The Clinic » Manual & physical therapies » Manual and physical therapies
Finding effective treatment for pain and other symptoms related to muscles, ligaments and tendons is often frustrating for patients. This is because there is no one treatment that works every time. We have found that a combination of techniques is the best approach, and usually delivers results.
Trigger points are hard, tender spots in muscle. After decades of study, little is known about why they exist or what makes them abnormal. The treatment of trigger points has been part of traditional medicine for centuries, but it was introduced to western medicine by Janet Travell, a noted pain specialist in the 1950s who became then-president Kennedy's personal physician.
Our treatment of pain includes injecting trigger points with local anaesthetic - freezing. This often gets rid of symptoms that radiate outward from these spots to big parts of the body. We have seen patients who have undergone multiple back surgeries to treat a herniated disc, only to find that their pain completely disappeared with a simple injection into a hip muscle.
This is sometimes the only treatment required, but often it needs to be combined with a routine of stretching and exercise, massage, heat and sometimes magnesium supplementation.
Chronic pain changes nerves. They become hypersensitive to pain and light touch, and behave abnormally - causing numbness, tingling, muscle twitching, changes in skin color and temperature. This needs to be addressed independent of the cause.
It has been found that regular injections with local anaesthesia can help heal nerves. Just like pressing the reset button on a computer, blocking the nerve stops the pain for several days - much longer than the action of the drug itself. This improves sleep, normalizes movement and allows people in pain to live like everyone else for awhile. Very important for healing.
The chiropractic and osteopathic professions are focused on restoring balance to the musculoskeletal system. Some patients have had bad experiences with unscrupulous practitioners who promote expensive treatment plans. A more appropriate approach is a trial of a short course of treatment sessions, followed by a reassessment of pain and function. If treatment provides lasting benefits - not just short-term effects - it should be continued.
There has been a lot of media coverage of the potential risk of chiropractic treatment, but it is actually quite safe. The scientific literature has demonstrated that the risk of stroke-like symptoms from damage to vertebral arteries during a cervical spine adjustment is vanishingly low - and it might be a coincidence. In one study this event was actually more likely to occur after a visit to a GP than after a chiropractic treatment.
This includes specific techniques like Active Release Technique, Graston Technique, Intramuscular Stimulation and other methods of treating soft tissues. They are useful for a wide range of problems, and target fascia, scar tissue and other kinds of pathology that affect muscles, ligaments and tendons. The best chiropractors have learned to use these techniques, and actually tell me that they perform very few spinal adjustments because the soft-tissue techniques simply work better.
We incorporate some of these approaches into our comprehensive assessment, but often we will refer patients to individuals who focus exclusively on these specialized techniques.
Acupuncture is a centuries-old part of Traditional Chinese Medicine, but it actually has its origins in the Ayurvedic medicine of India. It was brought to China by the same itinerant monk-healers who spread Buddhism in Asia, as they took refuge in monasteries during their travels.
Many acupuncture points involve very specific anatomical structures, but the principles of meridian theory and energetics is also very important for achieving the best treatment outcomes. For this reason, we strongly favor an acupuncture approach that combines TCM with training in modern medical anatomy. It is not easy to find a practitioner who has achieved this level of understanding, and many of our patients have responded well to acupuncture even though previous treatment did not help.
We believe that every medical doctor should learn the basics of acupuncture. It is a useful adjunct to medical practice and we find it helpful in many of the painful conditions we treat.
This is a technique that was developed in Germany in the 1940s by two medical doctors - brothers named Huneke. It is based on the fact that electrical disturbances called interference fields can be present in connective tissue. These interference fields can develop in areas that have been damaged by trauma, surgery or infection. They generate pain and also affect the proper functioning of the autonomic nervous system - which controls many other bodily functions.
If an interference field is causing a problem, treating it with a local injection of procaine can sometimes instantly eliminate all symptoms. This is called a lightning reaction, and is a very encouraging sign that total cure is possible. In many cases, a few injections are all that is needed to permanently eliminate the problem. We have seen miraculous cures using this technique, but it is less effective in people using drugs like opioids, anti-inflammatories, beta-blockers or tobacco and in those with mercury toxicity.
This is quite straightforward. Sometimes a painful arthritic joint can be completely fixed with an injection. This is commonly used to treat painful elbows, shoulders, knees, ankles and other joints. We only use a trace amount of cortisone - ten to twenty times less than the regularly recommended dose. We sometimes also use homeopathic remedies in our injections based on protocols we were taught at leading-edge clinics in Switzerland.
This is very different from the typical cortisone shot you might get from a regular physician, and it has more than a drug-like effect - there is the added benefit of stimulating a healing response.
A good massage therapist is a great person to know. Although the clinical research to demonstrate its benefit is still in the early stages of being done, we believe massage is good for the body. Not only does it feel good to be touched, but this translates into changes in stress hormones, cytokines and other parts of the immune system.
The technique that most massage therapists learn is called Swedish massage, a very rudimentary technique. We are very impressed with Eastern traditions of massage, such as Thai, Chinese and Ayurvedic massage. That being said, the additional energetic aspect which the consciousness of the therapist brings to the session is probably the most important part of the process. This is not something that can be taught - and is hard to find.
We work with a group of very skilled therapists who can make your day.