Methods of Treatment Offered
REMINDER: ALL TREATMENT STARTS ONLY AFTER A THOROUGH HISTORY OF THE PATIENT’S PROBLEMS AND A THOROUGH EXAMINATION.
- Peri-neural injection therapy: Safe injections of tiny amounts of dextrose or glucose with tiny needles to heal the pain in the nerves underneath the skin.
- Dextrose or glucose prolotherapy: Direct injections of injured tendons and ligaments to jump start healing.
- Gentle manipulation and specific exercises
- Dr. Abraham’s direct mechanical repair of the layer of important tissues under the skin: The fascia. (nonoperative)
- Referral to physical therapists that Dr. Abraham knows of and approves.
Prolotherapy is the injection of growth-stimulating dextrose or glucose into the body’s tissues to create new natural tissues. Traditional prolotherapy originated in England in 1927, developed by Dr. George Hackett in the 1930s with a book published in 1956. Two professional organizations regularly teach this technique to the U.S. and international physicians. The type of prolotherapy uses a larger 12.5% dextrose solution concentration. The most common substances used in Prolotherapy are dextrose or glucose, the same sugar that is in the blood. We use dextrose or glucose mixed with a local anesthetic and sterile water. This safe substance is introduced with a local anesthetic into the areas of injury.
Dr. Abraham has 40 years of experience with gentle manipulations. Often manipulations are useful instead of injections, or as an additional treatment. These involve performing very gradual movements with patients to relieve discomfort. He does manipulations after taking a careful medical history and performing a thorough physical examination. Through manipulation, various parts of the body can respond quite well.
Acute or chronic neck pain can respond very well to a few gentle and safe tugs of the head to relieve neck pain. The patient is lying down for neck manipulations. The upper back is another site responding often to manipulations. Often a person has pain in both places. Direct and brief pressure is applied at one or two spine levels with the patient lying down. Another useful and gentle technique is with the patient sitting. This consists of a gentle lifting of the body, a gentle rotation while providing a quick pat on the back. Manipulations are also helpful at elbows, wrists, knees, and ankles.
Physical therapy is often a useful part of treatment. Physical therapists have a great knowledge of the physical examination of a patient and can respond to the patient’s needs by retraining and strengthening. Every patient is different and needs their own set of guidelines for improvement. Dr. Abraham has a very long history of working with physical therapy and referring patients to therapists.
Dr. Abraham has a lot of experience coordinating with physical therapists. He additionally has years of training physical therapists in subjects that Dr. Abraham is an expert at. He is very careful to send patients to select individual therapists who understand and will do the correct job for his patients. There is a list of therapists that Dr. Abraham knows and trusts. Dr. Abraham will maintain communication with the therapist throughout the process.
The Fascial Distortion Model
This is a new non-invasive technique (no needles) that uses a deep massage technique for in-office therapy for chronic or acute musculoskeletal pain.
A very thin but important layer of tissue is present in the skin throughout the body. Each layer is known as Fascia.
This Fascia is best thought of as a tube of tissue over and around all the muscles in the body; the fascia connects closely to the outside borders of muscles and assists in proper movement. Damage to the Fascia can cause pain and this pain can last for years.
Fascia can itself undergo local damage. Then this Fascia becomes a unique and chronic source of pain. This damage can present in a variety of ways: a little depression under the skin; a ribbon of tenderness; a restriction of joint movement; an area that is tender to touch in a larger area (such as part of the thigh or arm).
We first find the areas of pain in the Fascia by asking the patient to show the pattern of pain with the thumb, fingers, and hands. Each patent demonstrates with fingers and hands where the pain starts and where it ends. Either single or multiple different types of fascial damage can be present in the same area or adjacent.
Treatment is "non-invasive”. No needles are used. We use our fingers and hands to essentially push in or rub away the pain by smoothing out the Fascial layer. It has been amazing to see how fast the pain can be improved or resolved merely by the pressure from the hands. We measure the duration of the pressure in a time period lasting from seconds to a few minutes.
Sometimes the applied pressure by the thumb, finger, or hand will cause a temporary increase in pain. Fortunately, the amount of pain produced in the processes of treatment is brief and not severe, unbearable, or damaging. Getting a bruise is unusual. Good improvement follows rapidly while still in the office.
This treatment, like many others, may need several repetitions to be permanent.
No insurance company will reimburse me for this work, so there will be a charge.
Direct Neural Treatment
This treatment is a new addition to Fascial Distortion Model Therapy.
We are using the same nerves lying just under the skin that we treat with dextrose (glucose ) solution to stop the pain and promote healing. We lightly touch a single nerve; then we determine if the nerve is stiffer than normal, painless, and/or swollen. My teacher for this work, Dr. Everett Johnson, has developed this method of direct gentle treatment of these nerves.
Each nerve is connected on either side to the loss layer of tissue under an even bit of skin, known as the Fascia. The nerves just under the skin can be pulled by an irritation of the fascia, much like a tiny wrinkle in a shirt.
Using one or two fingers, we press in different ways on the fascia connected to the nerve, not the nerve itself. This is a Direct Nerve Treatment. After a minute or so, any pain is much less; the fascia relaxes its hold on the nerve; and the nerve itself becomes softer, less painful, more normal, and feels softer. Like every type of treatment we do, one or more related sessions may be needed.
This treatment has the advantage of using fingers or thumbs only, gently, and no needles or injection of any solution.
There will a separate charge for Fascial Distortion (FDM) work in this office, in addition to any insurance co-pay, and for any injection therapy that is extensive on the same day.
Ozone is actually the product of running real oxygen, JUST LIKE THE OXYGEN, WE BREATHE INTO OUR LUNGS, through a little machine on my desk that changes it to a reactive healing form in tiny amounts. These tiny bits, known as OZONE, are very effective in healing muscles, ligaments, and other tissues in the body. OZONE has been used for over 35 years in Europe, and many, many published studies.