. Home exercise program based on movement impairment examination is also very effective component of successful and long lasting relief.


    Research at NYDNRehab

    Conference: EFIC Congress 2019 – Pain in Europe XIAt: Valencia, Spain
    Conference: 14th European Headache Federation CongressAt: Berlin, Germany (virtual congress), June 29 – July 02, 2020

    In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

    Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

    The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

    Dynamic ultrasonography examination demonstrating
    the full thickness tear and already occurring muscle atrophy
    due to misdiagnosis and not referring the patient
    to proper diagnostic workup

    Demonstration of how very small muscle defect is made and revealed
    to be a complete tear with muscle contraction
    under diagnostic sonography (not possible with MRI)


    Complete tear of rectus femoris
    with large hematoma (blood)


    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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