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 IN-OFFICE: 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 IN-OFFICE: 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 IN-OFFICE: 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

OUTPATIENT NERVE CONDUCTION STUDIES/ELECTROMYOGRAPHY: 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 IN-OFFICE: Physical Therapy: McKenzie Method, Strengthening, Flexibility, Dry Needling. Diagnostics: Imaging – X-ray, MRI Nerve Conduction Studies/EMG (see above) Lab – Rheumatology screens, Thyroid, Inflammation, Auto-immune disease, Massage/Acupuncture

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.