Finding solutions, improving function

“I focus on figuring out what might be contributing to a problem and then addressing each issue to get the best outcome” — Dr. Esther Yaniv


PHYSICAL Evaluations


Complete musculoskeletal exam (relevant to chief complaint as determined by me)

Neurological exam of the affected region

  • Lumbar – lower extremities

  • Cervical – upper extremities

Gait analysis

Scoliosis evaluation

trigger point injections


Trigger points are a tight band of fibers within the muscle, they are a Common source of pain

  • Typically referred as “knots”

  • Differ from tender points as they refer pain in a specific pattern when pressure is applied

  • Can persist despite trial of deep tissue massage and stretching

Injection of a local anesthetic +/- cortisone into the trigger point

Often injection is combined with “wet” needling, a back and forth motion of the needle to “break up” the tight fibers

May need to be repeated for longer lasting relief

Commonly combined with physical therapy

Bursa Injections


Upper extremity

  • Subacromial bursa for rotator cuff tendinitis

  • Lateral epicondyle bursa for tennis elbow

Lower extremity

  • Trochanteric bursa for lateral hip pain


Interventional Pain Management


Epidural Steroid Injections

  • Cervical

  • Lumbar

Lumbar facet injections

Lumbar medial branch blocks

Sacro-iliac joint injections

Hip injections

Nerve Conduction Studies/Electromyography

(Coming soon)

Diagnostic evaluation of numbness/weakness in the extremities

  • Upper extremity

    • Carpal Tunnel Syndrome

    • Ulnar Neuropathy

    • Cervical Radiculopathy

    • Peripheral Neuropathy

  • Lower Extremity

    • Peroneal Neuropathy

    • Tarsal Tunnel Syndrome

    • Sciatica

    • Peripheral Neuropathy

Coordination and Collaboration


Physical Therapy

  • McKenzie Method

  • Strengthening

  • Flexibility

  • Dry Needling


  • Imaging – X-ray, MRI

  • Nerve Conduction Studies/EMG (see above)

  • Lab – Rheumatology screens, Thyroid, Inflammation, Auto-immune disease

  • Massage/Acupuncture


Health Coaching

IN-office & Outpatient

Spine health is a reflection of overall health

  • Nutrition

  • Weight management

  • Sleep

  • Stress management

  • Exercises


  • Proper sitting techniques/ergonomics

  • Core engagement

Mind-body awareness

  • Breath control – functional breathing to reduce tension and pain

  • Mind-body awareness through healthy breathing techniques

  • Pain journaling

  • Addressing fear avoidance – moving through and after pain



Yoga has been shown to be helpful as a part of a comprehensive pain management regimen to:

  • To determine appropriate poses and modifications

  • To address fear avoidance by providing reassurance and guidance

  • To transition from physical therapy to an independent exercises program

A partner in recovery

Physiatrists receive special training in Physical Medicine and Rehabilitation. This branch of medicine emphasizes the diagnosis, treatment, and rehabilitation of conditions that cause temporary or permanent impairment. Physiatrists work with people of all ages. Their primary focus is on improving function.

The goal of physiatry is to help people be as functional and pain-free as possible so that they can get back to what is important to them. That can be returning to work, getting back on the golf course, or playing with the grandchildren.

Physiatry encompasses both the treatment of major injuries (such as spinal cord or traumatic brain injuries) and more common problems like back injuries, sports injuries, and joints affected by arthritis. While these types of problems aren’t catastrophic, they can result in chronic pain and the loss of function. All of this can have an enormous impact on our daily lives.

Physiatry centers on a team approach. The physiatrist and the patient form a team that can include physical therapists or surgeons. Many conditions that physiatrists treat are an inevitable part of living and the wear and tear that affects our muscles, bones, and tendons over time. Whether the problem is caused by an injury or by aging, the goal remains the same: maximizing function in spite of the problem.