Specialist Neck Doctors in San Francisco

What Sets Our Neck Pain Treatment Apart

Drs. Irène & Robert Minkowsky are physiatrists, osteopaths and orthopedic medicine specialists who have been in practice for over 30 years, treating and helping individuals with neck pain. Head or neck trauma, sports injuries, spinal stenosis with nerve compression, disc pathology, facet arthritis, and TMJ can all produce neck pain.

Neck Pain Treatment & Management

A variety of treatments are effective for both acute and chronic neck pain. They include osteopathic manipulation, myofascial release, craniosacral work, therapeutic exercise, improved ergonomics and movement reeducation and proliferative injections.

Drs. Irène & Robert Minkowsky provide treatment for both acute and chronic neck pain. The key is in a thorough medical history and detailed physical examination. They will diagnose your neck pain and provide a comprehensive and effective treatment plan. They look forward to working with you.

Located in SF, our physiatrists use nonsurgical and nonpharmacologic treatment to resolve musculoskeletal issues.

Common Neck Pain Issues We Can Help Address

Understanding Cervical Radiculopathy and Neck Pain

Are you experiencing neck pain that radiates down your arm and causes numbness or weakness in the hand? If so, you may be suffering from cervical radiculopathy. We’re here to help you better understand and manage this condition.

Also known as a pinched nerve, this occurs when a nerve root in the cervical spine (neck) is compressed or irritated. This compression can result from a variety of factors, including herniated discs, bone spurs, or degenerative disc disease. The pressure on the nerve can lead to pain, numbness and tingling that radiates down the arm into the hand or weakness in the arm or hand.

Several factors can contribute to the development of cervical radiculopathy, including:

• Herniated Discs: When the soft inner core of a spinal disc pushes through the tough outer layer, it can irritate or compress nearby nerve roots.
• Degenerative Disc Disease: Chronic postural stress on the discs in the spine can cause them to lose height and bulge, putting pressure on nerve roots. This coupled with the development of bone spurs and arthritis in the neck creates a narrowing of the spinal canal or foramen where the nerve exits. This condition is known as spinal stenosis.

The most common symptoms of cervical radiculopathy include:

• Neck pain: The pain may vary in character, but is frequently increased with movement.
  Range of motion: This may be decreased and painful.
• Arm pain: Pain that radiates down the arm, often following a specific nerve pathway and may be accompanied by numbness and or tingling in the arm or hand.
• Weakness: Muscle weakness in the arm or hand, making it difficult to grip or hold objects.

The usual approach is to see an orthopedic surgeon, get an MRI, go to physical therapy (PT), take an anti-inflammatory medication such as ibuprofen, and if not better, be offered surgery as the best treatment option. For those seeking a more thoughtful and natural approach to managing cervical radiculopathy, there are many other treatment options available.

At the Physicians’ Back Institute, Doctors Irène and Robert Minkowsky thoroughly evaluate and analyze all of the various factors that may be contributing to a patient’s problem and causing their symptoms. They do this by taking a detailed history of the patient’s condition and all of the factors that may be influencing it. This is followed by a detailed comprehensive physical examination. By the time they have finished a consultation visit, they have a clear diagnosis and blueprint as to how to improve the patient’s situation. Imaging is only done to confirm a diagnosis, not to make one. Treatment usually includes correcting postural stresses through improved ergonomics, a therapeutic home exercise program and osteopathic manual therapy to address functional imbalances in the body. These imbalances may be in the cranium, cervical and thoracic spine, rib cage or viscera. Addressing all of the issues improves the likelihood of successful resolution of symptoms.

Understanding the Relationship Between Spinal Stenosis and Neck Pain

Have you ever experienced persistent neck pain that just won’t seem to go away? You’re not alone. Neck pain is a common complaint that many people face, and one of the frequent causes is spinal stenosis.

What is Spinal Stenosis?

Spinal stenosis is a condition characterized by a narrowing of the space within the spine, where the spinal cord and nerves reside. This narrowing can occur in different parts of the spine, but most importantly in the neck (cervical spine) or low back (lumbar spine) region.

How Does Spinal Stenosis Lead to Neck Pain?

When the spinal canal in the neck becomes narrowed, the nerves that exit the spinal cord and travel to the arms, shoulders and hands may be compressed. This compression can result in various symptoms, with neck and arm pain being the most common. The pain can be accompanied by numbness, tingling, and weakness in the arms and hands.

Diagnosing and Treating Spinal Stenosis-Related Neck Pain

If you are experiencing persistent neck pain, a diagnosis as to the causes of the condition needs to be established. Contrary to popular belief often, held by individuals and doctors alike, it does not start with an MRI scan. It begins with a thorough clinical evaluation, for if all factors are not diagnosed and addressed, even surgery will not provide long term benefits.

There are many treatment options for spinal stenosis-related neck pain. Conservative treatment options include correction of postural stresses and body mechanics, a therapeutic home exercise program, cervical traction and anti-inflammatory medication. These measures provide immediate and long-lasting relief in the majority of situations. Although often proposed, surgery is only rarely necessary for relief of symptoms. Even if surgery is performed, a long-term cervical home program is necessary for neck stability and to prevent a recurrence of symptoms.

Preventing and Managing Neck Pain from Spinal Stenosis

Everyone ultimately does develop the structural changes of spinal stenosis, but not everyone is symptomatic from them. There are usually other factors that make the condition symptomatic. The key is to optimize function in the face of structural changes that we all develop.

• Maintaining good posture can alleviate pressure on the spine, slow disc deterioration and the arthritic changes that result from this. Optimizing ergonomics in the workplace (standing desk, computer) and in daily life (cell phone) is an important part of eliminating postural stresses.
• Gentle exercises to help strengthen the deep muscles supporting the neck, stretching large cervical muscles, improving shoulder rounding and strengthening shoulder muscles all take pressure off of the neck, improve symptoms and reduce the risk of recurrence.
• Traction, either manual or using a mechanical device.

By incorporating these strategies into your daily routine, you can effectively manage and potentially prevent neck pain associated with spinal stenosis.

Healing Herniated Discs with a Holistic Approach

Are you one of the millions of people suffering from the debilitating pain of a herniated disc? Have you tried various treatments with little to no relief? Knowing that 93% of lumbar disc herniations heal without surgery, it might be time to consider a holistic nonsurgical approach to heal your herniated disc. In this comprehensive guide, we will explore what a holistic approach entails and how it can help you find long-lasting relief and healing.

What is a Herniated Disc?

A herniated disc, also known as a slipped or ruptured disc, occurs when the soft inner core of a disc in the spine leaks out through the tough outer layer. This can lead to pain in the back or neck and, if nerves are irritated by the disc protrusion, radiating pain, numbness and weakness in an arm or leg can occur.

Traditional Treatments vs. Holistic Approach

Traditional treatment for herniated discs often includes medication, physical therapy, epidural injections, and occasionally surgery. While these treatments can provide temporary relief, they often fail to address the root cause of the issue. Spine surgeons rarely have much to recommend other than surgery. Most medical practitioners are at a loss at what to do and when to do it. This is where the comprehensive approach developed by the doctors at the Physicians’ Back Institute comes in.

A holistic approach to healing herniated discs focuses on treating the body as a whole, addressing not just the immediate physical symptoms, but also discovering the reasons the issue occurred in the first place. This may include poor body mechanics, lack of core muscle strength and stability and lower extremity muscle imbalance. This approach aims to restore balance and harmony to the body, helping it to heal naturally and effectively. The goal is not to get in the way of what the body does naturally, but rather to encourage and facilitate it on this path. Under the care of the physicians at the Physicians’ Back Institute, it is the rare exception that individuals with disc herniations require surgery.

Components of a Holistic Approach to Healing Herniated Disc

Herniated discs can cause excruciating pain and limit your ability to perform daily activities. Desperate for relief, patients often turn to orthopedic or spine surgeons as a first line of treatment. Before they know it, they are offered a surgical solution without being offered the opportunity of a less invasive solution.

At the Physicians’ Back Institute every patient is carefully evaluated and a treatment program tailored to the individual’s needs. A diagnosis is made on the basis of taking a detailed history and performing a physical examination. Most treatment can be initiated without requiring the results of x-rays or MRI imaging. The doctors Minkowsky have extensive experience in finding the right balance of exercise and lifestyle modification to help their patients recover from the most severe problems.

Anti-inflammatory medication is used for acute pain. If severe, an oral course of prednisone is prescribed. Response to prednisone is frequently a predictor of how a patient with a disc herniation will manage with a conservative treatment program.

Exercise; A therapeutic home exercise program focused on strengthening transversus abdominis and gluteal muscles to stabilize the spine and pelvis is often prescribed. Passive positions such as one with the legs on a chair or coffee table with bent knee alleviate spine pressure, open the spinal canal and openings for the nerves and is often helpful in diminishing pain. Knowing when to introduce yoga, Pilates or swimming into a rehabilitation program without triggering a flareup comes from years of experience. One size never fits all and the exercise treatment plan is unique for each individual.

Nutrition plays a crucial role in healing herniated discs. A diet rich in anti-inflammatory foods such as leafy greens, fatty fish, and berries can help reduce inflammation and promote healing. Additionally, staying hydrated and maintaining a healthy weight can alleviate pressure on the spine and improve overall spinal health.

Stress and anxiety can exacerbate pain and slow down the healing process. Mind-body techniques such as meditation, deep breathing, and mindfulness can help calm the nervous system and reduce pain perception. By incorporating these practices into your daily routine, you can improve your mental well-being and accelerate the healing of your herniated disc.

Exploring Alternative Therapies for Myofascial Pain

Are you tired of living with the constant discomfort and limitations that come with myofascial pain? Have you tried traditional treatments without finding the relief you seek? If so, it may be time to explore alternative therapies that can offer a new path to managing your symptoms and improving your quality of life.

Myofascial pain syndrome is a chronic condition characterized by localized muscle pain and tightness. It is often caused by muscle overuse, injury, or stress, leading to the development of trigger points within the muscle tissue. These trigger points can cause referred pain, muscle stiffness, and limited range of motion.

Myofascial pain usually has some underlying cause and this needs to be understood in order for a treatment program to provide long lasting relief.

Alternative Therapies for Degenerative Disc Disease

Degenerative Disc Disease is a common condition where the discs in the spine dry out. This can lead to pain, stiffness, and limited mobility, affecting quality of life.

Are you one of the millions of people suffering from Degenerative Disc Disease (DDD)? If so, you know firsthand the debilitating pain and discomfort it can cause. Traditional treatments such as medication, physical therapy, and surgery may not always provide the relief you seek. That is where alternative therapies come in. What is interesting about this condition is that disc degeneration alone usually does not cause pain. Everyone develops this condition, yet not everyone has symptoms. Other factors such as sedentary life style, poor conditioning, being overweight, stiff joints and inflexibility are all important factors in determining whether this condition is an MRI diagnosis without physical manifestations or a condition affecting one’s wellbeing.