Thursday, April 30, 2009

DRX 9000 NYC,Manhattan New study

Japanese study reports 76% of patients were satisfied after treatment on the DRX-9000! Are you suffering with a herniated disc? Have been told you need back surgery? Did you know that Non-surgical spinal decompression is available in Manhattan NYC? Visit our NYC herniated disc center If you live or work in New York City we are hosting a 45 minute presentation on how non surgical spinal decompression can help with chronic back pain and herniated discs. This workshop is a fantastic way to learn more about spinal decompression using the DRX 9000 and the SpineForce 3D rehabilitation system. Bring your MRI's and once the presentation is complete we will review MRI findings and help determine if you are a candidate for this procedure. There is no charge for this workshop and refreshments will be served. May 6th. at 7:30 please email drstevenshoshany@yahoo.com to register or visit NYC Disc herniation specialists Herniated disc doctor: A study titled, “The treatment of lumbar disc disease using DRX-9000” is published in the December issue of the Nigata University Journal of Health and Welfare. After treating fifty patients on the DRX-9000, Dr. Noriaki Yamamoto and others reported that 76% of patients were satisfied with the treatment. The patients received 30-minute sessions every week or 2 weeks, for 3 months and revealed a decrease in pain of 4.91 ± 0.93 to 2.69 ± 1.02 (p<0.01). Although the treatment program used by Dr. Yamamoto did not follow Axiom’s published protocol, positive results were still demonstrated. A previous study following Axiom’s protocol which was published in the December 2008 issue of the Journal of Medicine revealed a mean patient rating of 7.61 (0-10 scale) at the mid point of treatment and 8.1 after the final week of treatment. To review additional clinical studies please go to www.axiomworldwide.com/research.aspx

Tuesday, April 28, 2009

DRX 9000 NYC, Manhattan-Question regarding DRX 9000


www.drshoshany.com
I wanted to post a recent question I had a reader email me, In my usual fashion I will answer below. If you are suffering with a Herniated disc or Sciatica Non surgical spinal decompression is an effective treatment.Visit our Manhattan NYC practice where we specialize in non surgical spinal decompression.


Hi Dr. Shoshany,

Just a quick question. A DC with both the DRX and the DTS told me that studies show the DRX can achieve up to (unsure of the measurement scale) minus 200 negative pressure on the disc while the DTS only reaches a plus 70. Just want to hear any comments you may have regarding this specific issue... For example, have you heard of the study, can it be accessed on the internet...

I have read your comments regarding the differences in the different tables on the market, including the following summary:


"So in conclusion you get what you pay for, A Mercedes cost more than a Ford and they both get you from point A to B but the amenities on the Mercedes makes it more comfortable and a better experience."


For me the heart of the matter is this: can the DRX and the DTS both get you from point A to B? Could the end result of treatment with the DTS be just as effective without being able to achieve negative pressure on the disk (according to the DC mentioned above)? Thanks in advance for any response you might send me, no matter how brief!

I have had this question asked more then any other, I have several decompression tables in my NYC spinal decompression office. I was one of the first to bring spinal decompression to NYC.
Hands down you will get a more consistent and concise pull with the DRX 9000.
I often recommend patients to try and see the difference in my office, once they get on the DRX 9000 they don't want to go back on the DTS.
Now I am sure you will read conflicting information on the web by doctors that only own the DTS saying it does the same thing.
If that is all I had access to then I would use it, but if I had a choice? I would always go with the better equipment.

I do recommend that you incorporate a core strengthening protocol with you spinal decompression program. One mistake I hear about is patient that where just put on the machine and then only had ice and stim. If a patient does not educate the core muscles or learn proper bending and lifting they are prone to re-injury.
I find that the treatment lasts when you strengthen the core and teach the patient how to keep the core strong.
I utilize the SpineForce machine, I believe this is the finest piece of equipment to strengthen all of the postural muscles. Check out the website at www.spineforce.com
I posted some of the information about the benefits of the SpineForce below:

Prior to SpineForce, there was no KNOWN technology in the world able to precisely target and strengthen the most important muscle chains in the body, the 180 core spinal muscles. SpineForce fills this void.


SpineForce (the device/treatment) can be used for all athletes and sports/fitness enthusiasts, regardless of age or physical condition. It is a gentle, strengthening and rehab device to complement traditional training and strengthening exercises, building a foundation of core strength, aiding in proprioception, balance and equilibrium, while preventing debilitating structural disorders. SpineForce (the treatment) is affordable for all, as the benefits of improved core strength and back health, (preventing career-ending injuries, etc.). Many insurance providers will cover treatments & offset the cost.

Key Benefits of SpineForce (Treatments):

Precisely targets core strength irregularity
Strengthens core spinal muscles that are responsible for fluidity & bodily movement
Improves proprioception, balance, range of motion, coordination, fluidity, equilibrium and posture
Relieves back pain to prevent sports injuries and other debilitating spinal conditions
Supports sports trainer/therapist strengthening exercises/routines
Stimulates spinal fluids for improved neural responses
Provides whole-body cardio workout
Description: As one knowingly applies pressure to the handles with the upper body, a push/pull action, a moving platform works synergistically to keep the torso in highly targeted positions, forcing specific core spinal muscle chains to work in coordinated effort.

The effect? The core spinal muscles are strong and the spine is flexible, healthy and pain-free.
So to sum it up, Spinal decompression for treatment of herniated disc is excellent and I highly recommend the DRX 9000 table but I do urge you to take a more active role and request a core strengthening protocol. If you can make it up to Manhattan NYC I would be happy to see you! I am sure there is a a Chiropractor in your town that utilizes the protocols that I follow. Please email me a update.
www.drshoshany.com

Thursday, April 23, 2009

DRX 9000 NYC, Manhattan


DRX 9000 in Manhattan,NYC

Stop The Pain Before It Stops You!!

With the DRX 9000 technology, you can receive treatment of herniated and degenerative discs without surgery! If you are like many who suffer from chronic neck and back pain, you have probably tried several prescribed remedies to help ease your discomfort: frequent bed rest, high doses of pain medication. Perhaps even non-traditional approaches such as acupuncture. And like so many, you have come to accept the fact that you just have to learn to live with your pain.

You Don't Have To Live With That Pain Anymore!
Thanks to the concerted efforts of a team of top physicians and medical engineers, a major advancement in medical technology was made to effectively treat low back pain resulting from herniated or deteriorating discs. The result of their efforts not only significantly reduces back pain in 92-96% of patients, but enables the majority of patients to return to more active lifestyles.

The decompression can help if you have herniated and bulging lumbar discs with or without complication, degenerative disc disease, a relapse or failure following surgery or facet syndromes.

This new treatment uses state-of-the-art technology to gradually relieve neurocompression often associated with lumbar, lower back pain. The process has been proven to relieve pain by enlarging disc space, reducing herniation, strengthening outer ligaments to help move herniated areas back into place and reversing high intradiscal pressures through application of negative pressure.

For Lumbar Decompression
An upper chest harness / shoulder support and a pelvic harness are used to help distribute the applied forces evenly. Once in place, you are slowly reclined to a horizontal position. Following the physician's orders, the therapist localizes the pain, makes any adjustments and directs the treatment to the proper area. The pull of decompression helps to mobilize the troubled disc segment without inducing further damage to the spine. Following each therapy session a cold pack and/or electrical muscle stimulation pad is applied to help the paravertebral muscles consolidate and strengthen after treatment. This also prevents muscles from swelling and going into spasm.

Considering the DRX 9000 Technology in NYC?
Contact our Manhattan clinic at (212) 645-8151 or visit our website www.drshoshany.com
we will review your MRI,CAT scans or xrays and determine if you are a candidate for this procedure.
We utulize the Spineforce 3D rehab system, Power Plate whole body vibration, Cold laser therapy using the Erchonia laser, Kinesio taping and the Cox flexion distraction table.



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Monday, April 13, 2009

Manhattan DRX 9000 Spinal Decompression

Manhattan DRX 9000 Spinal Decompression
visit www.sohochiropractor.com
If you are visiting Manhattan and your back or neck goes out what do you do?
Spinal decompression on the DRX 9000 is a protocol that calls for numerous visits over a period of 6 weeks.
Chiropractic care can effectively reduce pain without medication.
Our Manhattan Spinal decompression practice offers Chiropractic care, Physical therapy, Acupuncture, massage and Pain management with a MD.
Our office is open Monday-Saturday and if it is a emergency chiropractic visit we can be reached anytime. www.emergencychiropractor.com

Wednesday, April 01, 2009

New table addition to Spinal Decompression NYC

I am excited to announce that I have added a new piece of equipment to my practice.
This table will compliment our Spinal decompression and Physical therapy programs.
It is based on the Mckenzie protocol.
To learn more visit our website at www.drshoshny.com


What is unique about this table?

The Evolution RMT Repetitive Motion Table



Rehab following a full decompression therapy treatment series is extremely important if the patient is to ensure themselves against reoccurrence and further injury. The Evolution DT has two computerized rehab programs incorporated within its 8 total programs available. These two programs are available for strengthening of the lumbar soft tissue. However, for more rehab we offer the Evolution RMT known for its outstanding results.

The Evolution RMT “Repetitive Motion Therapy” Table addresses mechanical disorders of the lower back using clinically proven techniques. The Evolution RMT Table is used in the clinical setting to enhance the effectiveness of repeated end range movement therapy for the low back. The RMT table enables the lumbar spine to be moved to the full degree of end-range movement in flexion and or extension a greater number of times than is physically possible by the patient alone. In the beginning stage of rehab, the patient often times has a hard time getting to full end-range position due to pain and because of poor physical endurance levels of the patient they cannot do movements long enough for a good enough response. The evolution RMT allows the patient to start rehab earlier and maintain the success of their prescribed home exercise program.



Evolution RMT Philosophy and Centralization Principles
The treatment protocols of the RMT Table are based on the patient’s directional movement preference and provides measurable and positive outcomes particularly in the management of acute & chronic, severe low back and leg pain (without a neurological deficit). Directional movement preference theory uses the rule of “Centralization” to evaluate and proceed into rehab using activities that “Centralize” the patient’s pain. Recently published scientific research articles have established that the presence of “Centralization” can be a strong indicator of discogenic pathology and is a highly accurate and reliable predictor of treatment outcome. Movement, activities and postures that cause the symptoms to “centralize” indicates the “preferred direction(s)” for the Doctor/Therapist to use in developing both an in office and self-treatment strategy for each patient. Simultaneously, the Doctor/Therapist must teach the patient how to avoid those positions, activities, and movements that cause the symptoms to move “Peripherally”. Many patients suffering from low back or neck pain, with or without referred pain, will unmistakably exhibit a “direction preference” when repeated movement and/or static positioning are applied to the spine. This means there will be a particular movement or position which will cause the symptoms to shift to a more central (proximal) location. Frequently there will be other movements or positions which will cause the symptoms to shift to a more peripheral (distal) location. An example of this is the patient who when asked to go into an extension movement (restoring normal lordosis) which in turn reduces the pain. This is the directional movement we want to begin exercise movements that will start their rehab. The Evolution RMT takes the patient through end-range passive range of motion repetitive movements and reduces the patient’s pain while increasing the patient’s range of motion.



Indications for use of the Evolution RMT
Patients who are assessed to benefit from the repeated movements on pain centralization, intensity, and location in flexion or extension.
These may include Disc patients, Stenosis patients, Facet Syndromes, or Sacroiliac syndromes where a limitation of movement occurs in the direction of “Centralization”.


Contraindications
Grade 3 and 4 Spondylolisthesis patients
Tumor or infection of the spine: Paget’s Disease etc.
Active Inflammatory diseases: Rheumatoid Arthritis, Ankylosing Spondylitis, Osteoporosis, or severe Osteomalacia (-2.0 or higher on T Scale)
Advanced diabetes
Fractures, dislocations, ligament tears or ruptures.
Instability of lumbar segments or has peripheral signs on both flexion and extension.
Patients with Neurological signs: Cauda Equina Lesions, Neurological Deficits, Loss of Bladder control, etc.
Patients that have surgical fusions.
Pregnancy


Evolution RMT Advantages
Variable Speed 1 – 8 Cycles per minute
Touch screen Digital Readout
Exact, Measurable Movement
Pause Button to Change Function During Treatment
Sliding Face and Lower Back Sections for Added Comfort During Motion
Automatic Return to Horizontal Neutral Position at the End of Treatment
Slide out Foot Section.
Programmable Timed Automatic Hold at end of Extension or Flexion.


Safety in Using the Evolution RMT
Table must never be used by untrained people.
Never have patients get on or off the table while it is in motion.
Instruct the patient to never reach underneath the table while it is in motion.
Instruct patients to keep their arms on the arm rests ensuring they do not allow their arms to go below the bed level.
Make sure patient’s clothing does not drape below the table top while in motion.
Always dismount table when in the Horizontal Neutral Position



Treatment Protocols
The Physician’s diagnosis and treatment of back and neck problems involves the use of repetitive end range movements that can influence the location and intensity of pain that arises from the spine. A skilled physical examination will reveal the direction of therapeutic motion that is used to resolve the condition. This is referred to as the “directional preference.” While restoring function can be an overwhelming task, the focus can be narrowed down to the primary goal of increasing the patient's functional range (FR). Initially, this consists of the painless or pain-centralizing activities revealed in the patient's history or range-of-motion examination. Therefore, the limits of the patient's FR consist of the aggravating movements and positions, and the key functional pathology related to those symptoms. So logically, before exercise can be prescribed, a thorough history and examination of the patient's mechanical sensitivities should be carried out.

Both history, examination, and imaging tests (X-Ray, MRI, CAT Scan) are involved in this analysis. For instance, the history should identify what positions or movements aggravate, relieve or are neutral to the patient's symptoms, in particular, peripheral symptoms. An example of this would be; the patient’s sitting and forward-bending intolerances strongly suggest a disc problem, and initial setting for the RMT and self-treatment would be "biased" toward extension. Another example of the importance of a thorough history is that many patients explain that they are worse after sitting or standing for a prolonged period of time. Such postural findings are often the only clues when the examination cannot reproduce time-dependent mechanical sensitivities.

Clinical examination should include orthopedic tests that seek out the movements or positions that provoke the patient's characteristic symptoms. Examples of these would be Kemp’s, Ganslens etc. Adding the use of repetitive tests of movements, such as those in the active and passive full range ROM tests, with the intention of better simulating normal activities that are typically repetitious is very important in establishing treatment parameters. In addition, the patient's own historical report of functional activities that aggravate symptoms can be confirmed by the examination of functional activities.

The movements and positions found to aggravate symptoms are used as an audit for pre and post-testing to assess the patient's progress. In contrast, the pain-centralizing or relieving positions and movement ranges are utilized for exercise training.



Patient Treatment General Safety Precautions
The Evolution RMT provides repetitive end-range of movement for the mitigation of pain with recovery of function for mechanical spinal disorders. It is a very effective tool but it should be used with some caution. Use the following guidelines in your treatment protocols.
Start your treatment in the mid-range of movement until familiarity has provided finer conclusions to be made in selecting starting and treatment angles.
We had said before that a Grade 3 or 4 Spondylolisthesis should not be treated with the RMT but if treating a Grade 1 or 2 the fixation belt should not be used.
In the presence of significant fixation of joint movement, joint and soft tissue scarring can be overstretched if the end range of movement is too excessive or if too many cycles are performed. Always be conservative in choosing end range points and cycle repetitions.
Posterior Disc Derangements will respond very well to the RMT. It is possible to reverse the derangement but once they appear to be stable it is to the patient’s advantage to place to transfer the patient to a more active therapy of self improvement procedures.
It is especially important to watchfully scrutinize the patient’s pain and or neurological status before, during, and after treatment. Communication of treatment results will ensure modifications that will improve results.
Patients should always be reminded to use the control “Stop” treatment button when treatment is uncomfortable or increasing symptoms.
Belt fixation with the patient prone creates the opportunity to cause injury. Before applying belt fixation it is important to manually test for appropriateness. Provided the “more pressure, less pain” test is answered in the confirmatory, belt fixation may be applied. Always apply belt fixation with the patient in their maximum tolerated extended position.



Treating the Chronic Low Back Pain Patient
The patient with “Chronic Low Back Pain” is our most difficult low back case. These patients typically enter the office complaining of constant pain and have been told they will have to “Live with their pain”. In actuality they do not have continuous pain. They actually suffer from recurring episodes that create the notion that their pain is continuous. The use of the RMT will increase the mobility of soft tissue, increase joint flexibility, and increase muscle strength. When these goals are accomplished the pain often has periods of days, months, and even years of discontinued pain and healthy function. In the beginning of treatment the clinician must be aware that the chronic patient may experience a pain of a different quality. His mobility may be restored but some persisting aching, probably of chemical origin may be present for 48-72 hours after the initial treatment. The patient should be made aware of this possibility. If pain persists proper modifications to treatment should be made.
www.drshoshany.com