For mild cases, observation might be recommended, but this doesn’t mean we take a “wait and see” approach. There are two types of observation:

• Passive observation: This is the approach many general practitioners take, where the patient or their family watches for any changes in posture and seeks an evaluation if they notice anything unusual. The risk here is that curve progression can go unnoticed until it becomes more severe.

• Active observation: This involves scheduled screenings to monitor any changes in spinal alignment. If there are risk factors (such as scoliosis in a close family member), active observation is the best approach to catch and manage any progression early.

ART is precise and targeted. When treating hand pain, I focus on specific muscles that often contribute to dysfunction. Some of the key muscles and soft tissues I work on include:

• Flexor Digitorum Superficialis and Flexor Digitorum Profundus – These muscles control finger flexion. Adhesions here can cause stiffness and difficulty gripping.

• Thenar and Hypothenar Muscles – These are the muscles in the base of the thumb (thenar) and pinky side of the hand (hypothenar). Tightness here can limit thumb mobility and grip strength.

• Lumbricals and Interossei – These small muscles help with fine motor control. Releasing restrictions here improves dexterity and hand function.

• Extensor Digitorum and Extensor Indicis – These muscles help with finger extension. If they become tight or restricted, it can cause pain on the back of the hand and difficulty straightening the fingers.

Trigger point therapy involves applying sustained manual pressure directly to the sensitive knots in your muscles. This technique targets the tight, hyper-irritable areas causing local or referred pain, aiming to release the tension, increase blood flow, and restore normal muscle function. By focusing on these specific points, the therapy helps reduce pain and improve mobility.

In my office, I use trigger point therapy when needed, particularly for patients with mild to moderate pain or stress-related muscle tightness. However, I often find that Active Release Technique (ART) is more effective for most of my patients. ART allows me to combine precise pressure with specific movements, which helps release the trigger point while addressing the surrounding tissue’s function. That said, when a patient’s needs call for it, I turn to trigger point therapy as a valuable tool in achieving relief and promoting long-term recovery.

Two recent studies highlight the potential of infrared laser therapy for Achilles tendon issues. The first study, conducted by Oliveira et al., investigated the use of photobiomodulation in patients with acute Achilles tendon rupture treated conservatively. Over a 12-week rehabilitation period, the group receiving infrared laser therapy experienced significantly less pain during walking compared to the control group. This difference was notable at both the 12- and 16-week marks, emphasizing the therapy’s role in pain relief during recovery.

Another study by Mårdh and Lund explored high-power laser therapy (HPLT) for chronic Achilles tendinosis. This single-blind, placebo-controlled trial found that patients receiving HPLT reported significantly reduced pain during weight-bearing activities. They also demonstrated increased pain thresholds compared to those in the placebo group. These results suggest that HPLT, a higher-intensity laser therapy, could be particularly beneficial for chronic tendon conditions where pain during movement is a major issue.

At my practice, I’ve used cupping therapy to treat various types of pain, including:

•Low Back Pain: Chronic and non-specific low back pain often respond well to targeted cupping, helping reduce stiffness and improve function.

•Neck Pain: Whether caused by postural issues or stress, cupping offers relief by loosening tight muscles and increasing blood flow to the area.

•Knee Pain: Patients with osteoarthritis or sports-related injuries frequently find reduced pain and swelling after a few cupping sessions.

Adhesive capsulitis, often called frozen shoulder, is characterized by stiffness and pain that restrict movement. It can develop gradually and significantly limit your quality of life. Traditional treatments include physical therapy, steroid injections, and in severe cases, surgery.

A prospective, randomized, double-blind study evaluated the efficacy of radial extracorporeal shockwave therapy (rESWT) for adhesive capsulitis. This study involved 106 patients divided into experimental and control groups. Over four weekly sessions, the experimental group received real shockwave therapy, while the control group received a placebo.

The results were compelling. Patients who received rESWT experienced significant improvements in shoulder movement, reduced pain, and better overall arm function at both four and 24 weeks after treatment. These findings show that rESWT is an effective and safe option for frozen shoulder, offering hope to those who have struggled with more traditional therapies.

A recent clinical trial sheds light on how effective DDN can be in treating TMJ disorders. In this study, 36 patients with TMJ dysfunction were divided into two groups: one received true deep dry needling on the masseter muscle, while the other underwent a simulated version. Evaluations were conducted at three intervals: before needling, 10 minutes post-needling, and again after 15 days. These assessments measured pain, jaw movement, muscle tone, and alignment to determine the impact of the treatment.

The results were impressive. Not only did patients who received the real DDN report significantly less facial pain, but they also experienced measurable improvements in jaw movement. The range of mouth opening increased, and the symmetry of jaw motion—an important factor in balanced and pain-free jaw function—was notably improved. Muscle tone decreased, and digital analysis of jaw alignment showed that the jaw moved more smoothly and symmetrically after needling.

Another key finding was the decrease in time required for the jaw to reach maximum force, an indicator of improved muscle relaxation and efficiency. Together, these results suggest that DDN is effective not only in reducing pain but also in restoring function and balance to the jaw, addressing both the symptoms and some of the underlying issues contributing to TMJ dysfunction.

Several terms are often thrown around when talking about light therapy: infrared laser therapy, Low-Level Laser Therapy (LLLT), cold laser, and red light therapy. It’s easy to get confused by the overlap in terminology, so let’s break it down.

• Red Light Therapy primarily uses LED bulbs, similar to standard household lighting, to emit therapeutic light. These LEDs typically operate at lower power levels (wattage) and within a wavelength range of 600-800nm. Due to this lower wattage and wavelength, red light therapy is limited in its ability to reach deep tissues, making it most effective for surface-level skin concerns.
  
  
• LLLT (Low-Level Laser Therapy), also known as Cold Laser Therapy, uses a Class III laser with less than 1 watt of power. The terms  “low-level” or “cold”, simply refers to the fact that class III lasers produce less heat in the tissues than a class IV laser. Operating in the 800-1100nm wavelength range—similar to infrared lasers—LLLT can produce comparable tissue responses but requires longer treatment times due to its low power.

Low back pain is often the result of muscle tension, inflammation, or nerve irritation. By applying infrared light, we target the root cause of the pain, helping muscles relax, reducing swelling, and promoting tissue repair. The heat generated by the IR light reaches deep into the muscles, enhancing flexibility and reducing stiffness, which is critical for improving mobility and comfort.

In my experience, combining infrared therapy with other treatments, such as chiropractic adjustments and Active Release Technique (ART), can provide even better outcomes. While adjustments help to realign the spine and relieve pressure on nerves, ART addresses tight muscles and adhesions that contribute to pain. Infrared therapy complements both of these treatments by promoting faster recovery.

So, what exactly is supine lumbar traction, and why is it so effective? This technique involves lying flat on your back (the supine position) while a traction device gently stretches the spine. By doing so, it creates negative pressure within the spinal discs, which can help retract herniated or bulging discs, relieving pressure on the nerves and reducing pain.

This method is not only effective but also offers a comfortable experience for the patient. Unlike other forms of traction that may place you in less comfortable positions, the supine position ensures your body is relaxed and supported throughout the treatment. This relaxation is crucial because it allows the traction force to be evenly distributed along the spine, maximizing the therapeutic benefits.