Wednesday, December 30, 2009

Trigger finger-treatment in NYC


Trigger finger treatment NYC
www.livingwellnewyork.com
This past holiday weekend I was with family for the holiday's and my father in-law had a terrible case of Trigger Finger.
I started to tell him how I have helped patients with this condition without surgery using a combination of non-surgical techniques like the Graston technique, Cold laser therapy and Kinesio taping in our NYC physical therapy and Chiropractic practice.
Below I have posted some information about Trigger finger.

A trigger finger occurs when the motion of the tendon that opens and closes the finger is limited, causing the finger to lock or catch as the finger is extended.

Causes of Trigger finger

Tendons that control the movements of the fingers and thumb slide through a snug tunnel of tissue created by a series of pulleys that keeps the tendon in place. The tendon can become irritated as it slips through the tunnel. As it becomes more and more irritated, the tendon may thicken, making its passage through the tunnel more difficult. The tissues that hold the tendon in place may thicken, causing the opening of the tunnel to become smaller. As a result, the tendon becomes momentarily stuck at the mouth of the tunnel as the finger is extended. A pop may be felt as the tendon slips past the tight area. This why pain and catching may be felt as the finger is moved.

The cause is not always known. Trigger fingers are more common in women than men. They occur most frequently in people who are between the ages of 40 and 60 years of age. Trigger fingers are more common in people with certain medical problems, such as diabetes and rheumatoid arthritis.I often find that patient complains of previous wrist,elbow and hand pains.

Symptoms of trigger finger

Symptoms of trigger finger usually start without any injury. Symptoms may include the presence of a small lump, pain in the palm, swelling, and a catching or popping sensation in the finger or thumb joints. Stiffness and catching tend to be worse after inactivity, such as when you wake in the morning. Often, finger movement will loosen up with activity. Sometimes, when the tendon breaks free, it may feel like the finger joint is dislocating. In severe cases, the finger cannot be straightened, even with help. Sometimes, one or more fingers are be involved. Patients with diabetes can have several fingers involved, for example.

Traditional treatment methods

If symptoms are mild, resting the finger may be enough to resolve the problem. Over-the-counter pain medications can be used to relieve the pain. Splints are sometimes used to rest the finger.

A physician may choose to inject a corticosteroid. Sometimes, the improvement is temporary and more than one injection may be needed. Injections are less likely to provide permanent relief when the triggering has been present for a long time, or if when there is an associated medical problem like diabetes.
If these treatments do not improve surgery is usually recommended.
I have successfully used the Graston technique,Cold laser therapy and kinesio taping to resolve this condition without surgery. To learn more about the Graston Technique visit the website at www.grastontechnique.com

I found a recent abstract online and posted it below

The conservative treatment of Trigger Thumb using Graston Techniques and Active Release Techniques®
Scott Howitt, DC, FCCSS(C), FCCRS(C),* Jerome Wong, DC, and Sonja Zabukovec, DC
* Address correspondence to: Dr. Scott Howitt, Assistant Professor, Clinical Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1. Phone: 416-482-2340 ext. 395, Fax: 416-488-0470; E-mail: showitt@cmcc.ca
Small right arrow pointing to: This article has been cited by other articles in PMC.

* Other Sections▼
o Abstract
o Résumé
o Introduction
o Case report
o Treatment
o Results of treatment
o Discussion
o Conclusion
o References

Abstract
Objective
To detail the progress of a patient with unresolved symptoms of Trigger thumb who underwent a treatment plan featuring Active Release Technique (ART) and Graston Technique.
Clinical Features
The most important feature is painful snapping or restriction of movement, most notably in actively extending or flexing the digit. The cause of this flexor tendinopathy is believed to be multi-factorial including anatomical variations of the pulley system and biomechanical etiologies such as exposure to shear forces and unaccustomed activity. Conventional treatment aims at decreasing inflammation through corticosteroid injection or surgically removing imposing tissue.
Intervention and Outcome
The conservative treatment approach utilized in this case involved Active Release Technique (ART®) and Graston Technique (GT). An activity specific rehabilitation protocol was employed to re-establish thumb extensor strength and ice was used to control pain and any residual inflammation. Outcome measures included subjective pain ratings with range of motion and motion palpation of the first right phalangeal joint. Objective measures were made by assessing range of motion.
Conclusion
A patient with trigger thumb appeared to be relieved of his pain and disability after a treatment plan of GT and ART.
Keywords: AA1 pulley, Active Release Technique, Graston Technique, flexor tendinopathy, trigger finger, trigger thumb, metacarpophalangeal joints.

I am attended the first series of the ART seminars this upcoming weekend, this will be a additional tool I use to treat this and other conditions.
Visit www.drshoshany.com

Thursday, December 10, 2009

Physical Therapy and Carpal Tunnel Syndrome

For many of us, our jobs revolve around a desk, a keyboard, a computer and a mouse. It’s simply a modern reality that much of our work and communication has become both sedentary and repetitive. So much so that we now RSI’s (Repetitive Strain Injuries) that reflect these issues like “Blackberry Thumb” and Carpal Tunnel Syndrome from improper keyboard posture. Carpal Tunnel Syndrome in particular affects thousands of people each year, and due to the nature of repeat strains, it causes people to miss work so they can immobilize and rest the ailing wrist. At Living Well Medical in NYC, we routinely help patients suffering with repeat strain injuries like Carpal Tunnel using a program of physical therapy supported by other treatment methods.

So just what exactly is Carpal Tunnel Syndrome and how does it develop? The carpal tunnel is the canal in the wrist through which the median nerve passes which innervates (supplies sensation and motor function to) the thumb, index and middle fingers as well as part of the ring finger. It is surrounded on three sides by bone and on the fourth side by the transverse carpal ligament. Several tendons also pass through this canal. You could call it a high traffic area of the wrist. With repeated strain or overuse, theses tendons swell and can compress the nerve causing pain, numbness, muscle weakness, and in severe or chronic cases, wasting of the muscles of the palm. Tingling, burning, and ‘pins and needles’ sensations are also commonly described symptoms with median nerve compression.

Carpal Tunnel Syndrome, also called median neuropathy at the wrist, can have significant effects on the ability to function normally, making general movement painful, and we depend on our hands for so much. It is one of our primary means of interacting with the world around us, so an injury of this sort can be more than a little frightening.

Physical therapy has been shown to help reduce pain in the carpal tunnel in moderate to mild cases. In particular, stretches and hand exercises are often combined with other therapies to achieve the best results. In most cases, splinting is also an important component of treatment as immobilizing the joint can help prevent further irritation and promote proper healing. Deep tissue ultrasound and other conservative treatment methods might also be employed by your physical therapist to stop the pain and numbness. At our practice, we integrate the Graston Technique, chiropractic care, and cold laser therapy as part of our physical therapy protocol to relieve pain and stimulate faster healing. Each of these individual treatments can be added on to physical rehabilitation to improve outcomes. This unique approach to treatment, coupled with our commitment to wellness, is what separates us from other practices.

If Carpal Tunnel Syndrome is causing you pain, Living Well Medical in NYC can help. Call us today at 212-645-8151 to schedule your appointment for treatment at our SoHo office.

Thursday, December 03, 2009

Diagnosing Muscle and Nerve Pain: Nerve Conduction Velocity and Electromyography in NYC

Severe pain can have any number of causes, many of them related to the muscles and the nerves, and part of the job of any effective pain treatment center is making an accurate diagnosis on the cause of pain. Doctors, medical centers and hospitals make use of a number of different diagnostic tools when a patient is in pain like x-rays and other imaging methods. However, making sense of nerve and muscle related pain can be a much more complicated endeavor that requires a specialized touch. Diagnostic images don’t always tell the whole story. That’s why we make use of tests like the Nerve conduction velocity study (NCV) and Electromyography (EMG) at Living Well Medical in NYC. By combining these state-of-the-art tests with a wide range of pain treatment protocols, we can help patients reduce pain and enjoy a better quality of life.

A nerve conduction study is a method of measuring and evaluating the function of the motor and sensory nerves in the human body. By applying an electrical stimulation and measuring the response, a specially-trained doctor can gather information about whether there is any interruption to correct nerve function. Typically, NCV’s are only performed for patients who are experiencing numbness, burning, tingling or muscle weakness. Measurements that are taken include latency which shows the time delay between the stimulus and the recording site and the amplitude which shows the size of the reaction. Nerve conduction velocity is often used to diagnose common conditions such as Carpal tunnel syndrome, spinal disc herniation, and other types of neuropathy (damage to the peripheral nerves). NCV studies help our NYC office make the right diagnosis the first time so that treatment can proceed smoothly.

Electromyography (EMG) is a method of recording and evaluating the activation signal created by muscles in the human body. By measuring the electrical potential that is generated by muscle cells when both active and at rest, abnormalities in the muscles and nerves can be detected and diagnosed. By placing an electrode on the muscle that is believed to be the cause of pain, a doctor can observe whether muscle contractions are activating in the acceptable normal ranges. Any deviation can help diagnose nerve and muscle dysfunctions like Carpal tunnel syndrome, sciatic nerve dysfunction, spinal stenosis, and various types of myopathy (a muscular disease that results in muscle weakness).

Living Well Medical in NYC has a medical doctor who is Board Certified in Pain Management on staff performing nerve conduction velocity studies (NCV) and electromyography (EMG) so that we can make the right choices in creating an effective treatment plan. Combining several non-surgical treatment options, we can help you stop the pain. This is just one aspect of Living Well that makes us special and different from your average pain treatment center. Call us at (212) 645-8151 for more information on evaluation and treatment.

Friday, November 20, 2009

Excellent treatment for soft tissue injuries in NYC-Carpal tunnel syndrome


NYC Chiropractor Adds New Therapy for Chronic Back, Neck and Joint Pain to Downtown Practice
Dr. Steven Shoshany, a New York City Chiropractor, Expands Services with Rehabilitation Technique for Muscle and Joint Pain. Called FAKTR-PM or Functional And Kinetic Treatment with Rehabilitation, Provocation and Motion, it can Help Patients Reduce or Eliminate Pain.

New York, NY -- In Downtown NYC, a well known local chiropractor is adding a cutting-edge therapy for the treatment of chronic and acute musculoskeletal pain called FAKTR-PM. Dr. Steven Shoshany of Living Well Medical (located at 632 Broadway between Houston and Bleecker Streets) has been helping patients find relief from back, neck and joint pain for many years and is always searching for ways to add another dimension to his services. Already integrating treatments like physical therapy, non-surgical spinal decompression of a herniated or bulging disc with the DRX 9000, pain management, digital x-ray, cold laser therapy, and gentle chiropractic care at his practice in NYC, Dr. Shoshany saw the possibility of providing another non-invasive option to patients as a great opportunity to better serve his patients.


Dr. Shoshany treats a patient at his NYC office.Called ‘Functional And Kinetic Treatment with Rehabilitation, Provocation and Motion,’ or FAKTR-PM for short, this technique was developed in 2002 by chiropractors, Dr. Tom Hyde, Dr. Greg Doerr, and Dr. Vince DeBono. It seeks to stop chronic and acute pain syndromes associated with fascia (the soft tissue component throughout the body that underlies the skin and provides support, protection and shock-absorbency) and other soft tissues like muscles. In order to help speed recovery of these types of injuries, the specific range of motion and circumstances under which pain is experienced are recreated during treatment to precisely determine. This is what is meant by provocation. By combining manual therapy with rehabilitative concepts, the function in painful muscles and joints can be restored and aches reduced.
Problems that can be helped with hands-on therapy with Functional And Kinetic Treatment with Rehabilitation, Provocation and Motion and tend to respond to treatment include:

- Tendinopathies like Tendonitis and Tendinosis
- Nerve Entrapments like Carpal Tunnel Syndrome and Piriformis Syndrome
- Muscle Pain from Strains or Sprains
- Edema as a result of Trauma
- Scar Tissue and Fibrous Adhesions

“I’m really excited to be bringing this new treatment to my patients. I think it can help a lot of people get rid of pain and feel well again,” Dr. Shoshany said of the addition to his practice. Dr. Shoshany is certified in the use of FAKTR-PM and is the first chiropractic doctor to offer this treatment methodology in NYC. For more information on FAKTR-PM and the other types of non-surgical pain relief available at Living Well Medical in NYC, call 212-645-8151.

Friday, November 06, 2009

Leg Pain, Sciatica and Lumbar Discs: Their Relationship and Treatment in NYC



The sciatic nerve is the largest nerve in the body, and consequently, irritation or compression of this nerve can lead to severe pain. This is what is typically referred to as sciatica, and it encompasses a wide range of symptoms. Perhaps the most common indicator is leg pain that travels down the leg. Many describe the pain as a burning sensation. Pain in the lower back and buttocks tend to accompany the leg pain, and it’s not unusual to have sensations of tingling, weakness or even experience numbness. We regularly treat patients who are suffering with sciatica at Living Well Medical in NYC, combining a number of cutting-edge, non-surgical treatments to stop pain.

As to the cause of sciatica, there are a number of different physical reasons for it, but pressure applied to the lumbar nerve roots of the sciatic nerve is the direct cause. Nerve pressure is often related to conditions like a herniated or bulging disc(s), degenerative disc disease, spinal stenosis, piriformis syndrome, and facet syndrome. In the case of discs, these cushions between the lumbar vertebrae that have herniated, bulged or otherwise malfunctioned compress the sciatic nerve (often referred to as a pinched nerve). The result is pain and frustration.

No matter what the mechanism for sciatica, the pain is extreme and can even become disabling. Many sufferers can’t seem to find relief from any treatment, even going so far as spinal injections. It feels like nothing will help, but no one wants to get back surgery. There must be an alternative, right?

Thankfully, there is an effective alternative to back surgery that has given patients hope for an end to the pain of sciatica. It’s called non-surgical spinal decompression, and at our office in NYC, we use the DRX 9000 spinal decompression system to help patients. This technology has only been around for about 10 years, but in that short time it has resonated with patients searching for a second opinion.

In many cases, treatment with the DRX 9000 is able to help repair the lumbar discs that are causing sciatic pain. Through a series of gentle stretches applied precisely to the discs, herniated fluid can return to its proper position, carrying nutrients with it which the disc can use to naturally encourage healing. Over time and throughout the course of a normal spinal decompression regimen, herniation of the lumbar disc can be reversed, leading to reduction or outright elimination of your pain.

All that being said, non-surgical spinal decompression with the DRX 9000 is not the end of the road for those suffering from sciatica and low back pain. Exercise therapy and changes in lifestyle might be necessary for continued wellness after treatment. But it does offer patients who are at the end of their rope an effective second option that doesn’t mean a scalpel.

For more information on comprehensive treatment for sciatica and leg pain in NYC, check out the website for Living Well Medical in Downtown Manhattan.

Wednesday, November 04, 2009

Healing a Herniated disc in 3 months without surgery


Three months for healing a Herniated Disc
www.drshoshany.com
Herniation of a nucleus pulosus causing nerve compression can heal spontaneously provided low intradiscal pressure can be mantained for 3 months.
It is commonly accepted that in the treatment of patients suffering from symptoms of herniated nucleus pulposus (lumbar disc lesion), conservative management should be tried before resorting to a surgical procedure.
the danger of surgical complications, the certainty that laminectomy will cause damage to the stability of the spine, and the occasional failure of surgical procedures to relieve symptoms indicate the advisability of an initial trial of conservative treatment.
Under favorable circumstances the protruded portion of the nucleus pulposus shrinks by dehydration, and the symptoms of the nerve root compression are relieved. Over a period of months the posterior wall of the anulus fibrosus heals by fibrosus,which can result in complete clinical recovery.
BUT,if excessive pressure on the disc occurs before healing of the annulus fibrosis has progressed significantly, the tear will recur, additional disc material will be expelled, and symptoms will return or become aggravated.
The purpose of a program of conservative management is to keep the intra-discal pressure sufficiently low for a period of time that permits adequate healing of the anulus fibrosus.
It takes approximately 3 months until a herniated disc patient can carry out the ordinary activities of daily living without the danger of recurrence.
Spinal decompression utilizing the DRX 9000 in our NYC Comprehensive herniated disc treatment facility allows us to speed disc healing and repair the injured anulur fibers.
Herniated disc NYC

Friday, October 30, 2009

Kinesio tape for NYC Marathon runner

Kinesio tape for knee on Flickr - Photo Sharing!
Kinesio tape for NYC Marathon runner
www.livingwellnewyork.com
Kinesio tape is extremely helpful and is used worldwide by elite and amatuer athletes.
This upcoming Sunday is the NYC Marathon, I had a patient that flew in from Italy to run the race.
This tape job that we did will allow her to complete the race.

for a patello femoral syndrome, she has pain on the lateral side of the knee right close to the medial border of the patella.
possible diagnosis of illiotibial band problem,I applied kt in this way:- facilitation of vmo + mechanical correction Y stripe 50% tension on tails with anchor applied medially with the tail that surround the patella + mechanical correction I stripe 75% - 100% tension in the middle that push the patella lateral to medial,.
after this application the pain in the functional demonstration was zero.
before the treatment she can not run, after this treatment, wearing kt she run without pain.
Pretty awesome stuff.
Dr. Steven Shoshany NYC Chiropractor and Certified Kinesio taping practioner
www.drshoshany.com

Monday, October 26, 2009

Sciatica NYC and Chiropractic care


Sciatica treatment Manhattan-Sciatica NYC

Sciatica is the pain that radiates down the buttock and back of the leg. In some cases, this pain may also involve the soles of the feet. Sciatic pain is usually sharp or burning in nature and is frequently accompanied by low-back discomfort. An important note to understand is that sciatica is a symptom of a problem, of something actually compressing the nerve roots that make up the sciatic nerve. This type of pain or discomfort is often seen in individuals ages 30 to 50 and it often does not occur from an event or injury but most commonly develops as general wear and tear of the lower joints of the spine.

To understand sciatic pain we must first discuss the sciatic nerve and its components. The sciatic nerve is a confluence of nervous tissue that emerges from the spinal cord in the lower back region. The nervous tissue exits between the spinal bones known as vertebrae, which then converge to form the sciatic nerve. About halfway down the thigh, the sciatic nerve splits into the tibial nerve and the common peroneal nerve. The tibial nerve continues down the calf and into the sole of the foot, while the common peroneal nerve innervates the front of the leg.

Sciatic pain is most commonly triggered by compression of the sciatic nerve. The compression will usually occur at the region near the spine where the nerve is formed. More specifically the bones, the vertebrae or the pelvic bones become restricted or out of alignment (subluxated) affecting the nervous tissue. Scientific studies reveal that vertebral subluxations are associated with an increased risk of low-back pain and sciatica.

In addition to vertebral subluxations, the sciatic nerve may be compressed by a ruptured spinal disc or disc herniation or by bony spurs caused by osteoarthritis. Swollen or tight muscles in the buttocks may also restrict the nerve. In some rare cases, the sciatic nerve may be compressed by a tumor or inflamed by a disease process.

Chiropractors take a unique approach to ending sciatic pain. The first thing we do is discover the cause of your pain, rather than merely covering your symptoms. Next, we work to correct the source of the complaint. Ending sciatic pain usually involves restoring motion and alignment to subluxated regions in the spine or pelvis.

Chiropractors will use gentle and safe maneuvers called chiropractic adjustments in order to correct the misalignment. Instead of suffering with unrelenting leg pain which is associated with sciatic pain, seek the care that will determine the cause and address it. Sciatic pain is your body’s way of telling you that something is affecting your overall state of wellness. Do not ignore the signals your body is sending and seek Chiropractic care to alleviate your symptoms the natural and effective way.
To Learn more about treating Sciatica in NYC visit www.livingwellnewyork.com
We specialize in Non surgical methods to treat Sciatica.

Friday, October 16, 2009

Sciatica treatment in New York City (NYC)


Sciatica treatment in New York City (NYC)
www.livingwellnewyork.com
The Sciatic Nerve
What is Sciatica?
Sciatica is the sensation of pain,tingling,or numbness in the buttocks and/or legs produced by an irritation of the sciatic nerve, which branches as it descends into the buttocks and down each leg to the ankles and feet. The primary cause of sciatica are herniated, bulging, or degenerated discs,which induce pressure on the spinal nerve roots.
Other causes include small,bony growths on the spine (bone spurs) or compression of the nerves through injury. In rare cases, the sciatic nerve may be irritated by conditions such as tumors,pregnancy, or piriformis syndrome.
In our NYC practice we specialize in treating Sciatica and bulging and herniated disc. Visit us online if you live or work in New York www.livingwellnewyork.com
We utilize a integrated approach to eliminate not only the pain, but the cause of the problem.
Spinal decompression using the DRX 9000 NYC,Cold laser therapy,Cox flexion distraction,Kinesiology tape, Pain Management.
Dr. Steven Shoshany www.drshoshany.com

Monday, October 12, 2009

Back pain relief NYC-Saturday or Sunday


Back pain relief NYC-Saturday or Sunday
www.drshoshany.com
In my 15 years as a Chiropractor in NYC, I have seen so many patients throw their back out on a Saturday or Sunday and not know where to turn.
I have always made myself available to patients and potential patients by offering emergency Chiropractic services in NYC. I established www.emergencychiropractor.com
Often times it is the result of bending the wrong way and coming back with sharp or shooting low back pain that may or may not radiate into the legs.
This is called Sciatica,In my previous posts I discuss various methods to eliminate Sciatica, some of this treatments include Spinal decompression on the DRX 9000, Chiropractic adjustments, Cox flexion distraction and the Graston technique
If this happens to you ICE is your best friend for the first 72 hours.
If you need a Chiropractor in NYC give us a call, either me or one of my NYC Chiropractors will see you!
www.livingwellnewyork.com
Call for a Chiropractor in NYC for Back pain relief (212) 645-8151

Wednesday, October 07, 2009

Spinal Decompression Therapy: Surgical and Nonsurgical-NYC Herniated disc specialists

Several NYC Back pain suffers have been asking me the difference between Surgical and Non-Surgical spinal decompression- This is great information from an excellent source on the web- www.livingwellnewyork.com Spinal Decompression Therapy: Surgical and Nonsurgical If you have lasting back pain and other related symptoms, you know how disruptive to your life it can be. You may be unable to think of little else except finding relief. Some people turn to spinal decompression therapy - either surgical or nonsurgical. Here's what you need to know to help decide whether it might be right for you. What is nonsurgical spinal decompression? Nonsurgical spinal decompression is a type of motorized traction that may help relieve back pain. Spinal decompression works by gently stretching the spine. That changes the force and position of the spine. This will take pressure off the spinal disks, which are gel-like cushions between the bones in your spine. Over time, negative pressure from this therapy may cause bulging or herniated disks to retract. That can take pressure off the nerves and other structures in your spine. This in turn, helps promote movement of water, oxygen, and nutrient-rich fluids into the disks so they can heal. Doctors have used nonsurgical spinal decompression to treat: Back or neck pain or sciatica, which is pain, weakness, or tingling that extends down the leg Bulging or herniated disks or degenerative disk disease Worn spinal joints (called posterior facet syndrome) Injured or diseased spinal nerve roots (called radiculopathy) How is nonsurgical spinal decompression done? You are fully clothed during spinal decompression therapy. The doctor fits you with a harness around your pelvis and another around your trunk. You lie face up on a computer-controlled table. A doctor operates the computer, customizing treatment to your specific needs. Treatment may last 30 to 45 minutes and you may require 20 to 28 treatments over five to seven weeks. Before or after therapy, you may have other types of treatment, such as: Electrical stimulation (electric current that causes certain muscles to contract) Ultrasound (the use of sound waves to generate heat and promote healing) Cold therapy. In our NYC Spinal decompression facility we utulize The Spineforce in conjunction with the DRX 9000 to strengthen core muscles. We utulize Kinesiology tape to stabalize muscles and Cold laser therapy to reduce pain and spped tissue healing. Who should not have nonsurgical spinal decompression? Ask your doctor whether or not you are a good candidate for nonsurgical spinal decompression. People with any of these conditions should not have nonsurgical spinal decompression: Contra-indactions to Spinal decompression Pregnancy Fracture Tumor Abdominal aortic aneurysm Advanced osteoporosis Metal implants in spine (sometimes we can work with these patients) What is surgical spinal decompression? Surgical spinal decompression is another option for treating certain types of back pain. But it is usually used as a last resort. If other measures don't work, your doctor may suggest surgical spinal decompression for bulging or ruptured disks, bony growths, or other spinal problems. Surgery may help relieve symptoms from pressure on the spinal cord or nerves, including: Pain Numbness Tingling Weakness Are there different types of spinal decompression surgery? Your doctor may suggest one or more types of back surgeries to relieve the pressure in your spine. In addition, you may need spinal fusion to stabilize your spine. The following are common types of back surgery: Diskectomy: In this procedure, a portion of the disk is removed to relieve pressure on nerves. Laminotomy or laminectomy: A surgeon removes a small portion of bone -- a section of bony arch or the entire bony arch -- to increase the size of the spinal canal and relieve pressure. Foraminotomy or foraminectomy: A surgeon removes bone and other tissue to expand the openings for nerve roots. Osteophyte removal: During the surgery, bony growths are removed. Corpectomy: This procedure involves removing the body of a vertebra and disk. What are the risks with spinal decompression surgery? As with any surgery, there are risks. These are some of the more common risks associated with spinal decompression surgery: Infection Bleeding Blood clots Allergic reaction to anesthesia Nerve or tissue damage Another risk of surgery is that it may not improve back pain much. It can be difficult to determine who will benefit from spinal decompression surgery. Spinal Surgery for a herniated disc should be your last resort when all other non-invasive methods have failed. All to often we treat patients that had a back surgery with little success. Spinal decompression using the DRX 9000 is safe and effective, if you are suffering with a herniated disc in NYC feel free to contact Dr. Steven Shoshany by visiting his website www.drshoshany.com
video
Watch this video on Spinal decompression an interview by Dr. Albrecht Heyer Phd. and Dr. Steven Shoshany DC.

Monday, October 05, 2009

Chiropractic care can help with headaches NYC


This October, during National Chiropractic Month, the American Chiropractic Association (ACA) is encouraging families to consider chiropractic care as a treatment for several types of headaches. While many people associate chiropractic care as a treatment for bad backs, there is growing documentation that chiropractic is also effective in the treatment of cervicogenic headaches, migraines and cluster headaches. "Research shows that spinal manipulation is an effective treatment option for headaches," says Dr. Dennis Craft of Craft Chiropractic Center in Charlotte and a member of the American Chiropractic Association
"Not only does drug-free, conservative chiropractic care provide almost immediate relief from pain, but it has significantly fewer side effects and longer-lasting relief than many commonly prescribed medications."

Additionally, doctors of chiropractic are trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling-all of which are important components in the management of chronic headache pain. If you frequently suffer from headaches, Dr. Craft and ACA recommend the following tips.

• If you spend a large amount of time in one fixed position, such as in front of a computer, take a break and stretch every 30 minutes to one hour.

• Low-impact exercise may help relieve the pain associated with primary headaches.

• Drink at least eight eight-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

• Avoid slouching.

• Try a low-fat, high-complex carbohydrate diet. A recent study demonstrated that such a diet can dramatically lower the frequency, intensity, and duration of migraine headaches.

• Reduce stress at home and work by planning ahead and engaging in relaxation and breathing exercises.

• Get plenty of sleep and maintain a regular sleep schedule.

This October, during National Chiropractic Month, talk with a doctor of chiropractic about how you can obtain headache relief through spinal manipulation and chiropractic care.

"When it comes to managing headache pain, there's no magic solution that works for everyone, but chiropractic care is certainly an effective treatment option every patient should keep in mind," Dr. Craft says.

Dr. Steven Shoshany a NYC Chiropractor is proud to be an American Chiropractic Association member
www.drshoshany.com

Wednesday, September 23, 2009

Running injury treatment in NYC



Running injury treatment in NYC


I have been treating runners injuries for over 15 year in my Manhattan Chiropractic practice.
I was never a huge fan of running I was more a bike rider,
but as more and more patients told me how much they loved it,I decided to give it a try.
I put on my Running shoes and stretched out and started slow.
I live in Downtown NYC and some of the granite sidewalks are a little uneven, and BAM not even 2 minutes into it I sprained my right ankle.
Of course I iced it right away for the first day or two.
The next day in the office I had the Physical therapist use cold laser and I had a Chiropractic extremity adjustment of my right talus by a friend that practices in Midtown.
I also had my associate use Kinesio tape using the fan method followed by stabilization applied up the outside of my leg.
I think this protocol really helped me get functional pretty quick.
I will continue treatment with the Physical therapist and we will probally add the Graston technique by next week.

I posted some information below about some traditional ways of treating a lateral ankle sprain. This information comes from Dr. Pribut's in Washington DC.
http://www.drpribut.com/sports/sportframe.html


Running Injury
Topic: Lateral Ankle Pain

Question I just twisted my ankle what immediate care should I give it? And by the way please tell me a bit more about ankle sprains.



Amswer: Ankle sprains are more common in athletes participating in sports with side to side movement than that with straight ahead motion.Court sports such as Basketball, Tennis and Raquetball all create a fair share of ankle sprains. Running on level ground does not often result in an ankle sprain but cross country running, trail running and stepping in a pot hole (or uneven sidewalks) all could potentially lead to an ankle sprain.

The most frequent ankle sprain is an inversion ankle sprain. This can injure the outer structures of the ankle.

Anatomy: The ankle includes the Talus or ankle bone and the ankle mortise created by the lower Tibia (inner ankle bone, leg bone) and fibula (outer ankle, leg bone). There are three main outer ankle ligaments. The anterior talo-fibular ligament, the calcaneo-fibular ligament and the posterior talo-fibular ligament. Other structures in this area which your doctor will want to examine which can also be injured in an inversion injury include the peroneal tendons (which can sublux or move out of place), the calcaneo-cuboid ligament, and the base of the 5th metatarsal (which can break).



Most Common Injury:

The most common injury resulting from an inversion ankle injury is a partial tear of the anterior talo-fibular ligament. This ligament may also tear completely. The next most frequently injured ligament is the calcaneo-fibular ligament and least injured is the posterior talo-fibular ligament. On occasion the fibula itself may be fractured or the talar dome is injured.

As already mentioned, the other structures on the lateral side of the ankle should always be carefully examined to make sure they are not injured.(I had a Grade 2)

The grading of ankle sprains is officially done on an inadequate 3 point scale. Grade 1 is a mild "stretch" of the ligaments, Grade 3 is a complete tear of the ligament and Grade 2 is everything in between. In my office I use a subjective 10 point scale to finer grade the ligament injury for the benefit of the patient.

Treatment For Minor Sprain:

If you have doubts or your ankle swells very rapidly you should head for the emergency room. Immediate treatment should consist of R.I.C.E.:

Rest
Ice
Compression - gentle
Elevation

The ice should be applied for about 15 minutes at a time and then off for about the same. Avoid damaging your skin with the chemical bags you can place in your freezer. Frozen corn or peas works just fine.

If the ankle does not respond quickly to this treatment, it is probably best to visit your sports physician for an evaluation and treatment. This way you'll avoid having your sprain be worse than a break.

Frequently for Grade 2 sprains, I'll recommend a plastic splint such as that made by Air Cast - Air Splint. This holds the ankle quiet as it heals and prevents most inversion and eversion. On occasion crutch walking for a few days (or longer) is needed. The first exercise I recommend after the ankle is starting to feel better is dorsiflexion - plantarflexion or just plain moving the ankle up and down. After more improvement small circles, painting the alphabet with your toes and other exercises can be done. Later still a theraband or other elastic band can be used to strengthen the muscles that help hold the ankle stable. Beam balance exercises and figure 8 running are also possible exercises later in recovery.

I recommend avoiding forcing your ankle to move in pain too soon. I also recommend avoiding weight bearing or walking in pain early in the course of an ankle sprain. There is no reason to start testing your ankle until it has had time to heal. Slow and easy gets more gain than rushing into painful exercises.

A Sports Podiatrist or Orthopedist and Physical Therapist can team together to make sure you have a speedy recovery.

Tuesday, September 22, 2009

Hand Wrist pain treatments using the Graston technique in NYC


Wrist Pain
www.livingwellnewyork.com

Txt Messaging Creates Hand, Wrist and Arm Ailments
By Julianne Lessard OTR/L, CHT, Springfield, MA
In this age of handheld electronics like cell phones, the iPod® and the PSP (PlayStation®Portable), it is easy to see how a new crop of hand injuries has developed. Age is not a factor here – from the 10-year-olds playing video games to the teenagers text messaging up to the young business professional with the Blackberry® – no one is safe.
As devices get smaller and more compact, the technology improves. Some phones come with a full keyboard – no wonder there has to be a special language, it would be too hard to type a full sentence!
In 2005 the American Society of Hand Therapists (www.ASHT.org) issued a National Consumer Alert. “Handheld electronics may require prolonged grips, repetitive motion on small buttons and awkward wrist movements. This combination can lead to hand, wrist and arm ailments such as Carpal Tunnel Syndrome and Tendinitis,” said ASHT President Donna Breger Stanton, MA,OTR/L,CHT FAOTA. ( 2005 ).
The following are some guidelines from ASHT for healthier use of handheld devices:
• Use a neutral grip when holding the device. A neutral grip is when the wrist is straight, not bent in either direction (not strong or weak). It will allow for wrist motion in a plane where more motion is available in the wrist.
• Take a break every hour or switch to another activity. Overuse of repetitive motions, such as pressing buttons, can cause tendinitis of the elbow or lead to Carpal Tunnel Syndrome (tendon or nerve irritation).
• If possible, place pillows in your lap and rest arms on pillows. This will allow you to keep your head in a more upright position and therefore decrease neck strain. The pillows will help support the arms so they do not have to be held up in the air.
• Sit in an appropriate chair that allows you to comfortably put your feet on the floor and also provides good back support.
• Switch hands frequently. This will allow the one hand to rest and reduce fatigue.
• Frequently focus on a distant object (away from the screen) to help reduce eye fatigue.
The best advice for patients is to tell them to listen to their bodies. No matter what they’re doing, if their arms and hands become sore, uncomfortable, achy or numb, then change their routine. Add tendon gliding exercises throughout their day. Simple changes can make a big difference in preventing tendinitis.
When treating patients with tendinitis, try using GT6 with a sweeping motion over the TM joint and J stroke to the hypothenar and thenar group. Also, use GT3 with strumming and a J stroke to the thenar and along the volar metacarpal heads. After only a few visits, the muscles are more pliable and have improved endurance and function. Stretching exercises will follow to re-align the fibers.
Tendon Gliding Exercises
These exercises glide the tendons gently through the carpal tunnel to minimize microscopic adhesions, reduce congestion and improve lubrication in the tendons.
Hook fist – touch your fingers to the top of your palm. The large knuckles should be pulled back as much as possible.
Full fist – touch your fingers to the middle of your palm. All three finger joints should be bent.
Straight fist – touch your fingers to the bottom of your palm. The tips of the fingers should be straight.
Thumb flexion – Start with your thumb pulled back from your palm as if you are hitch-hiking, then move your thumb across your palm and try to touch the tip of the thumb to the bottom of the small finger.
Source: handheldresources.com
To learn more about the Graston technique to treat hand or wrist pain in NYC visit Dr. Steven Shoshany's website at www.drshoshany.com
Graston tchnique, Cold laser terapy, Kinesio taping

Monday, September 14, 2009

Best treatment for tennis elbow? NYC


Best treatment for tennis elbow? NYC
www.livingwellnewyork.com
I have been treating patient in my NYC practice for years with "Tennis elbow".
Bing,the new search engine had a nice ad on top of NYC cabs,

Best treatment for tennis elbow, Heat or Ice? Bing you decide.

Some of my insight.

What exactly is Tennis elbow?

So by defintion "Tennis elbow" is Lateral Epicondlyitis ,Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone, at or near their point of origin on the outside of the elbow.

This can happen from any repetitive motion, My father had it years ago and he never even picked up a tennis raquet!!! My father hammered nails all day. But calling it lateral epicondylitis doesn't sound as good.

I will always go with ice. ICE brings down the inflamation and helps to reduce pain.
When I treat patients for this chronic condition treatment usually involves Graston technique,to break up the adhesions-more on Graston technique below.

Tennis elbow treatment NYC
The Technique:

* Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers
* Increases skin temperature
* Facilitates reflex changes in the chronic muscle holding pattern
* Alters spinal reflux activity (facilitated segment)
* Increases the rate and amount of blood flow to and from the area
* Increases cellular activity in the region, including fibroblasts and mast cells
* Increases histamine response secondary to mast cell activity

I also like to use Cold laser therapy with the Erchonia 635 NM. laser to decrease pain and inflamation.
I like to use Kinesio tape over and around muscles in order to assist and give support or to prevent over-contraction.
If your elbow is bothering you in NYC visit www.livingwellnewyork.com

Tuesday, September 08, 2009

Herniated disc NYC, New York City Herniated disc treatment, DRX 9000



Herniated disc NYC, New York City Herniated disc treatment, DRX 9000
Herniated disc NYC

Do you have back pain?

Do you have Sciatica? or even worse have you been diagnosed with a herniated disc?

I have a relationship with a excellent diagnostic center here in New York City, when a patient is diagnosed with a herniated disc they need information to make the right decision. Information is crucial because if a patient does not understand their condition they may be guided into a treatment that they cannot undue like a back surgery.
A conservative approach would be to recommend Physical therapy for 6weeks.
Chiropractic care should be included in management of the patient with the herniated disc.
In our NYC Multi-disciplinary office we utilize a integrated approach to treat and correct herniated disc problems with a combination of Physical therapy, Chiropractic care, Spinal decompression, acupuncture and advanced Core strengthening techniques.
We offer the most Comprehensive treatment in NYC for back Pain and the herniated disc.
The intervertebral disc has been estimated to be responsible for 26-40% of low back symptoms.
Disc Herniations are defined as displacement of disc material beyond the limits of the intervertebral disc space, involving less than 50% of the disc circumference and rarely occur without concomitant or pre-existing mechanical, degenerative, or muscular deconditioning.
Non-surgical spinal decompression using the DRX 9000,Core strengthening using the Spine Force.
Rehabilitation for patients with Herniated discs-NYC
Rehabilitation of the patient with a herniated disc consits of improving their strength and flexibility while, at the same time, addressing their posture and habits.
If you live or work in Manhattan,NYC and suffer with back consider a Comprehensive approach to not only get rid of your pain but solve the problem.
Have your MRI,NCV,EMG test's evaluated to see if you can benefit from our combined approach. Visit Dr. Steven Shoshany's website @ www.drshoshany.com to send your reports or learn more about methods.
Or visit www.livingwellnewyork.com to learn more about our Comprehensive disc herniation treatment methods.

Wednesday, August 26, 2009

KT Tape- available in NYC


Kerri Walsh Uses KT Tape to Take on 'Superman'

I found this recently, I have used all of the tapes out there, I know for a fact that she was taped Kinesio tape during the Olympics but now she favors the KT tape.
I use all of the tapes.

Kerri Walsh, the face of KT Tape, takes on Shaquille O'Neal in the new reality show "Shaq Vs.", which airs TUESDAY, AUGUST 25 (9:00- 10:00 p.m. ET) on the ABC Television Network. Photo courtesy of KT Tape. (PRNewsFoto/KT Tape)

PROVO, UT UNITED STATES

Get the Inside Story on Walsh's Secret Weapon, as Seen on the New Reality Show 'Shaq Vs.'

PROVO, Utah, Aug. 18 /PRNewswire/ -- Volleyball phenom Kerri Walsh is back on the court, and taking on one of the biggest names in sports, with a secret weapon in her arsenal. Kerri wore KT Tape to take on Shaquille O'Neal for the taping of his new reality show "Shaq Vs.", which airs TUESDAY, AUGUST 25 (9:00- 10:00 p.m. ET) on the ABC Television Network. Walsh is available for phone interviews to talk about her experiences on the show.


(Photo: http://www.newscom.com/cgi-bin/prnh/20090818/SF63017)


KT Tape enhances athletic performance by preventing and treating common sports injuries, enabling athletes to perform their best. It is the first-ever kinesiology tape to come in pre-cut strips specifically designed for consumer use. It is the only solution that provides pain relief and support before, during, and after activity without restricting motion. KT Tape works by gently lifting the skin off of the muscle, relieving pressure on the nerves and reducing pain without chemicals or medication.


Walsh first discovered kinesiology therapeutic tape as a way to relieve pain and support her shoulder without limiting her range of motion while recovering from rotator cuff surgery. She now uses KT Tape exclusively, and has relied on it to deal with the aches and pains of getting back into competition.


"I've used other kinesiology therapeutic tape to help me stay competitive when I'm injured, but I switched to KT Tape because it's the best tape out there," says Kerri Walsh, two-time Olympic gold medalist.


For a complete list of retailers, and videos demonstrating taping techniques, please visit www.kttape.com. Follow @KTTape on Twitter and become a fan on the KT Tape Facebook Page at www.facebook.com/kttape.


KT Tape(TM) provides muscle pain relief, increased mobility, and enhanced recovery for athletes of every level. Developed by Utah-based Lumos Inc., KT Tape(TM) is packaged in easy-to-use, pre-cut strips. KT Tape(TM) is officially endorsed by Kerri Walsh.


Lumos, Inc. designs, develops, and distributes specialty products for the sports medicine industry. The company's products are used by individuals and professionals to reduce pain, increase mobility, and accelerate recovery. The company's products are sold worldwide through retailers in the US, Canada, Europe, South Africa, and Australia. For further information, please visit the company's website at www.kttape.com.


KT Tape
KT tape, Spider tech, and Kinesio tape are all available in NYC
www.livingwellnewyork.com

Wednesday, August 19, 2009

Dr. Steven Shoshany-NYC Chiropractor appears on the Today show August 15th.

I finally figured out how to pull this segment from my DVR, This segment was about common causes and treatment of back pain. For those that missed this segment watch the video below. Chiropractic, Physical therapy, Medical care in NYC www.livingwellnewyork.com
video
I love the graphic of the herniated disc!

Monday, August 17, 2009

Today Show- Back pain-Causes and solutions-NYC

www.livingwellnewyork.com
Saturday August 15Th. I went over to 30 Rock and was interviewed by Amy Robach for the Today Show!
This was a great segment on Back pain causes and prevention and treatments.
It was four minutes long and once I obtain permission I will post it here.
I felt the interview went well and I was able to discuss that a integrated approach to treat back pain was the most effective.
I was able to talk about spinal misalignment's and muscular imbalances being the primary causes of most mechanical back pain.
Dr. Steven Shoshany-Chiropractor NYC
Visit my website at www.drshoshany.com

Thursday, August 13, 2009

Shoulder injury and treatment in NYC


This is a great picture of Nicole Branagh
as she reacts at the AVP Crocs Manhattan Beach Open on July 18, 2009 in Manhattan Beach, California. Nicole Branagh/Elaine Youngs defeated Brooke Hanson/Lisa Rutledge 21-18, 21-10.
She is wearing a Spider-tech support. Visit www.nucapmedical.com to learn more
I love this stuff!
We utilize this and may other tapes and treatments in our NYC Physical therapy, Chiropractic, Medical office.
Living Well Medical visit us online www.livingwellnewyork.com
Dr. Steven Shoshany DC, CCEP, Certified Kinesio taping practitioner

Wednesday, August 12, 2009

Herniated disc with myleopathy responds to DRX 9000 spinal decompression protocol


DRX 9000 NYC?
Herniated disc with myleopathy responds to DRX 9000 spinal decompression protocol.
www.drshoshany.com
Several months ago I had a new patient consult, he was complaining of lower back pain and loss of control of his right foot. He had difficulty in planting his foot and suffered from "foot drop".
Foot drop happens when the nerves supplying the muscles of the front of the leg have some pressure place upon them, In most cases it is a nerve root around L5-S1.

The patient had consulted with 2 orthopedic surgeons here in New York City (NYC). He was told he needed a laminectomy. He had tried Physical therapy for months with no improvement, traditional Chiropractic care gave him little comfort.
He did not want a invasive surgery.

In reviewing his medical records his MRI revealed a Disc bulge with superior migrating disc extrusion at L4-L5 without canal stenosis or foraminal narrowing and a Disc bulge with endplate osteophyte asymmetric to the right at L5-S1 causing mild foraminal narrowing. Slightly inferiorly migrating central disc extrusion noted without canal stenosis.
His Nerve conduction velocity and EMG test revealed a severe right L5 radiculopathy involving the anterior ramus division.
We concluded that he would be a good candidate for Non-surgical spinal decompression.
His treatment consisted of Spinal decompression on the DRX 9000, Core stabilization on the SpineForce, Cold laser therapy and Cox flexion distraction.
After 20 sessions in a 6 week period his back pain decreased and his foot drop has improved dramatically.
We conducted a followup NCV and EMG and found that the neuropathy has greatly improved. A post MRI to measure the degree that the disc herniation has been reduced and to measure the increase in the disc height has been ordered and will be updated shortly.
This is a difficult case and will require additional therapy to strengthen stabilizing musculature.
I am glad when I can prevent a patient from a invasive back surgery.
Back surgery should be a last resort when all other non-invasive methods have failed.
To learn more about spinal decompression in Manhattan NYC visit www.livingwellnewyork.com or my personal website
www.drshoshany.com

Monday, August 03, 2009

Spinal Decompression on a patient with a cervical fusion surgery

Spinal Decompression on a patient with a cervical fusion surgery. DRX 9000C for cervical spinal decompression
www.drshoshany.com
Cervical spinal decompression on a patient with a cervical fusion

Is it safe to preform spinal decompression on a patient that had a cervical fusion?

I recently completed a spinal decompression protocol on a patient that had anterior cervical discectomy from C3 to C5 with anterior cervical decompression and fusion from C3 to C5.
The patient had complaints of right bicep weakness even after the surgery.
He was very active and wanted to return to his daily activities of bike riding and horse back riding.
I consulted with his Spine Surgeon and he said it was safe to use spinal decompression on his neck. I often treat patients that have had lumbar discetomy with great success.
The patient tolerated the treatment well and results came quickly, we also utilized Cold laser therapy (Erchonia) on his Brachial plexus and cervical nerve root regions.
I am happy the patient had the ability to regain use of his arm and is back to his regular activities.
Spinal decompression for neck pain, arm pain in New York City (NYC) Manhattan
Contact(212)645-8151 or www.drshoshany.com
If you live or work in NYC and have had either a discetomy in the lumbar or cervial region and still have pain call us.

Wednesday, July 29, 2009

Laser therapy for disc herniation in NYC

Laser Therapy for Disc Herniations

Cold laser therapy in Manhattan,NYC

By Fred Kahn, MD, FRCS(c) and Michael Patterson, MSc

Low back pain has obvious lifestyle and financial burdens; when it is accompanied by radiation of pain and numbness in the lower extremities, it can be truly debilitating. Lumbar disc herniations account for only 4 percent of low back pain patients, but account for a high percentage of low back pain costs.

A painful disc herniation results when a tear of the annulus fibroses allows migration of the nucleus pulposus (protrusion), resulting in nerve root irritation. Lumbar disc herniations typically occur in individuals between the ages of 30-40 years,1-2 when the nucleus pulposus is still fluid and the annulus is weakened by strenuous activity and age. Due to this relatively young demographic, poor treatment outcomes can result in decades of suffering for these patients.

Prior to the existence of imaging studies, little was known about the healing mechanism of disc herniations. Imaging studies have confirmed what has been long suspected: Disc herniations can decrease in size and even disappear spontaneously, leading to decreased pressure on the nerve root.3

In adult discs, blood vessels are normally restricted to supplying only the outer layers of the annulus. Low oxygen tension at the center of the disc leads to an anaerobic metabolism, resulting in high concentrations of lactic acid and low pH. These deficiencies in metabolite transport limit both the density and metabolic activity of disc cells.4 Collagen turnover time in articular cartilage is approximately 100 years5 and is theorized to be even longer in the disc.6The result is that intervertebral discs have a limited ability to recover from metabolic or mechanical injuries such as herniations.

There have been a number of mechanisms investigated in attempts to determine how disc herniations heal. It is generally accepted that the herniated disc fragments are reabsorbed.7-8 Histological investigations have shown the presence of granulation tissue with abundant vascularization surrounding the fibrocartilaginous fragments.7 Within the granulation tissue, the prevailing cell types are macrophages with fibroblasts and endothelial cells.8 These cell types have been demonstrated to be positively affected by laser therapy. Thestimulation of macrophages and fibroblasts could be the primary mechanism by which laser therapy heals disc herniations.9

Inflammatory markers such as IL-1, IL-6 and TNF-a are also present at the site of disc herniations, leading to higher prostaglandin E2 concentrations. Two studies have demonstrated that laser therapy is effective in reducing prostaglandin E2 concentrations.10-11 Bjordal has demonstrated that inflammation is greatly reduced 75, 90, and 105 minutes after active laser therapy compared to levels prior to treatment.11 The reduction in inflammation appears to be another method by which laser therapy promotes healing in disc herniations.

There is substantial published research on the effectiveness of laser therapy in treating LBP and lumbar disc herniations. The majority of these research articles discuss chronic (nonspecific) low back pain either alone12-14 or with exercise.15-16 These positively inclined studies seem to be absent in reviews from either the American Pain Society / American College of Physicians17 or the Cochrane Collaboration.18

In the review of laser therapy for low back pain performed by the American Pain Society / American College of Physicians, four trials (566 patients) demonstrated that laser therapy was effective and one trial (140 patients) found laser therapy to be no more beneficial than a sham laser device. The conclusion from this review was: "Non-invasive therapies (low-level laser therapy) have not been shown to be effective for chronic, sub-acute or acute low back pain."17 A letter to the authors regarding their bias against laser therapy and in support of pharmaceuticals19 only prompted the authors to downgrade the evidence supporting acetaminophen and cite the Cochrane study to support their stance on laser therapy.

The Cochrane study they refer to found that "three high quality studies (168 people) separately showed statistically significant pain relief with laser therapy in the short-term (less than three months) and intermediate term (less than 6 months) when compared with sham laser therapy."18 Two small trials (151 people), also included in the Cochrane review, independently found that the relapse rate in the laser therapy group was significantly lower than in the control group at six-month follow-up. The conclusion was that "based on these trials, with a varying population base, laser therapy dosages and comparison groups, there is insufficient data to either support or refute the effectiveness of laser therapy for low back pain."

The resounding statements from both of these meta-analyses were that "more studies are required" and "larger trials on specific indications are warranted." Lacking in the conclusions were any suggestion of "how many patients and studies" are required to provide sufficient evidence. A recent study examining the effectiveness of laser therapy in treating lumbar disc herniations as measured using clinical evaluation and magnetic resonance imaging (MRI) found that "low power laser therapy is effective in the treatment of patients with acute lumbar disc herniations."20

Invariably, studies provoke questions. Some of the more common parameters for consideration are duration and extent of laser therapy treatment, joules per centimeter square of irradiation, power settings, etc. One must conclude these studies and meta-analyses, although well-intentioned, may in many instances be misguided. In our experience, almost 40 percent of all patients presenting for treatment suffer from back problems characterized by severe pain, and more than 85 percent can be treated successfully with laser therapy.21

The financial justification for the use of laser therapy as the first line of defense in disc herniations is overwhelming. Data collected from the SPORT trial found that the average surgical procedure cost $15,139, which rises to $27,341 when other costs such as diagnostic tests and missed work are factored in.21 The cost of conservative treatment in that same study averaged $13,108. In our experience, even the most extreme example of a herniated disc patient (receiving 40 treatments), resulted in a total treatment cost of just $3,200. When diagnostic tests and health care visits are factored into this equation, the total cost of laser therapy is closer to $5,700. This is a savings of more than $20,000 versus surgery and $7,500 over standard conservative treatment. Moreover, laser therapy is noninvasive and no adverse events have been reported in more than 3,000 publications.

In summary, this review of the current literature clearly reveals some of the shortcomings of meta-analyses and the performance of studies without standardized methodologies. We conclude that medical convention has demonstrated that the relief of symptomatic disc herniations continues to be problematic; and that both conservative and surgical solutions in the majority of cases appear to be equally ineffective. While the application of appropriate therapy requires a comprehensive understanding of the anatomy, pathology and biomechanics of the spinal column, we feel that laser therapy presents the most logical and effective therapeutic approach in managing these pervasive medical conditions.

References

Adams MA, Hutton WC. Prolapsed intervertebral disc. A hyperflexion injury. 1981 Volvo Award in Basic Science. Spine, 1982;7:184-191.
Gallagher S. Letter to the editor. Spine, 2002;27:1378-1379.
Teplick JG, Haskin ME. Spontaneous regression of herniated nucleus pulposus. Am J Roentgenol, 1985;145(2):371-5.
Urban JP, Smith S, Fairbank JC. Nutrition of the intervertebral disc.Spine, 2004;29(23):2700-9.
Verzijl N, DeGroot J, Thorpe SR, Bank RA, Shaw JN, Lyons TJ, Bijlsma JW, Lafeber FP, Baynes JW, TeKoppele JM. Effect of collagen turnover on the accumulation of advanced glycation end products. J Biol Chem, 2000;275(50):39027-31.
Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine, 2006;31(18):2151-61.
Doita M, Kanatani T, Harada T, Mizuno K. Immunohistologic study of the ruptured intervertebral disc of the lumbar spine. Spine, 1996;21(2):235-41.
Groenblad M, Virri J, Tolonen J, Seitsalo S, Kaeaepae E, Kankare J, Myllynen P, Karaharju EO. A controlled immunohistochemical study of inflammatory cells in disc herniation tissue. Spine, 1994;19(24):2744-51.
Young S, Bolton P, Dyson M, Harvey W, Diamantopoulos C.Macrophage responsiveness to light therapy. Lasers Surg Med, 1989;9(5):497-505.
Lim W, Lee S, Kim I, Chung M, Kim M, Lim H, Park J, Kim O, Choi H. The anti-inflammatory mechanism of 635 nm light-emitting-diode irradiation compared with existing COX inhibitors. Lasers Surg Med, 2007;39(7):614-21.
Bjordal JM, Lopes-Martins RA, Iversen VV. A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations. Br J Sports Med, 2006;40(1):76-80.
Toya S, Motegi M, Inomata K, Ohshiro T, Maeda T. Report on a computer randomized double blind trial to determine the effectiveness of the effectiveness of the GaAlAs (830nm) diode laser for attenuation in selected pain groups. Laser Therapy, 1994;6:143-148.
Soriano F, Rios R, Gallium Arsenide laser treatment of chronic low back pain: a prospective, randomized and double blind study. Laser Therapy, 1998;10:175-180.
Basford JR, Sheffield CG, Harmsen WS. Laser therapy: a randomized, controlled trial of the effects of low-intensity Nd:YAG laser irradiation on musculoskeletal back pain. Arch Phys Med Rehabil, 1999;80(6):647-52.
Gur A, Karakoc M, Cevik R, Nas K, Sarac AJ, Karakoc M. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain. Lasers Surg Med, 2003;32(3):233-8.
Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh-Manesh A, Pouryaghoub G. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: a randomised trial. Aust J Physiother, 2007;53(3):155-60.
Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.Ann Intern Med, 2007;147(7):492-504.
Yousefi-Nooraie R, Schonstein E, Heidari K, Rashidian A, Pennick V, Akbari-Kamrani M, Irani S, Shakiba B, Mortaz Hejri SA, Mortaz Hejri SO, Jonaidi A. Low level laser therapy for nonspecific low-back pain.Cochrane Database Syst Rev, 2008: CD005107.
Bjordal JM, Klovning A, Lopes-Martins RA, Roland PD, Joensen J, Slordal L. Overviews and systematic reviews on low back pain. Ann Intern Med, 2008;148(10):789-90.
Unlu Z, Tasci S, Tarhan S, Pabuscu Y, Islak S. Comparison of 3 physical therapy modalities for acute pain in lumbar disc herniationmeasured by clinical evaluation and magnetic resonance imaging. J Manipulative Physiol Ther, 2008;31(3):191-8.
Tosteson AN, Skinner JS, Tosteson TD, Lurie JD, Andersson GB, Berven S, Grove MR, Hanscom B, Blood EA, Weinstein JN. The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT). Spine, 2008;33(19):2108-15.
Kahn F. Low intensity laser therapy: The clinical approach. Proc of SPIE, 2006:6140, 61400F-1-61400F-11.

--------------------------------------------------------------------------------

Dr. Fred Kahn is a graduate of the University of Toronto, Faculty of Medicine, a fellow of the Royal College of Surgeons of Canada and the diplomate of the American Board of Surgery. He is the founder of Meditech International, Inc.


Dr. Michael Patterson received his undergraduate and master's degrees in medical biophysics from the University of Western Ontario. He is the research and education manager for Meditech.

Cold laser therapy is used in our NYC Physical therapy practice along with other cutting edge techniques and devices.
DRX 9000 non-surgical spinal decompression for herniated disc and sciatica, Graston technique for Soft tissue injuries.
www.livingwellnewyork.com

Thursday, July 09, 2009

Herniated disc NYC, New York City Herniated disc treatment, DRX 9000-Interview with Dr. Albrecht Heyer PHD-and Dr.Steven Shoshany

videoDR. ALBRECHT HEYER, PHD.,DSC interviews Dr. Steven Shoshany, DC,CCEP,CKTP on the benefits of spinal decompression to treat Chronic back pain,herniated disc and Sciatica. This video is from the "Heyer insights" originally aired on Manhattan,NYC Time Warner channel 35. I will be posting these videos on my Herniated disc page. This half hour video is very informative. Learn more about spinal decompression for herniated disc,Sciatica,leg pain by visiting my website www.drshoshany.com Dr. Heyer is a internationally recognized expert on health and healing and is in private practice in Manhattan. This interview allowed me the opportunity to discuss the different areas that our practice www.livingwellnewyork.com take in dealing with difficult to treat chronic back pain cases and herniated disc/sciatica conditions. Topics discussed include Sciatica/leg pain Disc herniation Chronic back pain orthotic fabrication Physical therapy and Rehabilitation Office ergonomics and methods to prevent back pain Chiropractic in NYC with Dr. Steven Shoshany call
(212) 645-8151

Tuesday, July 07, 2009

Kinesio tape for ankle sprain-Chiropractor NYC




I found this great article on how Kinesio tape helped a dancer with a ankle sprain/strain.
I have been using this tape with excellent results in my NYC Chiropractic practice.


Stuck on It
By Nancy Wozny

Houston Ballet trainer Mike Howard tapes Hitomi Takeda's legNavigating William Forsythe’s The Vertiginous Thrill of Exactitude last season, Houston Ballet corps member Hitomi Takeda took a serious fall, ending up with a lateral ankle sprain. With Stanton Welch’s world premiere of Marie and a tour of Spain on the horizon, an injury was the last thing Takeda needed. After a trip to the doctor, four days of rest, ice, compression, and elevation (the RICE protocol for injuries) and no signs of a limp, Takeda had her first application of Kinesio tape from Houston Ballet’s athletic trainer Mike Howard. The petite dancer sailed through Marie and the six-city tour without further strain. “I was wearing the Kinesio right under my tights,” she says.


Many dance medicine specialists and dancers have begun to use Kinesio. Developed more than 25 years ago, the method drew worldwide interest last summer when the U.S. Olympic volleyball player Kerri Walsh wore the tape to support her shoulder during the 2008 Games in Beijing. Unlike traditional athletic tape, the latex-free Kinesio stretches easily, and permits greater range of motion, making it popular with dancers. “The old way of taping tried to support ligaments, but we have learned it gave less support than we suspected,” says Dr. Rebecca Clearman, M.D., a physiatrist who works with Houston Ballet’s dancers. “Kinesio, on the other hand, helps dancers self-correct. If a dancer is hyper-extending, it can serve as a reminder.”


Kinesio can be used to stimulate or relax a muscle, depending on the direction of the recoil of the stretched tape, says Jennifer Janowski, a physical therapist at Chicago’s Athletico, a sports medicine physical therapy facility. Janowski has been working with Joffrey Ballet dancers for five years. “I use Kinesio on just about every dancer who walks through my door for all stages of injury, from recovery to prevention,” she says. “It’s like a brace, but better, because of the neuromuscular input.” She recommends getting the tape applied initially by a dance medicine professional with a knowledge of dance mechanics until the injured person learns how to use the tape correctly.


Whether relaxing or activating, the tape gets placed along the line of the muscle. For activating, the direction of the tape goes from muscle origin to insertion. “For supporting a fatigued Achilles tendon you would start the tape from the muscle belly and then run it to the Achilles,” Janowski says. “This would reinforce the Achilles to help prevent tendonitis.”


To relax a muscle, reverse the direction from insertion to origin. If a dancer has knee pain from overusing his quadriceps in jumping, for instance, Janowski tapes the quadriceps away from the activation point. This allows the tape recoil to pull back the fascia (the thin sheath tissue that encases all muscles) and relax the tension on the knee cap. The tape’s degree of stretch determines the strength of the recoil action, so each application can be tailored to a dancer’s needs. “Of course,” Janowski adds, “the dancer also should be reminded of the ways that their body mechanics are leading to these problems.”


Kinesio can also speed healing in an injury site. The tape improves lymphatic drainage by gently pulling the skin away from the fascia layer. “The application is done in a criss-cross pattern with finger-like projections coming out of the tape. This is close to the body’s own drainage system,” says Janowski.


However, Kinesio has its limits. Most bone fractures need to be treated with a cast. The tape should not be used over an open wound, though once the wound heals, Kinesio can help reduce swelling. Clearman and Janowski agree that Kinesio hastens dancers’ safe return to the stage. “It allows you to perform while still protecting yourself,” says Janowski.


Takeda will be the first to admit that Kinesio is not a magic bullet. She still had to strengthen her ankle and make sure she was following the RICE procedure correctly. Six months after the injury, Takeda continues to use the tape from time to time. “I have to take care of myself and use ice periodically, but the tape keeps my ankle alignment in check. I don’t roll in as much anymore. And,” she adds with a smile, “I have finally learned how to put it on myself.”



Nancy Wozny writes about health and the arts from Houston, TX.



Photo: Amitava Sarkar, Courtesy Houston Ballet

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Wednesday, July 01, 2009

Preventing back pain tips from Chiropractor NYC


Preventing back pain tips from Chiropractor NYC-Dr. Steven Shoshany D.C, C.C.E.P.
www.drshoshany.com


I wish everyone a Happy 4th. of July, If you are traveling this weekend read this article from the American Chiropractic Association below on ways to prevent Back from travel.


Travel Aches and Strains Can Be a Pain In Your Back


Traveling can be rough on the body. Whether you are traveling alone on business or on your way to a sunny resort with your family, long hours in a car or an airplane can leave you stressed, tired, stiff and sore.

"Prolonged sitting can wreak havoc on your body," says Dr. Scott Bautch, a member of the American Chiropractic Association's (ACA) Council on Occupational Health. "Even if you travel in the most comfortable car or opt to fly first class, certain pressures and forces from awkward positions can result in restricted blood flow. One of the biggest insults to your system from prolonged sitting is the buildup of pressure in the blood vessels in your lower legs. Contracting and relaxing the muscles helps the blood flow properly."

Dr. Bautch and the ACA suggest the following tips and advice to fight the pains and strains of travel before they occur.

Warm Up, Cool Down
Treat travel as an athletic event. Warm up before settling into a car or plane, and cool down once you reach your destination. Take a brisk walk to stretch your hamstring and calf muscles.

In the Car:

Adjust the seat so you are as close to the steering wheel as comfortably possible. Your knees should be slightly higher than your hips. Place four fingers behind the back of your thigh closest to your knee. If you cannot easily slide your fingers in and out of that space, you need to re-adjust your seat.
Consider a back support. Using a support behind your back may reduce the risk of low-back strain, pain or injury. The widest part of the support should be between the bottom of your rib cage and your waistline.
Exercise your legs while driving to reduce the risk of any swelling, fatigue or discomfort. Open your toes as wide as you can, and count to 10. Count to five while you tighten your calf muscles, then your thigh muscles, then your gluteal muscles. Roll your shoulders forward and back, making sure to keep your hands on the steering wheel and your eyes on the road.
To minimize arm and hand tension while driving, hold the steering wheel at approximately 3 o'clock and 7 o'clock, periodically switching to 10 o'clock and 5 o'clock.
Do not grip the steering wheel. Instead, tighten and loosen your grip to improve hand circulation and decrease muscle fatigue in the arms, wrists and hands.
While always being careful to keep your eyes on the road, vary your focal point while driving to reduce the risk of eye fatigue and tension headaches.
Take rest breaks. Never underestimate the potential consequences of fatigue to yourself, your passengers and other drivers.
In an Airplane:

Stand up straight and feel the normal "S" curve of your spine. Then use rolled-up pillows or blankets to maintain that curve when you sit in your seat. Tuck a pillow behind your back and just above the beltline and lay another pillow across the gap between your neck and the headrest. If the seat is hollowed from wear, use folded blankets to raise your buttocks a little.
Check all bags heavier than 5-10 percent of your body weight. Overhead lifting of any significant amount of weight should be avoided to reduce the risk of pain in the lower back or neck. While lifting your bags, stand right in front of the overhead compartment so the spine is not rotated. Do not lift your bags over your head, or turn or twist your head and neck in the process.
When stowing belongings under the seat, do not force the object with an awkward motion using your legs, feet or arms. This may cause muscle strain or spasms in the upper thighs and lower back muscles. Instead, sit in your seat first, and using your hands and feet, gently guide your bags under the seat directly in front of you.
While seated, vary your position occasionally to improve circulation and avoid leg cramps. Massage legs and calves. Bring your legs in, and move your knees up and down. Prop your legs up on a book or a bag under your seat.
Do not sit directly under the air controls. The draft can increase tension in your neck and shoulder muscles.
Safe Travel For Children:

Always use a car seat in a car when traveling with children below the age of 4 and weighing less than 40 pounds.
Ask the airline for their policy on child car seat safety. Car seats for infants and toddlers provide added resistance to turbulent skies, and are safer than the lap of a parent in the event of an unfortunate accident.
Make sure the car seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
Car seats for infants should always face the rear. In this position, the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.
Chiropractic Care Can Help...
"If you follow these simple tips, you can enjoy pain-free, safe travel," says Dr. Bautch. "If you do experience pain and stress on your back, doctors of chiropractic are trained and licensed to diagnose and treat problems of the spine and nervous system."

We will be open Monday morning July 6th. for those sprained backs and tennis injuries!

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Tuesday, June 30, 2009

Back pain NYC, Sciatica NYC, Spinal decompression NYC


Back pain NYC, Sciatica NYC, Spinal decompression NYC
www.drshoshany.com



I found a great article on a Consumers Report website, I posted a portion of the article below if you want to read the entire article click here

Readers weigh in on lower-back pain

Readers who have lower-back pain have written us a lot since the Consumer Reports Health Ratings Center Survey results were released in April. We’ve heard from chiropractic fans and chiropractic detractors, readers who have problems with opioid medications and readers who use such narcotics without a problem.

Many writers remarked that our coverage had failed to mention treatments that worked well for them. There was a spinal decompression success story as well as a "compression shirt" success story. There were those who were helped by a therapy called the Feldenkrais Method® and those who swore by another called the Alexander Technique. There was a reader who touted the book "Healing Back Pain: The Mind-Body Connection," by John E. Sarno, M.D., and another who touted Esther Gokhale’s "8 Steps to a Pain-Free Back." There was even a reader who advised patience: "Mother Nature's treatment method was just as effective as that provided by the medical professionals, and she didn't charge a fee."

Letters also reminded us that our survey had neglected to ask about a variety of practitioners, including pain psychologists, physiatrists (physicians who specialize in physical medicine and rehabilitation), pain management doctors, muscular therapists, and osteopaths.

In response to several compelling letters, we added a section on osteopathic medicine to our back-pain package. Osteopathic manipulative treatment (OMT) is another type of hands-on care (for subscribers), a category of treatment that respondents with lower-back pain ranked as very helpful in our survey. Osteopaths use OMT to complement conventional treatment by moving muscles and joints with techniques such as stretching, gentle pressure, and resistance. Indeed, one of our experts, James N. Weinstein, D.O. ,M.S, director of the Dartmouth Institute for Health Policy and Clinical Practice, was trained as an osteopath.

The wide variety of lower-back pain treatment options is the reason we asked more than 14,000 respondents to tell us what worked for them, including medications, physical treatments, products, and lifestyle changes. But we recognize that there are many more and, as always, appreciate hearing from you.

—Orly Avitzur, M.D., Consumer Reports medical adviser

Find out what type of lower-back pain you have, and see our Treatment Ratings (subscribers only) for a comparison of 23 lower-back treatments, including spinal manipulation, massage, and drug therapies.

For Chiropractic, Physical therapy, Spinal decompression in New York City, NYC contact (212) 645-8151 or visit us online at Manhattan Herniated disc specialist
IF you have a herniated disc and or chronic back pain and you live in the NYC area and have considered spinal decompression therapy visit my website to learn more.
Spinal decompression for herniated disc in NYC