Physical Medicine & Rehabilitation*
Physical medicine and rehabilitation, also known as physiatry, is a medical specialty focusing on the diagnosis, treatment and prevention of conditions affecting the nerves, muscles and bones within the body. This includes a wide range of injuries and illnesses that affect the way we move our bodies and can significantly affect our everyday lives. Treating these conditions is often a long-term process that requires gradually restoring strength, flexibility and functionality to the affected area so that patients can partake in their everyday activities with little to no restrictions.
Our experienced physical medicine specialists provide specialized treatment approaches for patients suffering from:
- Chronic neck or back pain
- Repetitive stress injuries
- Brain injuries
Other conditions may also be helped by our multidisciplinary approach, including a wide range of physical, psychological, cognitive or communication problems. A meeting with one of our physicians can help determine whether or not physical medicine and rehabilitative care can help your individual condition.
Personalized Rehabilitation Plan
In order to fully customize treatment, working with one of our physical medicine specialists begins with a thorough evaluation of your condition, as well as a one-on-one discussion of your personal goals and preferences for treatment. Diagnosis usually involves a review of the patient’s medical history, a physical exam, and imaging procedures performed to precisely target the location of the injury.
Additional procedures, such as electromyography (EMG), nerve conduction studies and evoked potential exams may also be performed to determine the specific cause of pain, weakness and numbness.
A customized treatment plan developed by one of our specialists often involves a combination of nonsurgical approaches designed to help relieve pain and restore strength and functionality to the affected area without the need for more invasive procedures.
Some of the treatment approaches we offer include:
Nutrition Counseling - A balanced diet is essential to maintaining a healthy life and preventing diseases such as obesity, diabetes and high blood pressure, among others. Patients of all ages can benefit from following dietary guidelines that provide sufficient nutrients, vitamins and minerals, which can be different for each person. Our nutritional counseling services involve a customized diet plan that takes into account each patient's nutritional goals, preferences, overall health and medical history.
Physical Therapy - Physical therapists (PTs) help patients recover through the use of restorative exercises that focus on developing muscle strength, flexibility, balance, posture, coordination and overall pain relief. PTs do their best to promote overall health and fitness to their clients both to aid in the patient's recovery, and also to prevent re-injury and maximize the patient's quality of life.
Occupational Therapy - Occupational therapists assist individuals with mental, emotional, physical or developmental disabilities in carrying out day-to-day tasks. They provide disabled individuals with customized techniques for eating, cooking, dressing, using the computer, and other activities. Occupational therapy provides disabled individuals with adaptive techniques, enabling them to lead happy, independent lives.
The frequency and duration of treatments will vary depending on each patient’s individual condition. Our doctors will work with patients on an ongoing basis, performing timely evaluations, in order to achieve the most effective results and meet each patient’s individual needs.
Platelet Rich Plasma (PRP)
What is PRP?
Platelet rich plasma (PRP), frequently called blood spinning therapy, has become a popular topic and has received a great deal of media attention as a treatment option used by many professional athletes today. The premise of PRP is focused around using the body’s own natural healing process to treat injuries.
PRP is an elective treatment option that is available for subacute and chronic injuries (lasting greater than 3-6 months). When an individual sustains an injury, the primary healing mechanism is centered on producing a rush of blood concentrated with healing factors to the affected area. However, healing generally slows or stops approximately 6-12 weeks following an acute injury. Additionally, some areas in the body lack a sufficient source of blood supply, and therefore do not receive the concentration of factors necessary for effective healing. This can lead to chronic injuries and degeneration of the affected tissue.
How is PRP Administered?
PRP is produced from a patient’s own blood. A blood sample is withdrawn from the patient, and then spun down to concentrate the healing factors (predominantly platelets) contained within the blood. These cells help promote cell recruitment and multiplication essential for healing.
Once the blood has been drawn and spun in the centrifuge, the platelet rich plasma is then re-injected into the affected area, recreating an inflammatory response the way your body would do naturally. Ultrasound guidance is frequently used to guide and direct the precise placement of the PRP into the affected tissue. Patients are then requested to rest the area for a short period of time prior to starting a regimented rehabilitation program.
Who Should Receive PRP?
PRP has been used in the treatment of a variety of injuries, including tendinous injuries, ligament sprains, muscle strains, joint injuries, and poor union after fractures. Many animal studies have been conducted which have shown improved healing in soft tissue and bone.
The most promising human studies to date have been in the treatment of chronic tendinosis of the elbow, in patients with lateral epicondylitis (tennis elbow). Studies have shown a 60% improvement in pain scores at 8 weeks post-injection, compared to a 16% improvement in control groups. By two year follow-up, patients in the PRP group were noted to have a 93% improvement in pain scores. They were also noted to have significant improvement in pain scores at 1 and 2 year follow-up when compared with corticosteroid injections.
Many of the other studies that have been published have been for the treatment of similar tendinous injuries, such as Achilles tendinosis and rotator cuff tears. Other studies have been conducted in the treatment of conditions such as knee osteoarthritis, medial collateral ligament (MCL) injuries, and ACL reconstructions showing favorable results.
However, the overall support of PRP in the literature is still limited, and more studies are needed to definitively prove its effectiveness.
Why do PRP?
PRP is a viable treatment option for patients who have a chronic injury that has failed conservative management. As healing generally slows or stops by 6-12 weeks after an acute injury, PRP may aid to reinitiate the healing process. As PRP is created from a patient’s own blood, the risk associated with procedure is very low, while the potential for healing can be quite beneficial.
Jose S. Campos, MD is a Sports and Spine physician, who is board certified in Physical Medicine and Rehabilitation and Sports Medicine. He completed his Sports and Spine Fellowship at Hospital for Special Surgery in New York, the #1 ranked Orthopedic Hospital in the nation by US News. While at HSS, Dr. Campos used PRP as a treatment option for a number of patients with a variety of musculoskeletal injuries. He was also actively involved in several clinical studies reviewing the clinical efficacy of Platelet Rich Plasma, including the treatment of hamstring tendinopathy and intervertebral discs.
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