Wednesday, December 8, 2010

Pinched Nerve in the Neck - What to do?


A stiff neck from sleeping funny or bad posture can be a bit of a pain, but for some people with neck problems, it takes on a whole new dimension. A pinched nerve in the neck can be exceedingly painful, so much so that sufferers are often forced to essentially take a break from their lives to recover and get relief from the pain. Here I hope to present a sort of “guide” for someone that believes they have a pinched nerve. But remember, if you are in severe pain, the best route to take is to see an NYC doctor about the problem right away.

Are there any surefire signs of a pinched nerve in the neck?

There is no “absolute” in terms of a pinched nerve in the neck, also called radiculopathy. However, there are some tell-tale signs that may indicate nerve impingement in the cervical vertebrae. That being said, only the proper medical tests like nerve conduction tests and EMG can tell if nerve impulses are indeed being interrupted. They include:

  • Headaches in back of head

  • Upper shoulder pain

  • Burning pain

  • Tingling, pins & needles in middle, ringer or little finger


What exactly is going on in a pinched nerve?

Although the physical mechanism can vary from place to place, the common thread in all types of radiculopathy is a nerve that is functioning improperly. It may be due to a herniated disc or scar tissue or a muscular problem, but in each case, a nerve is impinged by surrounding tissue and becomes inflamed, affecting its performance and often causing pain/disability.

What are the treatments for a pinched nerve?

At Living Well Medical in NYC, we have several different therapies available on-site that can help reduce inflammation, pain and swelling. In cases caused by a herniated disc, cervical spinal decompression is one of the more cutting edge treatments we use. It’s a next generation technology that can pinpoint individual spinal discs and may be able to stop the pain completely.

For other causes that are myofascial (related to muscles or the fascia), manual therapies like Active Release Technique, physical therapy and traditional gentle chiropractic methods might be more effective in treating the pinched nerve.

I’m pretty sure I have a nerve problem. What should I do?

The main point is to seek help and get the tests done to find out for sure. X-rays, EMGs and nerve tests can be done by our pain management doctors, and we have a vast referral network if you should need an MRI. But don’t wait. If you would like to speak to one of our experts, call Living Well Medical in NYC’s SoHo/NoHo area at (212) 645-8151.

- Dr. Shoshany, NYC Chiropractor

Thursday, November 11, 2010

New York Spinal Decompression





For several years, Living Well Medical in NYC has been helping patients with back and neck pain using spinal decompression therapy.

As a non-surgical treatment for patients with nerve compression in the spine resulting from injuries like herniated discs, bulging discs, spinal stenosis, degenerative disc disease and facet syndrome.

For spinal issues in the lower back like these, we chose the DRX 9000, an extremely effective decompression system that focuses on ailments of the lumbar spine. Because of the increasingly sedentary lifestyle in the modern world, lower back problems are becoming more common. The DRX 9000 was created to treat the lower back without the need for surgery.

That being said, spinal decompression is not the be-all and end-all for back pain treatment. It can take more than 20 treatments for some people to start seeing relief, and truly effective treatment should also involve postural training and strength exercises to provide greater overall stability. This can help prevent re-injury.

A single decompression session can take up to an hour, including time to be put into the harness and hook a patient up to the machine. The actual treatment often takes only a half hour. In the supine position, patients can relax and many doze off during a session.

One of major distinguishing features of Living Well Medical in NYC is that we have integrated other therapies into a complete spinal re-education program. Techniques like Active Release Technique, gentle chiropractic, cold laser therapy and physical therapy can help improve outcomes and regularly become a part of a custom treatment program.

The results are perhaps the thing we are most proud of about our spinal decompression protocols. Many patients who have found no relief with other methods and have come to us as a last resort only to find that spinal decompression was just what they were looking for all along. Everyone is different, but it offers a ray of hope for those who have not responded to other methods.

Want to know if you are a candidate for spinal decompression at Living Well Medical in NYC? Give us a call today at (212) 645-8151 and schedule your consultation today. We are waiting to help you.

- Dr. Shoshany, NYC Chiropractor

Monday, September 20, 2010

Vicodin and Oxycontin for breakfeast,lunch and diner?

Vicodin and Oxycontin for breakfeast,lunch and dinner?
To many patients rely on dangerous,addictive medication for their pain relief.

Chiropractic combined with spinal decompression provides a safe, non-drug,non surgical approach to dealing with Chronic and acute low back and neck pains.

We had a patient that was suffering with low back pain and horrible sciaitica, along with neck pain and tingling down into his arms.
His MRI revealed multiple cervical and lumbar disc herniations along with spinal canal stenosis and disc dessication.
We started with gentle Cox flexion, and spinal decompression on the DRX 9000.
We shot this video today, he is improving daily and on to a full recovery and without the pills.
Learn more about our non-surgical,non-drug treatments for Back pain in NYC


video

Dr. Steven Shoshany

Thursday, September 9, 2010

NYC Back pain treatment Testimonials

We collect testimonials over the years some patients post them on review sites and some email them to me.
I received these two this month via email and wanted to post them:

Back pain treatment NYC-Reviews

I had the amazing good fortune of finding Dr. Steve Shoshany while in NYC. I was injured in a bad car accident 5 months prior to meeting with Dr. Shoshany. I was experiencing pain and stiffness in my neck and sharp, shooting, and throbbing pain and numbness in both arms and hands. I was diagnosed via MRI with a herniated cervical spine disk that was causing strain on the nerve roots that run down my arms. Dr. Steve acknowledged my problem right away. He was able to treat me immediately after my first consultation with him. His treatments included chiropractic spinal adjustments, the cervical spine decompression machine (3D Active Track) for 30 minutes, and then ice and electrostem. I saw Dr. Steve every day for 6 days and the pain relief was immediate. My pain was 70% less in just 6 days! Before seeing Dr. Steve, I spent 5 months in physical therapy and sought treatment with my usual chiropractor, accupuncturist, and an orthopedic acupuncturist. I was undergoing neck traction at my local physcial therapy center in Los Angeles, but it did not compare to the immediate results of the 3D Active Track. Dr. Steve gave me individual attention during each session. His on-staff physical therapists were very friendly and attentive. His practice offered all the latest technology machines. Dr. Steve was able to refer me to a chiropractic office in Los Angeles and even offered to speak to any doctors necessary who would then take up my care. I've been to several other chiropractic centers and no other practice compares! Jessica C New York, NYC

After months of suffering with sciatic symptoms that were not relieved by acupuncture or prescription pain killers, I was skeptical that anything would help. But only two weeks after beginning my spinal decompression sessions with Dr. Shoshany, accompanied by physical therapy and training, I feel like a new person. My quality of life has completely improved, and the daily tasks that were so painful for months are now entirely manageable and virtually pain-free! I know I sound like an infomercial, but I am in utter shock and feel like celebrating!!!

Dr. Shoshany's practice is top notch: the loft-space office is gorgeous, modern, and impressive. He is a chiropractor who works with a physical therapist, a trainer, and an acupuncturist. They provide a holistic approach to healing, as well as the perfect balance of professionalism and personal kindness. They notice the way I lift my bag, they coach me and encourage me. They even researched a dance I was learning to see how it would impact my back! I adore them each.

I highly recommend this practice, both for the experience and the outcome. Good luck
Cecily K. New York, NYC
If you are suffering with back pain,neck pain,arm pain or shooting leg pain (sciatica)
give us a call at (212)645-8151 or visit www.livingwellnewyork.com for an immediate solution to your problem, we hope you can be the next person to write a testimonial for us!

Tuesday, August 24, 2010

Do I Have Sciatica? How Can I Tell?


Back pain comes in all shapes and sizes, just like people, and it does that for same reason - we are all different and pain affects us all differently. One of the more common words that people throw around when they are in pain is ‘sciatica.’ Although it is regularly used in conversation to mean a specific disorder, sciatica is in fact a group of symptoms and a condition in itself at all.

That being said, how can you tell if it really is sciatica? What are the symptoms to look out for? We’ll review a few below, but make no mistake, this blog post is not to take the place of actual diagnostic tests and seeing a doctor who can interpret them. If you are experiencing any of the below problems, talk to someone with expertise in your area. Living Well Medical, my practice, in NYC is equipped to help in these situations.

On to the meat and potatoes.

Perhaps the most common complaint with sciatica is burning, stinging pain in the lower back. The sensation is often, but not always, the result of a pinched or crushed nerve root. It is extremely unpleasant and sometimes debilitating.

Leg pain and pain in the buttocks that shoot out from the lower back are also common problems with sciatica. Again, this is usually because nerves are impinged due to a problem like a herniated disc or other musculoskeletal condition.

Also associated with sciatica is a pins and needles sensation (formally called paresthesia) or numbness in the lower back, buttocks and legs (all areas that are supplied nerve sensation by the radicular nerves that exit at the base of the spine.

If you feel any of these problems, talk to an expert. Give my office in SoHo NYC a call and make an appointment for treatment. We’re here to help.

-Dr. Shoshany, NYC chiropractor

(Check out my friend, Dr. Eben Davis, a San Francisco chiropractor, for more on non-surgical remedies.)

Friday, July 30, 2010

Power Taping seminar in NYC-Rock tape Kinesiology tape NYC


Taping movement, not muscles

I have using a variety of Kinesio tape for over 10 years in my Chiropractic practice in NYC, I have been using Rocktape for about 1 year now and this stuff is awesome! I am hosting a one day seminar on PowerTaping details below.

Kinesiology taping has been practiced for over twenty years and anatomy has been
classically taught on the “isolated muscle theory”, focusing on individual muscle
action.
Therapists frequently learn origin, insertion, innervation, and action of
muscles in a closed environment, with very little regard for their functional
effect on movement as a whole. As a result, many sport training and rehab
programs are based on rudimentary bodybuilding concepts that focus on muscles in
isolation. This isolated muscle concept has limited our views of how the body
coordinates movement.
In contrast, PowerTaping is based on the obvious yet largely overlooked concept of
muscles acting as a chain. PowerTaping’s revolutionary technique utilizes “longitudinal anatomy”, or “movement patterns” concept, the body’s integration of movement via multi-muscle contractions as a
means of connecting the brain to the body’s uninterrupted fascial web in order to enhance rehab and athletic performance via cutaneous (skin) stimulation.
Join us for a one-day seminar and learn how to integrate this new systemic approach to taping that promises
to benefit everyone. This clinic is designed to assist athletes, coaches, trainers, massage therapists, DCs, MDs and PTs in learning how to functionally tape to improve rehabilitation, sports performance and pregnancy.

Power Taping® Clinic
agenda - Sept 18, 2010
7:30 AM Registration
8:00 AM Introduction
8:15-10:00 Power Taping overview
Movement vs Muscle Based Taping Theory
Basics of taping
Functional Movement Evaluation - "Symmetry Profile"
10:00AM Break
10:15-12:00 HANDS ON - Rehab Taping Application
12:00 - 1:00 Lunch (on your own)
1:00 - 3:00 HANDS ON - Rehab & Pregnancy Taping Application continued
3:00 PM Break
3:15-4:30 HANDS ON - Specific Taping Chains
4:30-5:00 PM Testing

DETAILS
Instructors: Dr. Steven
Capobianco (D.C.,
CCSP, CSCS, author of
Power Taping Manual)

Location: Dr. Shoshany DC,
632 Broadway
#303 NY NY
Date: Sept 18th
Time: 8AM-5PM
Cost: $99 - Students,
$199 - Early
Registration (before
Aug 1), $250 thereafter
Includes Power Taping
Manual, 4 Rolls of
Tape, and Taping
Instruction Poster for
your office.
Register at www.rocktape.com or call us at 408.905.7071
http://rocktape.mybigcommerce.com/products/New-York-Power-Taping-Clinic-%252d-Sept-18.html
pay here use Shoshany for code
http://rocktape.mybigcommerce.com/products/New-York-Power-Taping-Clinic-%252d-Sept-18.html



$199
Chicago Aug 28! New York Sept 18!! San Francisco Oct 9! Austin Nov 13

Wednesday, July 21, 2010

Chiropractor NYC-Featured Chiropractor


--Staying At The Forefront Of Technology --


Featured Member: Dr. Steven Shoshany, Chiropractor – New York,New York NYC




I. Why Staying At The Forefront Of Technology Is Important:




Interviewer: What is the practice growth technique?

Dr. Steven Shoshany: I wouldn't necessarily point to a "technique" per se, but rather an attitude or an approach. For me, the focus is on cutting-edge technology and constantly attending seminars to learn the latest and most effective advances in my field. That way I can deliver the highest possible patient outcomes. The willingness to constantly put in the work and give patients more and better treatment is the "technique," if I had to put a name on it.

Interviewer: How did you get introduced to it?

Dr. Steven Shoshany: Remaining on the cutting edge has always been a part of my life, whether it's getting the latest gadget like a new phone or video game system or the most up-to-date treatment technology. It's a part of what drives me and it’s been a part of my success. Within the Chiropractic/Physical Therapy arena, there are always advances including on the diagnostic side, e.g., digital radiographs or musculoskeletal ultrasounds. These tools help us to better understand what is wrong with the patient so we can more effectively treat him/her.

Interviewer: How much of your staff's time does it take?

Dr. Steven Shoshany: I invest countless hours each year to learn the newest treatment methods like the Active Release Technique and the Graston Technique. All these tools allow me to confidently treat patients when others have had little success. We also upgrade our equipment to ensure we are using the most technologically advanced machines such as the DRX 9000 or the Erchonia cold laser.

Interviewer: What is the $ cost? Is a partner/vendor involved?

Dr. Steven Shoshany: Our office spends more on our equipment and training than most offices, I think. We strive to be the leader in the Metropolitan NYC area when it comes to non-surgical, cutting-edge techniques and procedures. When it comes to our patients, we cannot and chose not to go cheap; we invest in the best equipment, latest techniques and most competent staff because the value is passed on to patients who are looking for answers and relief from pain.

Interviewer: Results to date? Expected results?

Dr. Steven Shoshany: In general, we have gotten patients excellent results. We have so many different avenues available for treatment which generally translates into better outcomes.

II. Building a Multidisciplinary Practice:




Interviewer: What is the patient experience like in your practice?

Dr. Steven Shoshany: From the minute a patient walks in to our office, they are greeted and made to feel comfortable. We also respect a patient’s time; NYC is a busy place and patients have other places to be, so we are keenly aware of scheduling and patients hardly wait to be seen. Our practice is in a SoHo loft so it is spacious with high ceilings. It is a very tranquil setting that is conducive to healing. A patient can expect top-notch service and attention from our team of massage therapists, chiropractors and our physical therapist.

Interviewer: How does this differ from the competition?

Dr. Steven Shoshany: In my experience, most chiropractors practice solo, and they lose patients for various reasons. Maybe the patient is afraid of an adjustment or they are looking for a specific service. Our practice is multidisciplinary. The chiropractor works together with a physical therapist that can integrate strength, stretching and range of motion programs. We have a massage therapist that can work on tight muscles or aches. A medical doctor on staff can provide prescription medication or pain injections in the event they are needed. And we even have an acupuncturist. We try to cover all the bases to give patients everything they need in one place.

Interviewer: How does this benefit your patients?

Dr. Steven Shoshany: Patients benefit from a staff that works together every day and creates treatment programs for the individual. By offering all these services in one place, a person who is suffering with a condition like a herniated disc can get a combined approach or choose from a range of options. Having the ability to choose and having it all in one place is the key benefit we offer. Dr. Steven Shoshany, Chiropractor NYC – New York, New York

Spine-health Profile: http://www.spine-health.com/doctor/chiropractor/steven-shoshany-new-york-nyDr. Shoshany's Website: http://www.drshoshany.com/index.phpDr. Shoshany's Practice: http://www.livingwellnewyork.com
Twitter: http://twitter.com/drshoshany
Blog: http://spinaldiscdecompressiontherapy.blogspot.com/

Friday, June 18, 2010

Severe Back Pain & Herniated Discs


As far as frustrating problems that no one wants to go through as they get older, severe and chronic back pain is definitely up there on the list.

Herniated discs tend to be one of the more devastating conditions that are associated with back pain. Anyone who has ever suffered with pain related to nerve root compression and disc herniation will tell you the pain can be completely debilitating, literally forcing you to stop everything you do. It can just flat out take control. You can't work, you can't play, you can't sit and you can't stand without some kind of pain. It's a nightmare.

For anyone that doesn't know, a herniated disc occurs when the outer band of the disc (called the annulus) develops a tear, often due to trauma or wear and tear, and the cushioning center of the disc (the nucleus) spills out, often pressing against and irritating the spinal nerves nearby.

It used to be that herniated discs had very limited support in the way of non-surgical treatment alternatives, but those days are long gone. Today, practices that specialize in non-invasive, non-surgical approaches like mine in NYC, Living Well Medical, have a wide array of treatments to choose from, and in my case, we often use several in conjunction, depending on the needs of the patient who is in pain.

Specifically, non-surgical spinal decompression with the DRX9000 has made treatment without the fears of surgery a possibility for many of my patients. Spinal decompression is an exciting development that is fairly new on the scene as a back pain treatment. By stretching the spine very gently and precisely, discs that are causing nerve compression find their internal pressure reduced. Valuable fluids and nutrients can be pulled into the disc, and over time, herniated or bulging discs can start the process of repairing themselves which relieves pain.

Combining spinal decompression with physical therapy has helped us lower the possibility of re-injury by strengthening the muscles that support the spine. We have also successfully integrated other treatments like Active Release Technique and chiropractic adjustment into treatment programs for the better results. But in the end, it all depends on the condition of your back and what it needs to get better.

If you have severe back pain, give our front office in Manhattan's beautiful SoHo neighborhood a call at 212-594-8151. The surgeon's knife isn't the only option for a herniated disc, so see how we can give you an alternative that works.

- Dr. Shoshany, NYC Chiropractor

Wednesday, June 9, 2010

Surgery too often fails for back pain-best treatment for back pain


A great article from Yahoo below.

All to often patients jump into a back surgery, while there is a time and place for back surgery most times back pain can me managed with Chiropractic care,Physical therapy,Spinal decompression and Home exercises

Overtreated: Surgery too often fails for back pain


"Why did they cut you?"

The shocking question came from a respected spine surgeon tracked down by Keith Swenson, who was still in severe pain after an earlier back operation.

He didn't know what to believe. Two other surgeons had urged more operations, different ones.

And Swenson, who's from Howard Lake, Minn., is far from alone. Even though only a fraction of people with back pain are good candidates for surgery, complicated spine operations are on the rise.

So is the hunt for any relief.

By one recent estimate, Americans are spending a staggering $86 billion a year in care for aching backs — from MRIs to pain pills to nerve blocks to acupuncture. That research found little evidence that the population got better as the bill soared over the past decade.

"The way medicine is so Star-Treky these days, they believe something can be done," said Dr. Charles Rosen, a spine surgeon at the University of California, Irvine.

The reality is that time often is the best antidote. Most people will experience back pain at some point, but up to 90 percent will heal on their own within weeks. In fact, for run-of-the-mill cases, doctors aren't even supposed to do an X-ray or MRI unless the pain lingers for a month to six weeks.

Yet a study last year found nearly one in three aching Medicare patients get some kind of back scan within that first month.

Why is that a problem? Those scans can be misleading. By middle age, most people who don't even have pain nonetheless have degeneration of their disks, those doughnut-looking shock absorbers between vertebrae. So in someone who does have pain, pinpointing that a particular black spot or bulge on a scan is the true cause is tricky.

The bigger problem: When the misery lingers, there's no one-size-fits-most treatment.

"There are a lot of procedures going on for patients in whom we don't have good scientific evidence that it's going to help," said Dr. Richard Deyo of Oregon Health and Science University in Portland, who long has studied how people fare with different options for this tough ailment.

For example, there's a wide variety of spinal injections that aim to numb back pain, using different drugs and targeting different spots. Which one works depends on what study you read.

When the Institute of Medicine recently listed the 100 how-to-treat questions that doctors most need answered, back pain neared the top of the list.

Lots of things can cause chronic back pain, from arthritis to bone-thinning osteoporosis, which has its own controversy over whether cementing cracks in the spine really helps.

But those cushiony disks are a big reason. They naturally thin and shrink with age. Sometimes they herniate, or rupture, so the gel-like center leaks and pressures a nerve. Sometimes a vertebra slips out of alignment. Sometimes the spinal canal painfully narrows, a condition called stenosis.

The right operation can help, but specialists say only about 10 percent of people with lasting pain are candidates. More than 333,000 of the simpler decompression operations — laminectomies and diskectomies that cut away part of a bone or disk to relieve nerve pressure — were performed in 2007, the latest data compiled by the American Academy of Orthopaedic Surgeons. There were nearly 381,000 spinal fusions — more complex, riskier surgeries that bind vertebrae together with a bone graft and sometimes metal hardware.

There is some hopeful news — increasing evidence that more people should try pushing past the pain in aggressive exercise programs. Deyo calls them boot camps for back pain.

That's what ended Swenson's five-year pain odyssey. After a volleyball injury, scans showed he had degeneration in seven disks but one bulged in a way that doctors thought explained the pain radiating down both legs. They cut away part of that spot; it didn't help. Neither did multiple pain-blocking options.

"Exercise is medicine, but it has to be the right exercise," said Dave Carpenter, president of Physicians Neck & Back Clinics in Minneapolis, where Swenson finally turned.

The clinic's rehabilitation program focuses on strengthening muscles that support the spine, and published a study showing that only three of 38 patients prescribed surgery still needed it in the 13 months after completing tailored rehab.

Swenson, now 51, said he was so debilitated that it took several months to improve, plus two years of "maintenance" conditioning. Today, he's running a thriving gardening business near Minneapolis that ships peonies nationwide. It's a job that requires tremendous manual labor.

"Do I have flare-ups? Yes. But now that my back is strengthened, instead of flare-ups lasting one to two months ... the flare-ups last one to two days," he said. "This form of treatment is a lifetime change."

In New York City, Nicia Cortez wishes someone had told her of other options before her 2003 operation on a herniated disk.

"I was naive, and in severe pain. I didn't think properly at the time," said Cortez, who felt worse after surgery. It took her six years to work up the nerve to try again, this time a fusion that mostly relieved the pain: "I have my life back."

Her new doctor cautions that scar tissue and altered anatomy mean each subsequent back surgery has less chance of success than the one before.

"It's like trying to pave your driveway, layer upon layer, but at some point you replace the whole driveway. We don't have that ability with the spine," said Dr. Alok Sharan, spinal chief at New York's Montefiore Medical Center.

He makes patients exhaust nonsurgical options first, knowing that about one in five who has one back operation will have another in a decade.

"Sometimes people jump to this and think it will be a cure-all, and then five years later you need another procedure. If you're only 40, that's a big deal," Sharan said.

What's the best advice? First, some types of back pain are accompanied by red flags that need immediate attention — such as numb or weak legs or urinary problems. But for most people:

_Don't expect an X-ray, MRI or CT until a month to six weeks has passed, unless the doctor suspects a more serious problem. Following that guideline is becoming a quality-of-care measure in many organizations.

_Get back to normal activity as quickly as possible; the days of prescribed bed rest are over.

_Patients with sciatica, pain radiating down the leg, have the best outcomes from those nerve-easing decompression surgeries, Deyo stressed. California's Rosen said three criteria determine chances of success: a scan that correlates with the pain site; the patient has some weakness; and specific pain occurs when the doctor raises and straightens the legs.

Herniated disks heal on their own over about two years, but surgery for a faster fix is reasonable in good candidates, he said.

_Fusions are appropriate for far fewer patients, those with fractures, unstable or slipping spines, curvature of the spine and rare other reasons, Rosen said.

_Deyo recently studied surgeries for stenosis, that painful narrowing, and found decompression surgery as effective and less risky than fusions, which are more complicated and costly.

_A formal exercise program is especially effective if coupled with cognitive behavioral therapy that teaches patients to manage and function with pain, Deyo said.

_What if surgery fails? Usually, it was the wrong operation or the wrong candidate, said Rosen, who sees one or two patients a week classified as having "failed back syndrome" because of multiple failed surgeries.

Always get a second opinion. Rosen, who founded the Association for Medical Ethics, also recommends asking about a doctor's ties to companies that make spine-surgery products. That way you'll feel assured that a recommendation to cut doesn't come from a too-cozy relationship.

_Not a good candidate? A primary care physician can be a neutral adviser in helping navigate next steps. Patients with more challenging back problems may fare better at a multidisciplinary spine center with numerous specialists — in rehab and pain management — under one roof.
Living Well Medical in New York City is a multidisciplinary spine center that specializes in treating herniated discs,sciatica, spinal stenosis using Spinal Decompression,Chiropractic care, 3 dimensional rehab on the SpineForce, Physical therapy, Cold laser therapy and Pain management.
To schedule a consult call (212)645-8151


back pain treatment nyc

Monday, May 10, 2010

Pinched nerve in the neck-Arm pain-Is it carpal tunnel or a pinched nerve?


Pinched nerve in the neck,arm pain-Is it carpal tunnel or a pinched nerve? NYC

This past week we saw 5 patients that all that had very similar problems.
They all had pain in the arm and some into the fingers and even numbness and tingling into the fingers.
This is not only painful, but scary because patients wonder if it is permanent.
This numbness and weakness can make it difficult to play instruments,put on clothes and affect so many activies of daily living.
Most of the patients also complained of previous neck pain.
It is tremendously helpful to have diagnostics like digital radiographs and Nerve conduction velocity or NCV and EMG electromyography to help determine the exact reason why the patients has numbness and zero in on the cause. Often times patients already have a MRI that confirms the presence of bulging or herniated discs, If not we order a MRI.
Once we confirmed the presence of the problem we utilize multiple non-surgical methods to eliminate pain and return patients back to their normal routines.
Cox Cervial distraction is great and has been clinically proven to be an effective treatment for those that suffer from cervical herniated discs and radiculopathy.
We also utilize cervical spinal decompression.
Our NYC Physical therapy office is one of only a few in NYC that integrate cervical spinal decompression into our treatment protocols.

Cervical traction reduces Cervical disc herniations.
www.nycdisc.com

Many times patients with compressed nerves in the neck will present with shoulder, arm,and hand pain even weakness of grip. When this happens it's common for the patient to think the problem is in the arm or hand especially if there is no neck pain.

Yes, you can have a compressed or " pinched nerve" in the neck and not have any neck pain. In fact this is fairly common. You may even think you have carpal tunnel syndrome.

At our NYC physical therapy office, we are always concerned with where the nerves originate that control or innervate an area of the body that is not functioning properly or is experiencing symptoms, such as pain, numbness, tingling, or weakness in the upper extremities.

The nerves that exit from in between the bones of the cervical spine, travel down through the shoulder, then down the arms and into the hands. Pressure on these nerve roots will interfere with the transmission of nerve energy to the target cells...resulting in malfunction and symptoms.

The solution is to remove the nerve pressure. Often times this is easier said than done. Depending on how long the problem has been there and what the actual source of the nerve pressure is, will dictate the treatment. We offer Cold laser therapy, the Graston technique and Physical therapies like the Flexbar.
If you are suffering with a pinched nerve in neck or have arm pain or weakness in your arm give us a call at (212)-645-1495 and we schedule an immediate appointment or if you live or work in NYC- fax your MRI to (603) 584-5825 along with your contact information and we will call you back at no charge to discuss possible treatment options.

Friday, April 23, 2010

Low Back pain NYC-Herniated disc NYC-Sciatica NYC-Back pain NYC






Low Back pain NYC-Herniated disc NYC-Sciatica NYC-Back pain NYC-
NYC Low Back pain specialist
Call 1-212-627-8149 for an immediate appointment.



Over the past 14 years of treating patients with Low back pain,Sciatica and herniated discs in our Back pain and NYC Herniated disc treatment facility we have patients come in with MRI's that indicate disc involvement severe enough that if they where to consult with a surgeon they would recommend a back surgery. Some of the patients that come to us over the years have already had one or even two back surgeries.
I have listed below some of the MRI's findings on patients that have responded successfully to our Back pain/leg pain treatment protocols.
Our Protocols involve Spinal decompresion,Cox Flexion distraction, Cold laser therapy, Spine Force three dimensional Rehab,Custom made orthotics, Medical massage and more.

Clinical History: Low Back Pain


Findings: There is a slight scoliosis of the lumbar spine, convexity to the right.

There is no significant bony abnormality noted. There is disc space

narrowing at L3-4 and L4-5. There is probably disc space narrowing

also at L5-S1.


There is slight retrolisthesis of L4 on L5. There is minimal

retrolisthesis of L3 on L4










Findings: At L2/L3, there is a small left foraminal disc herniation and mild

canal and bilateral foraminal stenosis.




At L1/L2, there is mild diffuse bulging of the annulus fibrosis with a

small left paracentral annular tear.




Central disc herniations are noted at T11/T12 and T12/L1, effacing

the ventral thecal sac but without compression of the distal spinal

cord.




Impression: Degeneration of the lumbar discs and facet joins in superimposed

on congenital lumbar stenosis, with the largest disc herniation and

most severe canal stenosis at L4/L5.







Impression: Degenerative changes L3-4 disc space level.




Disc bulge in the midline L3-4 and right paracentral disc herniation

also present at this level.




Congenital central stenosis




Foraminal stenosis L3-4 disc space level.







Impression: Multilevel discongenic degenerative changes, most

pronounced at the L4/5 and L5/S1 levels.





Impression: Multilevel discongenic degenerative disease, most

severe at the L2/L3, L4/L5, and L5/S1 levels.




Moderate central canal stenosis from L2/L3 to L3/L4.




Multilevel moderate to severe neuroforaminal stenosis

without nerve root contact.


Stable postoperative changes from L4/L5 through L5/S1 with stable

soft tissue extending into the far left lateral/ ventral soft tissues at

the level of L4 consistent with postoperative changes.







Findings: At L5-S1, there is a rudimentary disc space and the canal and

neural foramina appear free of compromise at this level. Mild

hypertrophic degenerative changes of the facet joints are seen

at the L2-3 through L4-5 levels.




Intradurally, the conus tip and cauda equina appear intrinsically

within normal limits and there are no intradural abnormalities noted.

There are no fractures and destructive osseous lesions

demonstrated. There are no paravertebral soft tissue masses

noted.




Impression: A transitional vertebral segment at the lumbosacral junction is

referred as a sacralized L5 segment. Given this numbering

assumption, at both the L3-4 and L4-5 levels, there are

degenerative changes of the discs and facet joints, associated with

small, broad based, posterior disc protrusions/herniations, mildly

compromising the lateral recesses at both levels.



www.drshoshany.com

back pain nyc,herniated disc nyc,sciatica nyc,leg pain nyc, Chiropractic care Manhattan NYC



Findings: There is normal alignment. The alignment remains normal in flexion

and extension. In the neutral position there is straightening of the

normal lumbar lordosis




There is a transitional vertebra demonstrated on this study, the

lowest level on axial images being labeled L5-S1.




There is disk desiccation noted at L3-4 and L4-5.




Impression: Muscle spasm.


L3-4 and L4-5 central disk herniations, those two-level herniations,

encroaching on the anterior thecal sac best demonstrated in neutral

and extension views. There is tension spinal stenosis.




Impression: Muscle Spasm


Small focal left-sided disk protrusion at L5-S1 with slight disk

placement of the left S1 nerve root posteriorly.







Impression: Large left posterolateral disk extrusion at L3-4 with superior

migration of the extruded disk almost to the level of the L2-3

interspace. It compresses on the left L3 nerve root within the left

lateral recess.




Status post left L5 hemilaminectomy. Enhancing tissue in the left

lateral epidural space and surrounding the left S1 nerve root is

consistent with epidural granulation tissue. Soft tissue in the left

ventral epidural space representing either granulation tissue or

small left posterolateral disk protrusion without impingement on the

emerging S1 nerve root




Degenerated mildly bulging intervertebral disk with superimposed

small right foraminal disk protrusion at L4-5 possible impinging the

exiting right L4 nerve root.
www.drshoshany.com
back pain treatment nyc, herniated disc treatment nyc, low back pain treatment, Sciatica treatment NYC, Chiropractic care Manhattan

Back pain NYC-Low back pain NYC treatment-Sciatica NYC -Herniated disc NYC


Back pain NYC-Low back pain NYC treatment-Sciatica NYC -Herniated disc NYC
treatment www.nycdisc.com
Non-surgical solutions for Chronic Low Back suffers in Manhattan, NYC



Over the years we have treated some of the most difficult to treat Back pain patients in NYC in our Manhattan,NYC practice. www.livingwellnewyork.com

I gathered a few MRI report findings from some of our more difficult to treat patients and posted them below without the patient name of course.

Reading some of the findings you would expect for these patients to undergo spine surgeries to correct their problems, in fact most of these patients where told they needed a surgery to get them out of pain.
These patients came to our Manhattan Back pain clinic instead and received a combination of
Cox flexion distraction technique, Spinal decompression with the DRX 9000, Cold laser therapy with the Erchonia laser, Rehabilitation on the SpineForce, Custom fabricated corrective orthotics, Physcical therapy and massage.

Clinical History: Low Back Pain



Findings: There is a slight scoliosis of the lumbar spine, convexity to the right.

There is no significant bony abnormality noted. There is disc space

narrowing at L3-4 and L4-5. There is probably disc space narrowing

also at L5-S1.


There is slight retrolisthesis of L4 on L5. There is minimal

retrolisthesis of L3 on L4


Findings: At L2/L3, there is a small left foraminal disc herniation and mild

canal and bilateral foraminal stenosis.

At L1/L2, there is mild diffuse bulging of the annulus fibrosis with a

small left paracentral annular tear.

Central disc herniations are noted at T11/T12 and T12/L1, effacing

the ventral thecal sac but without compression of the distal spinal
cord.

Impression: Degeneration of the lumbar discs and facet joints in superimposed
on congenital lumbar stenosis, with the largest disc herniation and
most severe canal stenosis at L4/L5.


Impression: Degenerative changes L3-4 disc space level.

Disc bulge in the midline L3-4 and right paracentral disc herniation

also present at this level.

Congenital central stenosis

Foraminal stenosis L3-4 disc space level.


Impression: Multilevel discongenic degenerative changes, most

pronounced at the L4/5 and L5/S1 levels.


Impression: Multilevel discongenic degenerative disease, most

severe at the L2/L3, L4/L5, and L5/S1 levels.


Moderate central canal stenosis from L2/L3 to L3/L4.

Multilevel moderate to severe neuroforaminal stenosis

without nerve root contact.


Stable postoperative changes from L4/L5 through L5/S1 with stable

soft tissue extending into the far left lateral/ ventral soft tissues at

the level of L4 consistent with postoperative changes.


Findings: At L5-S1, there is a rudimentary disc space and the canal and

neural foramina appear free of compromise at this level. Mild

hypertrophic degenerative changes of the facet joints are seen

at the L2-3 through L4-5 levels.


Intradurally, the conus tip and cauda equina appear intrinsically

within normal limits and there are no intradural abnormalities noted.

There are no fractures and destructive osseous lesions

demonstrated. There are no paravertebral soft tissue masses

noted.

Impression: A transitional vertebral segment at the lumbosacral junction is

referred as a sacralized L5 segment. Given this numbering

assumption, at both the L3-4 and L4-5 levels, there are

degenerative changes of the discs and facet joints, associated with

small, broad based, posterior disc protrusions/herniations, mildly

compromising the lateral recesses at both levels.



indings: There is normal alignment. The alignment remains normal in flexion

and extension. In the neutral position there is straightening of the

normal lumbar lordosis

There is a transitional vertebra demonstrated on this study, the

lowest level on axial images being labeled L5-S1.


There is disk desiccation noted at L3-4 and L4-5.

Impression: Muscle spasm.


L3-4 and L4-5 central disk herniations, those two-level herniations,
encroaching on the anterior thecal sac best demonstrated in neutral
and extension views. There is tension spinal stenosis.

Impression: Muscle Spasm

Small focal left-sided disk protrusion at L5-S1 with slight disk
placement of the left S1 nerve root posteriorly.



Impression: Large left posterolateral disk extrusion at L3-4 with superior
migration of the extruded disk almost to the level of the L2-3
interspace. It compresses on the left L3 nerve root within the left
lateral recess.

Status post left L5 hemilaminectomy. Enhancing tissue in the left
lateral epidural space and surrounding the left S1 nerve root is
consistent with epidural granulation tissue. Soft tissue in the left
ventral epidural space representing either granulation tissue or
small left posterolateral disk protrusion without impingement on the
emerging S1 nerve root

Degenerated mildly bulging intervertebral disk with superimposed
small right foraminal disk protrusion at L4-5 possible impinging the
exiting right L4 nerve root.

Some of these patients had previous back surgeries and most all these patients suffered with back pain and have tried physical therapies, epidurals and pain management without success.
If you are suffering with Back pain,Sciatica,Low Back pain,Neck pain,sciatica, slipped,bulged and herniated disc pain in Manhattan NYC call us for an immediate no-charge consulation at (212) 627-8149

Thursday, April 8, 2010

Low Back Pain& Radiating Leg Pain- Back pain specialist helps to differentiate-Back pain treatment NYC


Low Back pain & Radiating Leg pain
NYC Back pain specialist-Dr Steven Shoshany

It is necessary to differtiate between pain in the lower back and pain, which radiates down the leg. It is common for the layperson to combine them into one category but to a physcian or surgeon,they represent different pathologies.
Lower back pain is not due to the pressure on a nerve root, as lower extremity pain is. Most low back pain is muscular or mechanical in nature, caused by overexertion, overuse, strain or sprain of the ligaments and tendons of the low back.
It may also be attributed to degeneration of the disck space and facet joints, which hold the spine together. It may also be caused by arthritis or stenosis or referred symptoms from organ involvement (bladder,gallblaffer, kidney, prostate One must also rule out organic causes as any form of cancer.

Lower extremity (leg) pain is often seen to radiate, termed "radicular pain". This refers to pain which shoots down the leg, from the low back or buttock. It usually results from pressure on a nerve, which produces a "pinching" of the nerve, which appears to radiate down the leg in the distrubution of the nerve pattern. Visit leg pain nyc for a excellent chart on nerve distribution.
When the "pinching" of the nerve is mild, one may experience numbness or tingling. As it progresses and becomes more severe, pain may develop. Further progression may present actual damage to the nerve and weakness may also result.
Each nerve in the lumbar spine has a specfic pathway. the nerves also carry threee distinct characteristic properties. They carry all threee of these properties to specific parts of the leg and foot.

1 One characteristic is known as sensory distribution property. What this means is that a nerve will supply the sensory (sensation) property to a certain part of the leg. for example the S1 nerve root, which is the first sacral root, supplies sensation to the lateral aspect of the foot (little toe).

2 One characteristic is known as the motor function property. What this means is that each nerve also supplies a characterisitc muscle.The S1 root supplies the calf muscles (gastrocnemius), which allows each of us to stand on our toes.

3 One characterisitic is known as the reflex pattern propert. Several of the nerves in the lumbar spine have a reflex associated with them. The S1 root has the Achilles reflex, which is elicted by tapping on the tendon of the heel.

Leg pain brought on by walking:

Neurogenic claudication refers to pain in the lower extremities brought upon by wallking. This is often caused by pressure upon the spinal nerves within the spinal canal, usually the result of the disc bulging into the nerves when standing.

Vascular or intermittent claudication is a type of pain, which must be distinguished from the lefg. and lower extremity pain from above. Vascular claudication is due to insufficient blood supply to the legs (arterial insufficiency), and is also brought upon by walking. the difference between the two is that merely standing (without walking) can cause neurogenic claudication but vascular claudication can only be brought on by walking.

Spinal decompression is truly the most effective procedure for severe and chronic cases of bulging, herniated discs, degeneration, arthritis, stenosis and pressure on nerves.

To learn more about our Back pain and herniated disc treatments visit www.drshoshany.com
Back pain NYC, Sciatica treatment NYC, Physical therapy NYC

herniated disc therapy questions, NYC-


Spinal Decompression

Subject herniated disc therapy

A recent question that was emailed to me and answer below:

Hello. I need a little advice that I hope you can give to me. In January 2010 I herniated my L2-3 disc. there was a central disc herniation with anterior thecal sac impingement and left foraminal impingement. I was going to a chiropractor who had me on the decompression table- the old fashioned kind where they strap your body in and there is calibrated wights that stretch your lower body as the table moves back and forth. It worked fine. But I was tod that I really needed a PT to help me rehab the core area and build myself back to normal. I have been going to a Mackenzie Specialist But all i was getting was heat treatments and then doing birddog exercises and a bicycle sort of exercise lying on my back. he also put me on this machine called the Repex machine- which stands for repetitive end range movements. Did Ok - but seemed to be going nowhere- I was doing the Mackenzie cobras at home every day Am and Pm. he told me not to do anything at home??? After almost 2 months of going to him I have now stopped. I do the cable exercises at home for my core- rotation and pulls etc etc BUT I still have some SLIGHT soreness in my left gluteal area and si AREA - this IS WHAT HE CALLS REFERRED PAIN.I understand that BUT what I need to know is how long will it take for me to feel 100% better. I have stopped ALL working out and am reallly really careful.I stand and sit with great posture and use lumbar supports in the car and at home. I also use the TENS machine and heating pads frequently. I read on many sites that COMPLETE SCAR tissue healing of a disc can take between 12-15 months. Does that mean this is when I will feel 100% better?????? I also have the book written by Jesse Cannone-- Lose the back pain.com and one exercise shows spinal decompression- by DRAPING yourself OVER the physio ball and letting yourself roll forward-- is this an OK exercise???If here is any added info you can advise me on I would be so very grateful for any expertise you can pass my way - either in the way of exercises besides the plethora of info I have found on the web or just some good old pat on the back to tell me that I will be OK- before this happened I could do anything- this back accident caused by doing deadlifts the WRONG way- has really slowed me down for the last few months- I would really like to get back to some exercises etc as soon as possible...P.S-- I do a lot of treadmilling since this occurred and just recently I have started to let myself hang from my chinning bar to let my spine decompress also-- please advise me on this also. Thanks so much for your ear and I hope to hear from you soon.

To answer your question,First I am not exactly sure about the type of spinal decompression table that you where treated on,there are so many table and products out there that claim to provide spinal decompression.
I use the DRX-9000 spinal decompression table in my NYC office, it provides consistent results and is very comfortable for the patient.
That being said, most everyone that completes spinal decompression needs to Rehab the Core muscles and strengthen the weak muscles and stretch the short muscles.
In my NYC non-surgical disc herniation facility we utilize the SpineForce Rehab system, it works by targeting all of the deep spinal muscles and works on strengthening them and stretching them, it's pretty awesome,check it out at www.spineforce.com
I like pull ups as well, that is a great way to lengthen your spine and strengthen your upper body, just be aware of any swaying and concentrate on form.
I don't know the Repex machine, but I use a machine that basically does a similar thing it is a repetitive flexion extension machine that does the Mackenzie technique.
It sounds like that you are doing everything you can and need to allow yourself time to heal, The disc is a avascular structure (meaning it has a poor blood supply) it takes time to heal after spinal decompression.
I have had patients complete a protocol and sometimes not see their desired results until a month or two after our last session. Healing a herniated disc takes time.
It is important to work on the core muscles and it sounds like you are already doing that, keep a positive mental attitude.
Good luck, and one more thing if after 2 months you are still hurting-I would go out and get a weight bearing MRI and add flexion,extension views
To learn more about herniated disc treatment in NYC
visit www.nycdisc.com
chiropractic care manhattan,chiroprator nyc, back pain treatment

Monday, March 15, 2010

End Back pain naturally NYC


I have been practicing Chiropractic care in NYC for 14 years now and the past 7 years I have been utulizing Non -surgical Spinal decompression with the DRX 9000 spinal decompression table.
www.drshoshany.com

I remind my patients that spinal decompression is not a panacea, but in most cases when all other methods have failed patients can expect great things from spinal decompression. A patient that recently completed a spinal decompression protocol with us in our NYC office was kind enough to email me a testimonial in english and spanish. I posted it below.


Spinal Decompression testimonial

My name is Sylvia Rivera and I am 59 years old. This is my story. It has been 5 years since I began suffering from backaches. I have been hospitalized, taken many pain killers, patches and different kinds of injections such as epidurals, joint facets, cortisone and many other relievers. But these just proved to be temporary pain relievers. At times I could not walk,tie my shoes,pick anything up or carry anything. I thought my life was over, as I have always been extremely active and had to stop dancing which has always been a passion of mine. However, since I went to Living Well Medical and met Dr. Shoshany my life has changed for the better. I can do so many things I thought I would never be able to do again. Now I can dance, walk and enjoy my life . I am so happy that I met Dr. Shoshany and was recommended the Spinal Decompression treatment. Dr. Shoshany made my life healthier and I am much happier. If you want your life back, I strongly recommend seeing Dr. Shoshany

In Spanish:
Mi nombre es Sylvia Rivera Y tengo 59 anos y esta es mi historia. Hacen aproximadamente cinco anos que he estado sufriendo de dolores de espalda. He estado internanda, he estado tomando medicamentos fuertes y injeciones en la espina dorsal con un poco de sedante o sea anestesia, me han recetado parchos para aliviar los dolores, Y he estado en tratamientos de terapia fisica por un ano. Me sentia casi invalida no tenia vida social, no me podia levanter de la cama todo era con mucho esfuerzo y con dolores constante. Desde que conoci al Dr. Shoshany en la clinica Living Well Medical y me hicieron el tratamiento de decromprencion mis dolores han disminuido en una forma fantastica. Ahora puedo amarrarme los zapatos, puedo bailar, caminar mejor y disfrutar de lo que me habia resignado,! disfrutar la vida!. El tratamiento que el Dr. Shoshany me ha recomendado ha sido lo mejor que me ha pasado en muchos anos. Si quieres tener tu vida activa otra vez Y sentirte mas fuerte deberias ir a ver al Dr. Shoshany YO LO RECOMIENDO.

As you can read this her quality of life has greatly improved, I see this type of recovery daily in our office.
If you or a loved one suffers with Back pain, Sciatica, pain from a pinched nerve or herniated disc consider Spinal decompression treatment prior to a surgical intervention.
If you have a MRI report I can review it at no charge and determine if it makes sense to come in for a No charge consultation. Fax the MRI report to
(212)777-1653 please inculde a cover sheet with your name and contact information, I will do my best to return calls within one day.
to learn more about Spinal decompression visit www.truespinaldecompression.com

Wednesday, February 3, 2010

How Can I Tell that I Have a Herniated Disc?


Chances are, during the course of your life, you've heard someone talk about having "slipped a disc." They likely mean a herniated disc. It's something I encounter week in, week out at Living Well Medical here in NYC. Maybe you got into a car accident that did it. People with jobs that require a lot of heavy lifting or weight-bearing are also some of the more common sufferers. What's more, as you get older, it gets easier for a spinal disc to herniate.

Now, not everyone who has a herniated disc will even feel pain. We see it all the time. On the other hand, there is definitely the potential for severe pain.

So maybe you have some awful back or neck pain, and you suspect a herniated disc. How in the world can you possibly tell if it is, in fact, a disc herniation? Are there certain symptoms? Are there any signs that conclusively point to it as the culprit? I'll explore these questions a little below and hopefully help anyone with chronic low back or neck pain get some answers.



There are symptoms that are associated with a herniated disc. Radiating arm and/or leg pain, a weak grip, numbness, tingling, pins and needles, deep muscle pain, and pain in the mornings and nights are all symptoms that one can experience because of a herniated disc. Unfortunately, there are a number of nerve entrapments causes that can lead to similar symptoms, so in terms of a "definitive" set of symptoms, a self-diagnosis for any one of these symptoms just can't be 100% accurate.

The only sure-fire way to know if you have a herniated disc is to get medical imaging scan done, specifically an MRI. I know, probably not the news you were hoping to hear, but the truth is that there are just too many other potential reasons for the types of pain described above. Diagnostic imaging can give a physician the detailed images of the spine they need to understand what is happening to you.

If you are in pain, Living Well Medical in NYC has a strong relationship with MRI facilities throughout the city, so you can get the help you need. And if you do have a herniated disc, we can prescribe effective, non-surgical treatment like spinal decompression, gentle chiropractic care, and physical therapy. Give us a call at 212-645-8151 today if you need someone who can guide you through stopping pain.

- Dr. Shoshany