PHYSICAL EVALUATIONS IN-OFFICE

Complete musculoskeletal exam (relevant to chief complaint as determined by me) Neurological exam of the affected region Lumbar – lower extremities Cervical – upper extremities Gait analysis Scoliosis evaluation

TRIGGER POINT INJECTIONS IN-OFFICE

Trigger points are a tight band of fibers within the muscle, they are a Common source of pain Typically referred as “knots” Differ from tender points as they refer pain in a specific pattern when pressure is applied Can persist despite trial of deep tissue massage and stretching Injection of a local anesthetic +/- cortisone into the trigger point Often injection is combined with “wet” needling, a back and forth motion of the needle to “break up” the tight fibers May need to be repeated for longer lasting relief Commonly combined with physical therapy

BURSA INJECTIONS IN-OFFICE

INTERVENTIONAL PAIN MANAGEMENT OUTPATIENT

COORDINATION AND COLLABORATION IN-OFFICE

NERVE CONDUCTION STUDIES/ELECTROMYOGRAPHY (COMING SOON)

Upper extremity Subacromial bursa for rotator cuff tendinitis Lateral epicondyle bursa for tennis elbow Lower extremity Trochanteric bursa for lateral hip pain

Epidural Steroid Injections Cervical Lumbar Lumbar facet injections Lumbar medial branch blocks Sacro-iliac joint injections Hip injections

Physical Therapy McKenzie Method Strengthening Flexibility Dry Needling Diagnostics Imaging – X-ray, MRI Nerve Conduction Studies/EMG (see above) Lab – Rheumatology screens, Thyroid, Inflammation, Auto-immune disease Massage/Acupuncture

Diagnostic evaluation of numbness/weakness in the extremities Upper extremity Carpal Tunnel Syndrome Ulnar Neuropathy Cervical Radiculopathy Peripheral Neuropathy Lower Extremity Peroneal Neuropathy Tarsal Tunnel Syndrome Sciatica Peripheral Neuropathy