Treatment

Phase 1 is mainly for pain control and to increase ROM (Range of Motion)

• It is vital to decrease pain prior to starting any type of strengthening exercises. Otherwise, you end up with more spasm and less ROM, significantly delaying progress. This is something I know from experience that many treatment plans cannot do not consider, or simply ignore. When you start rehabilitation exercises (especially if before pain control), most patients have mild exacerbations. When and if they occur, we must be able to alleviate them. If we cannot, it drags out treatment plans to months on end. We use heat/electrical muscle stimulation, ultrasound, massage, active release technique and spinal manipulation/adjustments to decrease pain and increase ROM. If you are in severe pain, and/or not responding in 1-2 treatments, we will refer you to the proper MD for more aggressive methods of pain control.

 Phase 2 is mainly to increase Range of Motion and begin mild strengthening

While working in hospital physical therapy units early in my career, I learned our first goal was to increase ROM. I came to realize we were very good at extremities, but not very good at spines. In fact, new PTs were usually assigned neck and back pain cases, because they were so difficult and had good outcomes. While observing the first chiropractor I shadowed, I saw immediate increased ROM in virtually every patient getting off the table! Patients with antalgic leans (bent over, tilted, leaning right or left) were leaving almost completely upright! The chiropractor then told everyone, “see you next week”. At the end of the night, I asked the doctor, when do you rehab the patient and release them? This is when he said, “we don’t release patients, this is lifetime care”. He then went on to claim multiple systemic changes (less: allergies, heartburn, common colds, heart issues, bed wetting, etc.) which I questioned at the time and now know doesn’t happen. I never make any of those claims or even that we can “fix scoliosis” a musculoskeletal problem! We do not fix systemic disorders.

Phase 3 is to further increase strength, so you don’t need us.

Getting stronger is the single most effective way to maintain long term relief and require less future care. While strengthening doesn’t mean you will never need a chiropractor again, I believe it will greatly decrease your risk of future exacerbations and definitely the need for “regular” care. Once you learn the specific exercises we teach you, (typically 1-4 visits, depending on your past PT or regular exercise routing) you are released to PRN or “as needed care”. We do not recommend monthly visits and never any “package deals”! Ninety-nine percent of the time you will know when you need us, in the 1 % that you do not, we recommend just calling our office. Dr. Tancredi will get back to you within one day and either recommend you come in, see and MD or tell you what type of home treatment will help.