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Posted on 07-15-2018

Summary Of Treatments at Mid-Atlantic Spinal Rehab & Chiropractic

As my avid blog followers are already aware, I am a Baltimore Chiropractor with now five clinics in Metropolitan Baltimore. In addition to clinics in Northwest Baltimore (Park Heights Avenue) and Downtown Baltimore (Fells Point, Eastern Avenue), we also have clinics on Wilkens Avenue (Catonsville), Dundalk (North Point Blvd.), and in Glen Burnie (Baltimore Annapolis Boulevard). Some of the questions that keep coming up when I meet prospective patients is - what is a Chiropractor? What services do you provide in your clinics? Can you help me and my particular situation?

It made me realize that it was probably time to come up with a blog post that deals with specifically all of the therapeutic services that we provide. That way they are all located in one place and if anyone has any specific questions about a particular procedure they can ask me. So in no particular order here is a summary of the therapeutic procedures that my clinics provide:

  • Initial Evaluation:

During your first visit you will receive an initial evaluation in order to determine the treatment plan that best suits your individual needs. This evaluation will include a complete history, physical examination of presenting musculoskeletal symptoms, range of motion evaluation, orthopedic evaluation, neurological examination, chiropractic examination, and x-ray evaluation if clinically indicated. At the end of the initial evaluation we will have determined your working diagnosis (what is wrong), prognosis (how likely you are to make a complete recovery), and treatment plan (what we intend to do to help you get back to normal).

  • Re-Evaluation:

You will undergo a periodic re-evaluation of your condition approximately every 10-12 visits, or every 4 weeks, whichever occurs first. We will assess how well you are responding to treatment and we will make future treatment recommendations at that time. Those recommendations may include referrals for advanced imaging or for co-treatment with other specialists such as orthopedists or pain management doctors, depending on your response to treatment up to that point in care.

  • Final Evaluation:

All good things must come to an end. Once it is determined that you have reached Maximum Medical Improvement (MMI) for your injuries a final evaluation will be performed. During the final evaluation your provider will determine what subjective complaints you have remaining. We will perform repeat physical evaluations, range of motion evaluations, and orthopedic evaluations. You will be released from our care with instructions on what to do if your pain or symptoms return.

  • Moist Heat Packs:

One or more moist heat packs are wrapped in several layers of towel and placed on the area of complaint. Moist heat promotes healing by improving circulation. This allows muscles to become more elastic giving relief from muscle tension and spasms.

  • Cold Packs:

One or more cold packs are wrapped in a towel and placed on the area of complaint. Cold packs reduce inflammation and swelling that occur following an injury.

  • Electrical Muscle Stimulation:

Electrodes are placed on the skin by a professional who increases the muscle stimulation to the patient’s tolerance. This therapy improves circulation and decreases inflammation treating muscle pain and spasm. The electric muscle stimulation therapy also helps to “trick the brain” by overriding its pain signals with low voltage, thus helping reduce pain.

  • Mechanical Traction Table (Roller Table):

Patient is placed face up on an intersegmental traction table while a mechanism applies pressure to different regions of the spine. This therapy induces passive motion to the spinal joints thus increasing the flexibility of the spine and promoting healing. Each joint segment (where two spinal vertebrae connect) is stretched using the patient’s body weight and a rolling lever to passively separate joint articulations one-by-one from the neck all the way to the lower back.

  • Ultrasound:

Professional applies the ultrasound using an applicator and a water-based gel to the area of complaint. Ultrasound generates heat using sound waves that can penetrate deeper into the musculature then a moist heat pack. This form of deep heat increases blood flow and promotes healing. This treatment is used very commonly with swollen joints to help reduce joint swelling (edema). We often also use ultrasound on very bony joints (i.e. wrists, hands, ankles, feet) where the application of heat may be less appropriate.

  • Therapeutic Exercises:

Professional will instruct the patient on various exercises to be performed. The professional will increase the duration, repetitions and difficulty depending on individual patient need. This type of exercise helps to increase range of motion and promotes muscle healing. It also facilitates the patients return normal activities of daily living. Therapeutic exercises can be performed either in an individual (one-on-one) or group setting.

  • Massage Therapy:

The chiropractor will use his/her hands and/or a series of tools that uses vibration to massage the tissues that require treatment. This therapy causes relaxation of the muscles, increased blood flow and softens muscle adhesions promoting healing of the injured areas. Massage therapy is directed to the soft tissues (muscles, tendons, ligaments, etc.) rather than to the spinal joints.

  • Manual Therapy:

The chiropractor will use his/her hands or a series of tools to apply focused pressure to stretch tight and tender muscle fibers. This procedure includes manual traction therapy and myofascial release treatment. The goal of this treatment is to increase a pain free range of motion and to facilitate a return to functional activities. Manual therapy is directed to the soft tissues (muscles, tendons, ligaments, etc.) rather than to the spinal joints.

  • Chiropractic Spinal Manipulation Therapy:

The chiropractor will use his/her hands or an adjusting instrument to impart a controlled force to a joint resulting in mobilization or manipulation of that joint. Inducing motion into a joint increases range of motion and improves tissue circulation promoting healing. Chiropractic manipulation ranges in intensity from spinal mobilization (passively moving joints to their end range of motion as performed by a Chiropractor’s hands), to instrument assisted mobilization (using tools to tap the vertebrae to induce spinal motion), to drop techniques (utilizing momentum from a table to drop out beneath a joint) to high velocity low amplitude spinal manipulation (the traditional joint manipulation most people associate with chiropractic manipulation). It is very important to note that not all patients have spinal conditions which indicate traditional spinal manipulation, and as such, the providers may need to utilize alternative and less invasive techniques to impart the desired spinal mobilization/manipulation indicated for a particular patient. In short, we will impart spinal mobilization/manipulation beginning will less invasive and working towards more invasive techniques as clinically indicated and as tolerated.

I recognize that this is a fairly long list. So if you require further explanation let us know and one of the many chiropractors and support staff at Mid-Atlantic Spinal Rehab & Chiropractic would be happy to help you.

Dr. Gulitz

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