A nerve conduction study (NCS) is a test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body.
Nerve conduction studies are used mainly for evaluation of paresthesias (numbness, tingling, burning) and/or weakness of the arms and legs. Conditions like: Carpal Tunnel Syndrome, Nerve Injury of the Upper and Lower Extremities, Pinched Nerve in the Lower Back and Neck (radiculopathy), Neuropathy. The type of study required is dependent in part by the symptoms presented. A physical exam and thorough history also help to direct the investigation.

Aquatic therapy or pool therapy is physical therapy that is performed in the water. Aquatic therapy uses the resistance of water rather than weights. It aims to rehabilitate patients with injury and chronic illnesses by placing less stress on the joints during exercise.
Aquatic therapy can be performed on patients who plateau on land and experiences pain.   Heated aquatic therapy benefits are: decrease pain in arthritic joints, increase flexibility, reduces muscle spasm, increase circulation, increase diuresis and cell metabolism.

Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance the function, reduce pain and promote relaxation and well-being.

Acupuncture is the procedure of inserting and manipulating needles into various points on the body to relieve pain or for therapeutic purposes.  More broadly, acupuncture is a family of procedures involving the stimulation of anatomical locations on or in the skin by a variety of techniques.  The most thoroughly studied mechanism of stimulation of acupuncture points employs penetration of the skin by thin, solid, metallic needles, which are manipulated manually or by electrical stimulation.  Acupuncture needle does not pierce tissue, it only separates; the result is little to minimal pain and bleeding.

Physical therapists provide services to individuals and populations to develop and maintain to restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by aging, injury, disease or environmental factors. Functional movement is central to what it means to be healthy. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, treatment/intervention, habilitation and rehabilitation. This encompasses physical, psychological, emotional, and social well being. Physical therapy involves the interaction between physical therapist, patients/clients, other health professionals, families, care givers, and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skills unique to physical therapists.

Chiropractic is a health care discipline and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system. The main chiropractic treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues; treatment also includes exercises and health and lifestyle counseling. Traditional chiropractic assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function. The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become restricted in their movement as a result of tissue injury. Manipulation of the affected joint and tissues restores mobility, thereby alleviating pain and muscle spasm, and allowing the tissues to heal.

A personal trainer is a person who helps people exercise. The scope of practice for a personal trainer is to enhance the components of fitness for the general, healthy population. The five classic components of fitness are muscular strength, muscular endurance, body composition, cardiovascular endurance, and flexibility, although there are other subsets like power, skill, and speed. The personal trainer can be use as an adjuvant to medical treatment to increase strength, endurance loss from immobility of a medical condition.

Platelet-rich plasma (PRP), the first practical application of tissue engineering, has produced a respectable database of research findings and clinical outcomes in a variety of settings. A concentrated source of autologous platelets, PRP contains and releases (through degranulation) at least seven different growth factors (cytokines) that stimulate bone and soft tissue healing. The separation and concentration of the platelets is an exact science. Extreme care must be taken when blood products are harvested and processed.
Because of factors involving its availability and cost, platelet-rich plasma (PRP) has become an increasingly popular clinical tool as an alternative source of growth factors for several types of medical treatments. PRP injections can be performed in tendons and ligaments all over the body. Sports injuries, arthritic joints, tennis elbow, carpal tunnel syndrome, ACL tears, shin splints, rotator cuff tears, plantar fasciitis and iliotibial band syndrome may all be effectively treated with PRP. PRP is a natural approach to healing tendon, ligament, and joint injuries. The procedure is less aggressive and less expensive than surgery. It allows your body to heal itself. PRP will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues.
To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and automatically produces the PRP. The entire process takes less than 15 minutes and increases the concentration of platelets and growth factors up to 500%. When PRP is injected into the damaged area it stimulates the tendon, ligament, joint, cartilage, causing mild inflammation that triggers the healing cascade. As a result new collagen begins to develop. As this collagen matures it begins to shrink causing the tightening and strengthening of the tendons or ligaments of the damaged area.
Research and clinical data show that PRP injections are safe, with minimal risk of adverse reaction or complication. Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long term healing. PRP therapy is healing and strengthening these tendons and ligaments, thus strengthening and thickening the tissue up to 40% in some cases. Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery as well as a remarkable return of function.
While responses to treatment may vary, most people will require from one to a maximum of three treatments. There is no limit to the number of treatments you can have, if the treatments are spaced appropriately. The risks and side effects do not change with the number of injections. Your doctor will discuss this with you.

Please view this informative article on PRP uses in treating Tennis Elbow.

Trigger points or trigger sites are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. Trigger point practitioners believe that palpable nodules are small contraction knots and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. The local twitch response is not the same as a muscle spasm, this is because a muscle spasm refers to the entire muscle contracting whereas the local twitch response also refers to the entire muscle but only involves a small twitch, no contraction.
Trigger points can cause pain and restrict range of motion. Trigger points become symptomatic when a muscle is mechanically or metabolically stressed, such as maintaining a static position for long periods of time, or when a muscle is fatigued from repeated use. Trigger points may not be released spontaneously or manually through physical therapy. In these circumstances injecting the trigger points can be an effective means of inactivating them, releasing the taut muscle to restore range of motion and decrease pain.
Trigger point injection is commonly performed with local anesthetic such as lidocaine. Lidocaine is mixed with saline to achieve the therapeutic dilution, and then injected directly into the muscle. After the injections, the patient is placed under a heat lamp for 15 minutes to further facilitate muscle relaxation. To help further relieve pain, you may receive electrical stimulation to the muscle. The injection will need to be repeated every 1-3 weeks up to 4 times, though the time and number of injections needed varies by patient.

Steroid (cortisone) injections are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly a steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit. While the effects of the injection tend to be temporary - providing relief from pain for one week up to one year - an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial injection is effective for a patient, he or she may have up to three in a one-year period. At the Truong Rehabilitation Center, all steroid (cortisone) injections are performed with ultrasound guidance for precision, resulting in increased effectiveness, less adverse effects, less needle pain, and require fewer medications.

While most people are familiar with the use of diagnostic ultrasound to visualize a fetus in a mother's womb, such sonography is in many cases the radiologic method of choice in visualizing tendon, ligament, bursa and muscle. In the field of radiology, diagnostic ultrasound is widely accepted as a standard imaging method for extremity joint problems. For example, our high frequency ultrasound imaging of shoulder rotator cuffs and knee collateral ligaments provide higher resolution and significantly more detail than MRI.
Ultrasound imaging, also called ultrasound scanning or sonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound exams do not use ionizing radiation (as used in x-rays). Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels.
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.  Ultrasound images of the musculoskeletal system provide pictures of muscles, tendons, ligaments, joints and soft tissue throughout the body.

SDT treatments are one of the most gentle and comfortable therapies available. The treatments utilize equipment with proven safety and efficacy. Most patients report a mild sense of stretch on their backs or hips and often fall asleep during treatment sessions. Decompression therapy is similar to traction however the advances in equipment and procedures make this a new and highly effective form of care. Continual improvements in the delivery system and regular updates in protocols keep SDT in the forefront of non-invasive disc therapy. CLICK FOR A DOWNLOADABLE SDT BROCHURE.

Adult Mesenchymal stem cells (MSCs), are multipotent stem cells that can differentiate into a variety of cell types, including: osteoblasts (bone cells), chondrocytes (cartilage cells and tendons) and adipocytes (fat cells).   MSCs are obtained from the bone marrow, most commonly from the back of the iliac crest (or "hip bone”).Harvesting MSCs for injection therapy is done right in the office. First, the skin is numbed with lidocaine. Then, the hip bone is numbed so that the stem cells can be extracted from the bone without pain. A special needle is then passed through the cortex of the bone into the marrow cavity. This is a painless procedure in most cases.  The liquid marrow is then slowly drawn into a syringe. Once an adequate amount of liquid marrow is obtained, the needle is removed and a bandage applied. The syringe containing the liquid marrow is then placed in a special centrifuge. After the marrow is spun, the highly concentrated stem cells are then passed into a new syringe, from which the injection is given. The entire procedure takes about one hour and is minimally uncomfortable.
CLICK HERE FOR MORE INFORMATION ON ADULT STEM CELL THERAPY