Leon E. Popovitz, MD
Top-Rated Orthopedic Surgeon
Specializing in Arthroscopic Surgery of the Shoulder & Knee.
For appointments 212.759.4553

Non-Surgical Orthopedics and Rehabilitation

The non-surgical orthopedic doctors at NY Bone and Joint Specialists believe in treating a patient with the most natural and effective methods possible. Many conditions and injuries can be rehabilitated using conservative treatments, allowing the body to heal itself.

Our team of doctors are experts in pain management and rehabilitation and can offer the best possible treatment option for all musculoskeletal or neuromuscular ailments. There are a variety of conservative treatment options that may be used to treat injury, disease, or irritation of joints, bones, muscles, and other tissues of the body.

Electrodiagnostic Testing –

EMG & Nerve Conduction Studies

Many musculoskeletal injuries result in nerve damage or dysfunction that can cause chronic pain, numbness, or weakness in areas affected as well as distant regions of the body. Nerve roots originating in the spinal cord are often compressed if injury or disease causes inflammation that narrows that spinal canal. This can not only result in pain of the back or neck, but numbness and malfunction in the body’s limbs through which the nerves branch out. Nerve damage is also common in the pelvic region, most often in women, which will lead to pain, incontinence and other nervous dysfunctions that could interrupt simple life functions.

To properly treat nerve dysfunction, it is necessary to pinpoint which nerves are the cause of pain. Due to the fact that pain may radiate beyond the affected nerve root, this can many times not be done by a simple physical examination. An EMG is a diagnostic test that measures the electrical activity that occurs from nerve stimulation.The experts at NY Bone and Joint Specialists are able to read the graphs that measure these pulses and determine which nerves are acting abnormally. A Nerve Conduction Study is done simultaneously to locate any severe nerve damage. Once the source and severity of nerve dysfunction is determined, appropriate treatment plans can be constructed to alleviate symptoms.

Interventional Pain Management

Pain management methods are non-surgical procedures that aim to treat irreversible conditions and act as regular therapy to alleviate chronic pain when necessary. It is often used in conjunction with physical therapy to alleviate symptoms of conditions such as arthritis, disc damage, pinched nerves, or other joint disorders. Our pain management specialists can decide what type of injection is most appropriate after diagnostic tests that determine exactly which nerves or joints are the source of the pain. There are three types of injections which are most commonly used, and are effective in treating a number of conditions.

  • Nerve Root Blocks – This injection is fist used to determine exactly which nerve root of the spine is causing the problem. A needle is inserted precisely into a nerve root in the back, injecting a corticosteroid agent that will numb pain if that is indeed the source. If the injection is effective in relieving pain, it can be done as a regular therapy, blocking pain for weeks at a time, allowing a patient to perform physical therapy routines with less discomfort.
  • Epidural Steroid Injections – This form of therapy injects corticosteroids into the epidural space of the spine, targeting the nerve roots that may cause pain throughout the back, neck, and limbs. It decreases inflammation in the spinal canal which relieves pressure on the nerve roots, preventing pain for a certain time period.
  • Sacroiliac Joint Injections – This injection targets pain originating in the hip joints. The origin of the pain is first determined by injecting anesthetic into the joints. If the patient feels immediate relief in the hips and lower back, the sacroiliac joint injection would be effective. A mixture of corticosteroids is injected directly into the joints, reducing inflammation and alleviating pain and stiffness for a certain number of weeks at a time.
  • Read More About Other Interventional Pain Management Options Here.

Physical Therapy and Rehabilitation

Physical therapy and rehabilitation is a key element in recovering from injury or managing pain from conditions and diseases that affect the musculoskeletal or neuromuscular system. It is the most natural method of healing and is often the most effective. A physical therapist is able to construct a routine of specific exercises, modalities, and activities that target specific problem areas, treating them in ways that will relieve pain and prevent the pain from recurring. Physical therapy and rehabilitation is a very effective way to allow the body to heal injuries that are not severe enough to be irreversible without surgery.

Oftentimes injuries to muscles, ligaments, or tendons will be stretched and massaged until symptoms are alleviated, followed by strengthening of the tissues to prevent future injury. Routine therapy can also help manage pain caused by disease, such as degenerative disc disease or arthritis. Modalities, like ice or heat, are often used to alleviate symptoms, while strengthening of targeted areas makes the affected areas increasingly more resilient to pain.

Physical Therapy and rehabilitation is also crucial when recovering from surgery. Though surgery may correct an injury or defect, the healing process is essential in recovering function of a body part. Stretching and massaging the surgically treated area will increase flexibility and reduce internal scarring, allowing the body to heal with proper range of motion. Surrounding muscles and tissues also become weak after periods of injury and rest, so it is essential to build strength in the targeted area to support the corrective surgery.

Sports Medicine and Rehabilitation

Sports medicine is not only the treatment of  an athletic injury, but also a method of preventing injury and improving athletic performance. Sports injuries may come about gradually, causing damage to a heavily-used body part over the course of many workouts, or as a sudden accident. Trauma and repetitive motions are the most common onsets of pain and sports injury. There are numerous conservative methods in treating such ailments and many may be tried to find the most effective treatment plan for a particular patient’s injury.

Sports therapy and rehabilitation is usually the first option that a physician will recommend to their patients. Much like physical therapy, Sports rehabilitation uses a customized routine of modalities, stretches, and exercises that strengthen weak or damaged areas. Sports rehabilitation goes a step further in that a therapist will guide a patient through activities that correct athletic motions that cause stress or pressure on more delicate areas. It is essential to strengthen and maintain the muscles, tendons, and ligaments that support the joints during stressful, repetitive actions.

Platelet-Rich Plasma Therapy Injections

A Platelet-Rich Plasma injection is a therapy for chronic joint pain that is rapidly gaining support and notoriety in the physician community. This type of injection therapy aims to allow the the tissues of the body to heal themselves. It is not only effective in managing pain from chronic conditions such as arthritis, but is also effective in repairing injuries that have damaged soft tissue, such as ligament tears or tendinitis. The procedure begins with a a sample of the patient’s own blood, which is then manipulated until a plasma forms with a very high concentration of blood platelets. This plasma is re-injected into the painful area, where it sends growth signals to the body. New cells then begin to form, repairing the damaged tissues. Due to its minimal side effects, this procedure can be used as a regular therapy until pain subsides or the tissues have regenerated. It is often used in collaboration with a physical therapy regimen, which encourages blood flow to the area, further strengthening the immune system.

Women’s Orthopedics and

Pelvic Pain Management

Women often experience more complex musculoskeletal and neuromuscular pain than do men. The pelvis is a common source of discomfort in women, though pelvic pain may arise in males as well. During pregnancy a number of changes takes place in the female body that can stress the pelvic region, including the lower back and hips. Hormones are released that loosen sacroiliac joints of the hips in preparation for birth, making the pelvic region unstable as it supports added weight. This not only causes pain upon movement, but can compress nerves in the pelvis that lead to more serious symptoms, such as incontinence, pain during intercourse, and muscle spasms. Pelvic Floor Dysfunction can interrupt daily life functions and become severely painful. Pelvic issues, along with hip and lower back pain, can last long after pregnancy or occur without becoming pregnant at all. Our Women’s Health physician specializes in treating such issues through multiple, non-surgical methods, along with physical therapy.

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