Charles E Steiner, DO
2364-A Blizzard Lane, Albany, OH 45710
September 15, 2009
NON-SURGICAL TREATMENTS for BACK, NECK and JOINT PAIN
We work to promote healing, and not just to conceal pain.
Dr Steiner has been using a step-wise treatment sequence since 1994 to alleviate back and joint pain, and he has added to it as necessary over the years. This approach has consistently provided excellent results with the least treatment possible. He has perfected joint reduction techniques so that they are nearly painless, and many surgeries have been avoided for conditions that could heal by themselves given the right non-surgical treatment. PLEASE SEE US BEFORE CONSIDERING SURGERY.
The musculoskeletal exam of the low back is includes more detain than typical exams. For example, the evaluation of the SI joint bony structures includes (1) three-dimensional evaluation of the position of each iliac bone with respect to the sacrum at both ends, (2) deviations in two axes of rotation for each iliac bone, (3) deviations in four 4 axes of rotation for the sacrum, and anterior / posterior rotations around the horizontal axis and combinations of these rotations, and (4) the alignment of the SI joints not only at the upper joint, but also at the smaller lower joint. He also knows how to interpret patterns of muscle spasms to know what the joints are doing.
The examination of the lumbar spine not only includes the anterior / posterior positions and right / left rotations, and side-bending of the lumbar vertebrae, and the lumbar spine curve, but it also includes the lumbosacral angle as compared to normal for their age. Deep abdominal muscles that can shape posture are also examined. Examination of the thoracic spine also includes the ribs and rib muscles since they are a powerful force that can pull the spine.
The soft tissue exam of the back not only includes warmth, tenderness, joint stiffness, skin drag and swelling, but also includes resting muscle tone in 9 muscle groups (the paraspinal, lower abdominal, quadratus lumborum, iliacus, psoas, gemellus, gluteal, pelvic floor and piriformis muscles). The neck, shoulders and other joints have similarly detailed exams. The knee exam includes the normal orthopedic exam of the four knee ligaments, the popliteal muscle and joint fluid, but also corrects for internal rotations from above (the hip) and external rotations from below (the ankle). Many persons have chronic ankle sprains and donít even know that their ankle is not working right or that their knee is not moving in the correct direction because of a twist in the leg.
Manual therapy treatments specifically isolate each structure needing treatment. Since muscles usually determine the position of the bones, re-setting the muscle tone helps the body to accept the adjustments. Several techniques are used such as Indirect Myofascial Balancing, and Stretching, but the most frequently used technique is to directly challenge the nerves that control resting tone and follow this with Reflex Inhibition and Myofascial Balancing. Skeletal structures are realigned using Muscle Energy, Functional Technique, or High Velocity Low Amplitude Traction combined with rotation or Long Lever techniques. These treatments effectively realign the structures and reduce pain at the time of treatment. Normally the joints and muscles go through a period of soreness as tissues heal and joints adjust to their new positions. Typically two weeks after a treatment 70% of the treated areas are still in correct alignment. Neuromuscular treatment to re-set muscle tone is usually successful in reducing pain and correcting structural misalignments even if they have been present since birth. Most patients have substantial improvement after 3 visits.
The musculoskeletal exam of the neck includes the evaluation of the vertebrae positions and the cervical curve, and the position of the vertebrae with respect to the base of the skull and the top of the back, as well as the muscle tone around the neck, upper ribs, chest and muscles between the vertebrae
Dr. Steiner avoids using the standard cervical rotation and thrust technique since there is a slight risk of injury or fracture or dissection of the vertebral artery. He relaxes the muscles at the suboccipital area and around the misaligned vertebrae, then uses his fingertips to put mild pressure in the direction that the vertebral joints should slide, and then uses a mild traction pulse to gap the vertebrae. The joints move into position without risk or trauma. He adds mild rotation to the traction treatment for difficult adjustments.
Other treatments are used if necessary. Medical treatments with numbing agents and muscle relaxers are frequently used to improve rest and increase blood flow. Cranial Manipulation is used if there has been head trauma or if a misalignment of the skull bones is identified on examination. Exercises and stretches are recommended if appropriate, and these techniques have been proven over time. The goals of all of these treatments are to improve healing and not just to conceal pain.
If the above treatments have failed and there is hypermobility in the sacroiliac joint, a sacroiliac (SI) joint stabilization with a lumbosacral support belt may be ordered to hold the joint together. If this is successful, then the patient is weaned off the belt over a period of several weeks.
Severe traumas, such as motor vehicle accidents, are very difficult to treat. It is difficult to correct spinal misalignments after a car accident, but it can be done and requires repetitive adjustments. If the patient braced against the impact or was slammed into an object, other structures will need adjustment, such as the hip joint, ankles, knees, wrists, shoulders, diaphragm or skull.
If the affected joint does not heal after realignment, exercise and bracing, Dr Steiner uses Prolotherapy or Low Level Laser to stimulate joint ligament growth. Dr Steiner gets improved joint strength in 75% of the patients treated with Prolotherapy because he realigns the joints accurately to bring tissues together so they can heal quickly. The Low Level Laser can be used to promote growth and decrease laxity in loose ligaments even in difficult areas with a lot of tendons, nerves or blood vessels. Even PCL and ACL sprains can be treated without surgery is not completely torn, since the Low Level Laser can be used to treat the ligaments from the back side of the knee, where it is easy to reach the ligaments.
Traction is helpful for 70% of patients with herniated disks, when the extruded disc contents are not large or oddly shaped. This is a proven technology. Several researchers in different countries, including the United States have demonstrated that herniated disks can be pulled back into the disk body. After combining the results of hundreds of studies, the English also found that if traction is painful, it resulted in no benefit. When a traction test is done, we will not continue if it is painful or if you get numbness or nerve pain. If the patient has bulging or mildly herniated discs and the MRI does not show a large herniation or a loose fragment, then disk decompression therapy has a 70% chance of relieving symptoms. We have a computer controlled Disk Decompression traction unit that works for the low back and neck. It is suprizingly comfortable and effective. I have used this technology successfully avoid surgery and speed healing in several cases of herniated discs. These treatments are often effective, and they are safer and less costly than surgery.
Step into a new level of integrated treatment Ė make an appointment with Dr Steiner.
CALL (740) 566-4720 for evaluation and treatment.