Thursday, June 25, 2009

Herniated disc NYC , Sciatica NYC, Herniated disc doctor in Manhattan

Treatment for failed back surgery syndrome and herniated disc in Manhattan.

After watching President Obama speak about affordable health care and evidence based medicine I am trying to understand why Back pain is not addressed.

Some Back Pain Facts & Statistics

Although chiropractors care for more than just back pain, many patients visit chiropractors looking for relief from this pervasive condition. In fact, 31 million Americans experience low-back pain at any given time.

A few interesting facts about back pain:

One-half of all working Americans admit to having back pain symptoms each year.

Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.

Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.

I see patients everyday that are told they need a back surgery or patients have tried numerous spinal injections and they are still in pain.
I am currently treating several patients that have had a back surgery.

If you read the recent study put out by the American Pain society it clearly states that back surgery and epidurals is not the answer to treat chronic back pain and the herniated disc.
I currently have a one patient that had a artificial disc put in his lumbar spine and he still is in pain and one patient that had a fusion of his fourth and fifth cervical and guess what, he is in pain too.
All to often patients rush out to see the spine specialist and surgery is recommended.
I am not saying that surgery is evil, because there is definitely a time and place and over the years I have referred patients to consult with spine surgeons and they felt better.
What I am seeing is that patients are jumping to quickly into a invasive procedure without exhausting all conservative measures first.

Herniated disc protocol in our Manhattan NYC clinic is a Intensive interdisciplinary rehabilitation program.
This Protocol involves Non-surgical spinal decompression on the DRX9000,three dimensional rehabilitation using the Spine Force, Massage therapy, Acupuncture,Nutritional support.We custom fabricate corrective orthotics to correct improper gait bio mechanics.

Research review by investigators in the Oregon Health & Science University Evidence-based Practice Center prompts America Pain Society to issue new clinical practise guideline
The American Pain Society (APS) has issued a new clinical practise guideline for low back pain that emphasises the use of noninvasive treatments over interventional procedures, as well as shared decision making between provider and patient. The findings are published in the current (May 1, 2009) issue of the journal Spine.

The new APS guideline, based on an extensive review of existing research, provides clinicians with eight recommendations to help determine the best way to treat patients with low-back pain. It also expands its current and previously published guideline for initial evaluation and management of this chronic condition.

"These recommendations are based on an even more complete body of evidence than was available just a few years ago. Consequently, we believe these recommendations will give physicians more confidence when treating patients with persistent back pain," said Roger Chou, M.D., lead author, director of the APS Clinical Practice Guideline Program, and associate professor of medicine (general internal medicine), Oregon Evidence-based Practice Center, Oregon Health & Science University.

"Unfortunately, randomised trials for a number of commonly used interventional procedures are still too limited to generate evidence-based recommendations, and our review also highlights the need for more research," Chou added.

Low-back pain is the fifth most common reason for doctor's visits and accounts for more than $26 billion in direct health care costs nationwide each year. While a number of interventional diagnostic tests and therapies, and surgery are available, and their use is increasing, in some cases their usefulness remains uncertain.

"We have advocated strongly in many of our recommendations for physicians to use shared decision making because of the relatively close trade-offs between potential benefits relative to harms, as well as costs and burdens of these various treatment options," Chou explained. Shared decision making involves a patient's full participation in medical choices after receiving comprehensive information about the impact of all options on his or her particular life situation.

To develop the guideline, a multidisciplinary APS panel, augmented by experts on interventional therapies, reviewed 3,348 abstracts and analysed 161 relevant clinical trials. The panel found that the evidence for the use of these interventions was mixed, sparse or not available. Based on the data the panel gathered, the APS now recommends:

1. Against the use of provocative discography (injection of fluid into the disc in order to determine if it is the source of back pain) for patients with chronic nonradicular low-back pain.

2. The consideration of intensive interdisciplinary rehabilitation with a cognitive/behavioural emphasis for patients with nonradicular low-back pain who do not respond to usual, non-interdisciplinary therapies.

3. Against facet joint corticosteroid injection, prolotherapy, and intradiscal corticosteroid injections for patients with persistent nonradicular low-back pain, and insufficient evidence to guide use of other interventional therapies.

4. A discussion of risks and benefits of surgery and the use of shared decision making with reference to rehabilitation as a similarly effective option for patients with nonradicular low-back pain, common degenerative spinal changes, and persistent and disabling symptoms.

5. Insufficient evidence to guide recommendations for vertebral disc replacement.

6. A discussion of the risks and benefits of epidural steroid injections and shared decision making, including specific review of evidence of lack of long-term benefit for patients with persistent radiculopathy due to herniated lumbar disc.

7. A discussion of the risks and benefits of surgery and use of shared decision making that references moderate benefits that decrease over time for patients with persistent and disabling radiculopathy due to herniated lumbar disc or persistent and disabling leg pain.

8. Discussion of risks and benefits of spinal cord stimulation and shared decision making, including reference to the high rate of complications following stimulator placement for patients with persistent and disabling radicular pain following surgery for herniated disc and no evidence of a persistently compressed nerve root.

Chou and his colleagues also reaffirm their previous recommendation that all low-back pain patients stay active and talk honestly with their physicians about self care and other interventions. "In general, noninvasive therapies supported by evidence showing benefits should be tried before considering interventional therapies or surgery," said Chou.

Recommendations from the first APS Clinical Practise Guideline on Low-Back Pain are intended for primary care physicians and appeared in the Oct, 2, 2007, issue of the Annals of Internal Medicine. For diagnosis, the first APS low-back pain guideline advises clinicians to minimise routine use of X-rays or other diagnostic tests except for patients known or believed to have underlying neurological or spinal disorders

About the American Pain Society

Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practise to reduce pain-related suffering.APS was founded in 1978 with 510 charter members. From the outset, the group was conceived as a multidisciplinary organisation. APS has enjoyed solid growth since its early days and today has approximately 3,200 members. The Board of Directors includes physicians, nurses, psychologists, basic scientists, pharmacists, policy analysts and more.

This is an exciting new study because it confirms what Chiropractors have been saying for many years, Surgery and drugs to manage Low back pain is not the best treatment option.
In our New York City office we combine the best of the latest non-surgical technology like Spinal decompression,3D Spinal rehab, Physical therapy, Medical care and of course Chiropractic care to offer patients the most comprehensive care for back pain treatment.
Visit our website at
or my personal website which has an impressive amount of research on the benifits of non surgical spinal decompression

Monday, June 15, 2009

Sciatica treatment in NYC,New York City,Manhattan

What You Need to Know About Sciatica from

By: Stephen H. Hochschuler, MD

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg.

What You Need to Know About Sciatica NYC

The clinical diagnosis of sciatica is referred to as a "radiculopathy", which means simply that a disc has protruded from its normal position in the vertebral column and is putting pressure on the radicular nerve (nerve root) in the lower back, which forms part of the sciatic nerve.

Sciatica Causes

An important thing to understand is that sciatica is a symptom of a problem — of something compressing or irritating the nerve roots that comprise the sciatic nerve — rather than a medical diagnosis or medical disorder in and of itself. This is an important distinction because it is the underlying diagnosis (vs. the symptoms of sciatica) that often needs to be treated in order to relieve sciatic nerve pain.

Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine.

Sciatica symptoms
For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse.

While sciatica can be very painful, it is rare that permanent nerve damage (tissue damage) will result. Most sciatica pain syndromes result from inflammation and will get better within two weeks to a few months. Also, because the spinal cord is not present in the lower (lumbar) spine, a herniated disc in this area of the anatomy does not present a danger of paralysis.

Sciatica symptoms that may constitute a medical emergency include:
Progressive weakness in the leg
Bladder/bowel incontinence or dysfunction.
Common Causes of Sciatica:

Lumbar herniated disc-see spinal decompression nyc,herniated disc treatment nyc

Spinal stenosis

Degenerative disc disease

Patients with either of the above symptoms may have cauda equina syndrome and should seek immediate medical attention. In general, patients with complicating factors should contact their doctor if sciatica occurs, including people who: have been diagnosed with cancer; take steroid medication; abuse drugs; have unexplained, significant weight loss; or have HIV.

Sciatica medical definition: radiculopathy

To clarify medical terminology, the term sciatica (often misspelled as ciatica, cyatica or siatica) is often used very broadly to describe any form of pain that radiates into the leg. However, this is not technically correct. True sciatica occurs when the sciatic nerve is pinched or irritated and the pain along the sciatic nerve is caused by this nerve (radicular pain) and is called a radiculopathy. When the pain is referred to the leg from a joint problem (called referred pain), using the term sciatica is not technically correct. This type of referred pain (e.g. from arthritis or other joint problems) is quite common.

Sciatica treatment in Manhattan-visit www.drshoshany.comSciatica nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors. Typical sciatica treatment include:

Non-surgical sciatica treatments, which may include one or a combination of medical treatments and alternative (non-medical) treatments, and almost always includes some form of exercise and stretching. The goals of non-surgical sciatica treatment should include both relief of sciatica pain and prevention of future sciatica symptoms.
Sciatica NYC, Non-surgical spinal decompression in Manhattan
The Piriformis is a muscle that often tightens and causes pressure on the Sciatic nerve- The Graston technique is very effective in treating Piriformis syndrome.

Thursday, June 11, 2009

The Latest DRX9000™ Study Data Published In Peer-Reviewed Journal

Suffering with Chronic back pain in New York City? Stop suffering- Proven techniques can end the pain.
Herniated disc treatment New York City-NYC www.drshoshany.comThe Latest DRX9000 Study
Data Published In Peer-Reviewed Journal! Manhattan,NYC

A study titled, "Prospective Evaluation of the Efficacy of Spinal Decompression via the DRX9000 for Chronic Low Back Pain" was published in the December issue of The Journal of Medicine. The study authored by Dr. John Leslie, Mayo Clinic, et al, was designed to evaluate the effectiveness and safety of the DRX9000 in the treatment of chronic lower back pain. Patients enrolled in the study had suffered an overall average of 266 weeks of low back pain. At the conclusion of the study, 16 of the 18 patients reported improvement in low back pain, greater than 50%. The authors state, "Patients also reported having better daily activity function as measured by the Oswestry Disability Index." Reprints are available through Axiom Worldwide. To view this article please visit here.
Visit the most Comprehensive herniated disc treatment center in NYC

Monday, June 8, 2009

DRX 9000-Non Surgical Spinal decompression, Manhattan, NYC

Spinal Decompression in Manhattan New York City-Call (212) 645-1495

Spinal decompression patients we see at NYC Back Pain Relief Center suffer from "chronic back pain" due to various back related injuries and conditions. Our patients have already seen countless doctors and back specialists in addition to trying multiple types of treatments such as bed rest, over the counter and prescription medications, chiropractic care and physical therapy. I have seen how patients become dependant on Vicodin, Percoset and Oxycontin. These medications do not solve the problem and are habit forming.

Often times our Spinal decompression patients have even undergone back surgery for their back pain caused by herniated discs, degenerative discs, sciatic and spinal stenosis.
They come to us because even after all of the treatments they have tried they are still experiencing pain and want to know how spinal decompression can help them.

If you want to learn more about how this treatment works visit our website and scroll down to the bottom and use the Virtual Decompression application.
This has a spinal decompression overview and multiple charts to learn more about your condition.Visit Manhattan Herniated disc treatment

DRX 9000 Spinal decompression,Back Pain Relief Center in Manhattan New York City,(NYC),chronic back pain,back pain,herniated discs,degenerative discs,Sciatic and spinal stenosis,Spinal Decompression Therapy are all conditions that we treat successfully in our Manhattan office.
We are offering a no-charge review of MRI findings to determine if you are a candidate for spinal decompression therapy-fax your written MRI findings to
(603) 584-5825 and a call back phone number,A spinal decompression specialist will call you back within 4 hours.

DRX 9000-Non Surgical Spinal decompression, Manhattan, NYC

Spinal Decompression

Spinal decompression patients we see at Back Pain Relief Centers suffer from "chronic back pain" due to various back related injuries and conditions. Our patients have already seen countless doctors and back specialists in addition to trying multiple types of treatments such as bed rest, over the counter and prescription medications, chiropractic care and physical therapy. Often times our Spinal decompression patients have even undergone surgery for their back pain caused by herniated discs, degenerative discs, sciatic and spinal stenosis. They come to us because even after all of the treatments they have tried they are still experiencing pain and want to know how spinal decompression can help them.

Spinal decompression,Back Pain Relief Centers,chronic back pain,back pain,herniated discs,degenerative discs,sciatic and spinal stenosis,Spinal Decompression Therapy

Monday, June 1, 2009

Alexander technique NYC

This appeared in today's paper.
We have always offered a multi-disciplinary approach to treating patients problems.
The Alexander Technique for Back Pain?
as seen in the New York Times

A recent study in the British Medical Journal BMJ found that the Alexander technique, a noninvasive method of adjusting body postures to relieve stresses, may aid in the treatment of back pain. New York Times reader Karen G. Krueger of New York City had some questions about that research. We contacted Paul Little, professor of primary care research at the U.K.’s University of Southampton and lead author of the BMJ study.

I have found that very few medical professionals in this country know about the Alexander technique; I myself found it through a friend in the arts — the technique is widely taught in music conservatories and drama schools as a means of enhancing performance and avoiding injury. What can you tell readers about the Alexander technique and how it works?

The Alexander technique involves a teacher using both gentle hand contact and verbal instruction to help patients learn to become aware of and avoid harmful habits of muscle use which may cause and maintain pain. The Alexander technique is not a form of back exercise -– rather it is applied in everyday tasks like standing, walking, sitting at a desk or playing a musical instrument. We hypothesize that the Alexander technique works through release of tension, decompression of the spine, more balanced muscle activity and improved flexibility.

In what circumstances should a back pain patient pursue the Alexander technique (with or without an exercise program) as opposed to other, more invasive approaches, such as medication or surgery?

I would recommend any patient try the technique before more invasive interventions; that is, patients with chronic or recurrent functional back pain where there are no clear “red flags,” such as progressive or multilevel neurological symptoms, steroid use or a recent history of trauma.

Have your studies demonstrating the effectiveness and cost-effectiveness of the Alexander technique to treat back pain increased the profile and availability of the technique to patients in Britain?

I think the profile has improved but not hugely — the medical establishment is inevitably slow and cautious about recommending new interventions when they perceive them to be novel.

The medical research establishment in the United States has begun to study various alternative health practices to address back pain and other chronic conditions for which traditional medical approaches have had limited success. What can you say about other “alternative” therapies for back pain?

There is encouraging evidence in the short term for massage and yoga and also some evidence for acupuncture, and for chiropractic when combined with exercise regimens. In terms of “alternative therapies” for back pain, try and use something that is based in good research evidence.

The Alexander technique has been around for many years. New York Times Personal Health columnist Jane E. Brody wrote about the technique back in 1990.
Dr. Steven Shoshany at Living Well Medical offer Alexander technique and many other postural corrective techniques. We offer Acupuncture, Spinal Decompression, Massage, Physical therapy
or call offfice at (212) 645-8151