A New Era in Non-Operative Spine & Musculoskeletal Care
Where you receive the initial treatment for your pain can make all the difference.
New York Spine & Sport Rehabiliatation Medicine PC is dedicated in bringing patients to their optimal level on function through a multi-disciplinary approach of providing individualized management options. Focus is on quality and outcome of patient care with emphais on communication with the patient and the patient’s referring provider to facilitate continuation of care in the patient’s home community.
Our team of board certified pain specializing MDs and PAs of physical medicine, rehabilitation medicine and anesthesiology background bring decades of clinical expertise to specialize in the non-operative treatment options related to spine, sports, joints, musculoskeletal, nerve and regenerative medicine .
Our clinical philosophy is to not only specialize in the clinical comprehensive management of most acute, subacute and chronic pain conditions, but also understand the patient that has the pain. Each pain patient is then managed using a multidisciplinary approach with treatment targeted at not only the condition causing the pain, but also the related co-morbidities of chronic pain , such as sleep, mood, emotional disorders, lifestyle modifications etc.
Natural history of the pain condition from simple conditions to complex pain syndromes, is explained in detail with various state of the art treatment options in consideration.
We use the latest and most advanced available treatment options to not only minimize pain , but more importantly to improve physical, mental and emotional function. From traditional acupuncture, therapeutic massage, active patient specific physical therapy, ergonomics, injury prevention, psychological screeening, weight loss program to interventional pain management techniques to get to source of pain and advanced pain interventions such as spinal cord stimulator and neuromodulator program, kyphoplasty, percutaneous disc decompression techniques and others, we are dedicated to limit patient pain suffering and improve quality of life.
We believe where you get the initial treatment for pain can make all the difference. Combining active and targeted physical rehabilitation therapies with advanced pain management interventions is key for early recovery and favorable outcome. Inadequately treated pain can lead to the development of chronic pain syndromes with its debilitating multi-system & organ impairments.
Often the only treatment required maybe a tailored, physician directed and patient specific physical therapy program. A spine physical therapy program may include a progression from emphasis on pain reduction to stabilzation exercises to gym program. Therapeutic exercises are geared to each patient’s medical condition, co morbidities, level of activity and return to physical function. Certain physical exercises, if not tailored to condition and patient can render treatments ineffective or even worsen the condition. Passive and prolonged physical therapy or chiropractic treatments often only relieve pain temporarily and inadequately often promoting further disuse, dysfunction, disability and depression (the 4 D syndrome). We recommend and highly emphasize an active physical therapy such as soft tissue flexibility, joint mobility, abdominal program, posture, body mechanics, ergonomics and if needed modalities for spine pain .
Medical advice integral for long-lasting results in musculoskeletal conditions such as continuation of home therapeutic exercises, improvement of aerobic conditioning with overall fitness, lifestyle changes, weight loss and smoking cessation are strongly advised. This has been shown to be the most effective modality in managing most pain condition, especially in the long run
The goal of interventional pain management is to control pain to facilitate rehabilitation and improve function. This may aid in breaking the pain cycle of drug dependence and disuse. Interventional pain injections/interventions are performed to direct potent medications and or heat waves to the precise source or interface of the pain. Use of steroid reduces inflammation and swelling of targeted nerve roots in the epidural or joint interface to relief pain, tingling and other symptoms. The fluoroscope allows pinpointing the pain source safely and precisely. This also allows use of lower steroid dose and number of procedures done per patient. By locating the source of the pain and controlling it, the body is given a chance to recover from the pain, avoid drug dependence, disability and improve quality of life. These injections can help diagnose and treat the source of the pain. These interventions can be indicated for patients who have significant pain scales, have used various pain medications and/or wishes to limit narcotic use or dependence, have significant limitations in activities/function and have tried conservative care such as physical therapy with limited and temporary relief. Possible benefits, side effects, complications and alternatives are discussed in detail. No contraindications should be present.
Adult Stem Cells/ PRP/ Regenerative therapy can be provided as a treatment option. One of the most exciting recent developments in the treatment of chronic musculoskeletal conditions is the use of adult mesenchymal stem cells (MSCs). Adult mesenchymal stem cells are undifferentiated cells that have the potential to become other more specialized types of cells. They can be isolated from your own body or allograft BioD, processed and re-injected back in the same body at the damaged, injured or arthritic and painful affected area. Regenerative therapy is an outpatient procedure that is done at the point of care. It involves the application of a concentrated form of platelet rich plasma (PRP), and/or bone marrow aspirate or adipose (fat) tissue to the affected area. Patient has undergone physical therapy, pain medications, local joint injections and other less invasive treatments. The intent of this treatment is to relieve pain and improve function, but there have been reports of cartilage thickening and many patients have successfully delayed or avoided surgery.
Spinal Cord Stimulator (SCS)/ neuromodulation program: If pain relief with pain management blocks (such as sympathetic, epidural and or other blocks as clinically applicable), other less invasive treatments and medications are limited or short term, the patient can be a candidate for longer lasting therapy such as Spinal Cord Stimulation. The patient’s clinical examination should be consistent with chronic pain syndrome secondary to chronic neuropathic pain from any cause, commonly from lumbar radiculopathy and post-laminectomy syndrome. There is plenty of evidence in the literature for the safety and effectiveness of SCS in these conditions. The SCS trial is intended if the patient is a candidate for the permanent implantation of SCS device. The SCS trial procedure involves insertion of temporary (trial) electrodes, and if successful in reducing pain, followed by a permanent implantation with minimal surgical technique. This procedure is effective and may in turn reduce pain, related symptoms and improve physical and mental function.
Opioid prescription in our practice: Certain pain conditions may necessitate the use of opioids in our clinical practice, especially for severe acute or subacute (less than 4-6 weeks) pain.
Opioid medications should be tapered to the minimum dose needed and the ultimate goal to use only nonopioid therapeutic pain management. Patient will continue with non-opioid pain managment options including as appplicable non-narcotic pain medications, acupuncture, physical therapy, pain management interventions, psychological, lifestyle modications and surgical corrective surgery as and if indicated. The patient was explained the goals of short term narcotic management. The natural history of the present illness is therefore taken into consideration.
New York Spine & Sport Rehabiliatation Medicine PC is dedicated in bringing patients to their optimal level on function through a multi-disciplinary approach of providing individualized management options. Focus is on quality and outcome of patient care with emphais on communication with the patient and the patient’s referring provider to facilitate continuation of care in the patient’s home community.
New York Advanced Surgical Intervention Care
New York Advanced Surgical Intervention Care is dedicated to provide quality Office Based Surgery (OBS)/ Anesthesia Care with requirements as per the new public health law regarding OBS and as designated by Commissioner of New York State.
Sireen Gopal, MD
President & Medical Director
Clinical Assistant Professor Albert Einstein College of Medicine
New York Spine & Sport Rehabilitation Medicine, PC
New York Advanced Surgical Intervention Care, PLLC
President & Co-Founder
New York Medicine Doctors PLLC
