Conditions and Treatments

“We Help When You Hurt”

We Have Treatments for these Conditions:

» Arthritis
» Shoulder pain
» Oseteo-arthritis
» Neuropathy
» Lower back pain
» Facet Syndrome
» Herniated discs & sciatica
» Tendonitis/bursitis
» Neck pain
» Joint Aches and Pains
» Headache
» Carpel Tunnel Syndrome
» Whiplash
» Sport injuries and acute sprains and strains
» Hip pain
» Work related injuries
» Knee pain and OA of the Knee
» Post CVA (stroke)

Methods of Treatment

Combination therapy:

As the name implies, combination therapy involves more than one modality in an effort to combine their individual therapeutic effects. It is a kind of best of both worlds treatment protocol. The goal is to hasten the healing process and improve treatment outcomes by combining the therapeutic benefits of more than one modality. It usually refers to the combination of ultrasound and some electrical stimulation, but also refers to the application of one or more of the treatment modalities listed below. For example, combining trigger point injections to relieve the acute pain with chiropractic adjustments, acupuncture / cupping, and Rapid Release Therapy simultaneously.

The utilization of combination therapies is highly effective treatment for trigger points, fibromyalgia, and sports and recreational injuries.

Chiropractic Adjustments:

Chiropractors gently restore misaligned vertebrae and other bony articulations by using manipulative procedures commonly known as adjustments. Recent studies indicate that 94% of manipulative therapy performed in the United States is performed by chiropractic doctors. In most cases chiropractors use their hands to skillfully apply corrective pressure in a specific direction at a specific location. In some cases adjusting instruments are used to accomplish or assist in correcting misalignments. The gentile force or thrust helps restore the alignment and mobility of the vertebrae, and to restore proper functioning of joints and articulations. Since the bones of the spinal cord are in close proximity to vital nervous tissue, misalignments can interfere with proper nerve functioning resulting in numbness, tingling, weakness, and organic and tissue dysfunctions. The correction allows weakened or injured muscles and ligaments to stabilize and heal, and attempts to restore proper nerve function.

Chiropractors are specialists in correcting subluxation and other misalignments, and helping to restore neuro-musculoskeletal integrity. Under normal circumstances, chiropractic adjustments are painless. Often patients report that they feel immediate improvement, increased mobility, and general feeling of well being after being adjusted. In cases of trauma, such as injuries resulting from car accidents, recreational or acute injuries, or conditions associated with spasm, or swelling, some discomfort may be experienced due to local injury and or inflammation. It is also common to feel a brief sensation in the area being adjusted following an adjustment due to the sudden decompression of affected nerves. As the condition is corrected and proper alignment and functioning are restored, the adjustment procedures are quite pleasant.

Adjustments Without Neck Twisting:

Chiropractic manipulations can be performed by utilizing adjusting instruments. This technique employs a hand held instrument called the “Integrator®” which automatically discharges a predetermined adjustment force when a predetermined contact pressure is reached at the specific point to be adjusted.  This allows the doctor to make a correction without “twisting or cracking” the neck. The instrument that was originally developed for research is now being used by specially trained chiropractors worldwide.

Spinal Decompression / Closed Disc Reduction:

Spinal decompression is a specific form of chiropractic adjustment of the intervertebral disc, posterior facet joints, and bony ligamentous canals of the spinal column. Closed disc reduction refers to attempting to decrease disc protrusions and herniations without surgery [hence the term “closed”]. The technique we utilize was originally developed by Dr. James Cox in 1973. The technique has advanced over the years through continued research and clinical validation. Dr. Michelli has been utilizing this technique with specialized equipment in combination with other spinal manipulations since 1981. Dr. Michelli is certified in Cox cervical and lumbar spinal decompression technique. The technique utilizes specific adjusting tables that are designed to:

  • Decompress intervertebral discs.
  • Adjust the position of the vertebra and the posterior facet joints.
  • Relieve nerve root pressure.
  • Reduce the effects of stenosis.
  • Decongest the inter-vertebral foramina.
  • Reduce the hydrostatic pressure inside the disc.
  • Free longitudinal adhesions.

In short the technique is designed to address the many component parts that give rise to the symptoms of low back pain and disc problems. The treatment goals are to relieve pain and improve posture and structural function, increase pain free range of motion and locomotion.

Guided Injections: Ultrasound & X-ray

Knee Joint Hyalgan Injections:

An estimate 21 million Americans have Osteo arthritis and it is the leading cause of work disability in the US The procedure of injecting Hyalgan into the Knee joint is called “visco-supplementation”. This program is a non-surgical FDA and Medicare approved knee treatment protocol. This intra-articular knee rehabilitation program is an 8 week program with a series of 5 weekly injections that are performed under fluoroscopic guidance. This real time guidance is necessary because precise placement is critical to maximize positive outcomes. Research studies have demonstrated that even in the hands of practitioners that are experienced with joint injections, in the absence of real time guidance the injections are often inaccurate1, and may contribute to incidence of local tissue damage.  The researchers that conducted the study commented that ” intra-articular injections are often inaccurate…inaccurate injections might contribute to incidence of local tissue damage (atrophy of soft tissue and fat). Surprisingly, accuracy at the knee and shoulder – the two most commonly injected joints was poor… These results may imply, however, that injection techniques need[s] to be refined”. This is why we perform the injections under real-time fluoroscopic guidance.

 The primary treatment goals are to reduce pain, improve joint function, improve quality of life, avoid knee replacement, and the toxic effects of other therapies.

[1] Accuracy of Needle Placement into the Intra-Articular Space of the Knee. Jackson, DW. Evans, NA. Thomas,BM The Journal of Bone and Joint Surgery (American) 84:1522-1527 (2002)

Physical ThrapyAdjunctive therapies

We utilize adjunctive therapeutic modalities and procedures in an effort to hasten recovery, reduce the pain, swelling, inflamation, and discomfort associated with acute injury, and to restore proper functioning with  rehabilitation. The particular choice of modality is made based on your history, examination results, and treatment goals.


Physical, chemical, and or mechanical, irritations cause the nervous system to respond by alteration of its normal physiological homeostasis [balance]. These alterations in nerve irritability, or deviations from normal nervous system functioning give rise to the signs and symptoms of injury, illness, and disease, including the perception of pain. Ultrasound is a very useful modality because is has mechanical, chemical, thermal, and neural effects that have been shown to have therapeutic benefits.

The most common conditions that ultrasound is indicated for are: treatment of joint contractures, pain, muscle spasms, peri-arthritis, trigger points/ fibromyalgia, and tendonitis etc. It can assist in the elevation of pain thresholds, and increases molecular movement known as “micro-massage” which results in increased membrane permeability and aids in the dispersion of fluids and metabolic byproducts.


Most electrotherapies are utilized to provide the same general therapeutic benefits. They increase local circulation and blood supply to injured tissue, stimulate motor and sensory nerves, restore proper muscle tone, and thereby hasten the resolution of acute and chronic inflammations and their by products. Different wave forms have been developed with the comfort of the patient in mind. Some wave forms have been shown to produce a particular therapeutic effect and others have been found to be more effective for specific purposes like muscular re-education, or to stimulate the rate of repair by rapidly promoting absorption and the removal of waste products.


For additional information regarding these and other services available at our office, please call 516.599.3999


We Have Treatments for these Conditions.

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