FAQs
GENERAL FAQ
What are the benefits of multidisciplinary treatment?
How do I know what kind of treatment I need? How long will it take?
I have never had Physical Medicine before, what can I expect on the first visit?
Are all the practitioners licensed?
How soon will I feel better?
Did you just open Performance Rehab?
Do you have X-ray capabilities? How About MRI? What about Neuro Diagnostic equipment?
What is the cost?
What insurance do you accept?
Do I have to do Medical, Chiropractic, Physical and Massage therapy treatments?
How do I make an appointment?
DRX9000™ SPINAL DECOMPRESSION FAQ
What is Spinal Decompression and how does it work?
What is spinal manipulation?
Do I have a pinched nerve?
Do I have a slipped disc?
How long will I need treatment?
Is it safe for pregnant women?
Can I get spinal manipulation if I've had back surgery?
I have Osteoporosis, can I get spinal manipulation?
How does manipulation help my disc problems?
What causes lower back pain?
If I undergo DRX9000™ treatment, how long does it take to see results?
How long does it take to complete DRX9000™ treatment?
Do I qualify for the DRX9000™ treatment?
Are there any side effects to the DRX9000™ treatment?
PAIN MANAGEMENT FAQ
What is an Epidural Steroid Injection?
What is the goal of the injection?
How is the injection performed?
How long does the injection take?
How many injections will I need?
What are the expected results?
What are Trigger Points?
What are Trigger Points Injections?
What should I expect after the injection?
What is Facet Joint Injection?
Who is a candidate for Facet Joint Injections?
How long does the injection take?
What can I expect after the injection?
What is Radio Frequency Lesioning?
Am I a candidate for Radiofrequency Lesioning?
How long does the proceedure take?
How is it actually performed?
What should I expect after the procedure?
What are the benefits of multidisciplinary treatment?
Certain cases require multiple types of treatment in order to be addressed properly. In the past, patients would be required to visit multiple providers at different locations to obtain multidisciplinary care. Performance Rehabilitation's state-of-the-art facility allows you to consult with medical and chiropractic physicians, physical therapists, massage therapists, spinal decompression specialists, neuropathy experts and more - all under one roof. Here, you can conveniently access a wide range of services that may be used individually or in conjunction with each other to successfully treat: chronic or acute conditions.
How do I know what kind of treatment I need? How long will it take?
It never hurts to research your symptoms and educate yourself about any conditions you may have. But when it comes to treatment, it is highly recommended to let trained professionals decide on the best course of action. After a thorough examination, which may involve X-ray, MRI or other diagnostic tests, our specialists will advise the therapy program that is most suited to your needs, schedule and lifestyle.
Treatment session times vary and depends on the patient's needs.
I have never had Physical Medicine before, what can I expect on the first visit?
During your first Physical Therapy visit, a licensed Physical Therapist will review your medical history and do a physical evaluation, which may include measuring your strength, balance, flexibility and coordination. Goals will be assessed and a treatment plan outlined. Actual therapy may or may not begin during your first visit.
Because exercise is a common component of Physical Medicine, you may experience tenderness or soreness during or after treatments. Some of these exercises will likely need to be done at home. Your Physical Therapist will continually monitor your reaction and make any adjustments necessary to keep risk of injury low. In some cases, the use of special equipment will be recommended, such as splints, crutches or specific footwear.
As your pain, swelling and disability decrease - and your strength, flexibility, and endurance increase, your
Physical Therapist will alter your program accordingly, with the ultimate goal of reincorporating all of your
normal daily activities into your lifestyle, without any pain or discomfort. For more information about Physical
Medicine, click here.
Are all the practitioners licensed?
Yes, our team of doctors and therapists at Performance Rehabilitation are fully licensed and board certified
in their respective disciplines. To learn more about our highly qualified and dedicated team, click here.
How soon will I feel better?
We aim to help patients start feeling better as soon as possible. Many of our patients notice an improvement after their first visit, but each case is unique. Much depends on the extremity of your existing condition and your body's response to the prescribed program of treatment. Most of all, your hard work and dedication to your own therapy will be the biggest factor in your healing and recovery process.
Did you just open Performance Rehab?
Performance Rehabilitation has been serving the communities of Watchung and Somerset since 1999. Our state-of-the-art equipment is updated regularly, and the Center was recently renovated to ensure the comfort of our patients. We are currently in the process of opening a second office in Hunterton County, NJ. Please contact us if you want to learn more about when the new location will be open.
Do you have X-ray capabilities? How About MRI? What about Neuro Diagnostic equipment?
Convenience for our patients is a key focus. We offer X-ray and Neuro Diagnostic capabilities on-site in addition to a
wide array of other equipment. MRIs are offered off site.
What is the cost?
It is our goal to make quality care affordable for just about anyone. Costs are generally assessed
on a per-visit basis or care basis. You may inquire about cost-per-treatment before beginning your
program. At Performance Rehabilitation, we also accept many types of insurance.
What insurance do you accept?
Please visit out insurance information page to see a full list of insurance companies accepted and other health plan information.
Do I have to do Medical, Chiropractic, Physical and Massage therapy treatments?
Though multidisciplinary treatment can be highly effective, it is not always necessary for every patient. In certain cases, one type of treatment will be sufficient to address your specific needs. Our mission is to improve your quality of life and get you back to your peak physical performance. We will prescribe only the treatments that are appropriate for your diagnosis. In some cases, treatments may be added to or removed from your regimen, based on your progress and prognosis.
How do I make an appointment?
You can make an appointment by calling our main office at (908) 756-2424. Office hours vary and are by appointment.
Please call for an appointment today! To save time at the office, feel free to print and fill out our New Patient
form below. To learn more about our facility and for directions, click here.
What is Spinal Decompression and how does it work?
Spinal Decompression Therapy DRX9000C is 100% non-invasive and can be used as an alternative to back surgery.
By enlarging the space between the discs, oxygen and nutrients are encouraged to flow to the discs and promote
overall health. For more detailed information about Spinal Decompression, including videos, 3Dtutorials,
and testimonials, click here.
What is spinal manipulation?
Spinal manipulation is using a specific force in precise direction, applied to a joint that is fixated, 'locked up' or not moving properly. A spinal manipulation adds motion to the joint, helping the bones gradually return to a normal position and motion. The purpose of this safe and natural procedure is improved spinal function, improved nervous system function, and improved health.
There are hundreds of ways to manipulate the spine. Usually the doctor's hands or a specialty designed instrument delivers a brief and highly accurate thrust. Some adjusting methods are quick, whereas others require a slow constant pressure.
Do I have a pinched nerve?
Typically a 'pinched nerve' will result in numbness, burning, or a 'pins and needles' feeling. When a bone pushes on a nerve, this is a serious condition that requires immediate attention.
Several other possibilities exist that may also cause numbness and/or a burning sensation. Nerves are more commonly stretched or irritated, which will produce a numbness feeling.
Do I have a slipped disc?
No, it is not possible for discs to slip. The disc is a pad-like tissue located between two vertebrae which act as shock absorbers for the spine. The center of the disc is made of a fluid, soft, 'jelly-like' substance. When discs become damaged, tears can occur in which the soft center can leak out and push on the nerves. This is known as a ruptured or herniated disc and is extremely painful.
Spinal manipulation can be a form a therapy and has an excellent safety record. It is the result of a conservative approach to health that avoids invasive procedures or addictive drugs. In fact, spinal manipulations are considered safer than back surgery, muscle relaxers and even aspirin.
How long will I need treatment?
Spinal problems are often neglected since early childhood, and may require ongoing supportive care for optimum spinal function. These long-standing problems are often associated with muscle weakness, soft tissue damage, and degenerative changes to the spine.
Most patients find that periodic check-ups help keep them in optimum shape. Those who are active, have stressful jobs, or want to be their very best, find that a schedule of preventative visits is helpful in the maintenance of good health.
Some patients seek care only when their ache or pain becomes unbearable. Unfortunately this style of 'crisis management' can be more costly and time-consuming in the long run.
How long you decide to benefit from care is always up to the patient.
Is it safe for pregnant women?
Yes. Besides helping to relieve the discomfort, many expectant mothers experience that spinal manipulation helps to normalize nervous system function.
Can I get spinal manipulation if I've had back surgery?
Yes, your physician will avoid areas of your spine surgically modified. However, surgery often causes instability above or below the involved level. These "reactions" will be the focus of your treatment.
I have Osteoporosis, can I get spinal manipulation?
Yes, regardless of your age, size, or condition, care can be helpful. The specific needs of each patient are considered. If yours is not an appropriate case, we'll refer you to another specialist.
How does manipulation help my disc problems?
The purpose of manipulation is to locate and correct areas of the spine that interfere with the proper nervous system control of your body. Because the intervertebral discs are so close to the spinal cord and nerve roots, disc involvement is quite common. Spinal manipulation helps to restore proper motion and position of malfunctioning spinal bones, reducing nervous system involvement. If caught before permanent damage occurs, disc tissue often returns to a more normal size and shape.
What causes lower back pain?
Low back pain can be caused by a number of factors from injuries to the effects of aging. The spinal cord is protected by the vertebrae, which are made of bone. Between each vertebra are soft discs with a ligamentous outer layer. These discs function as shock absorbers to protect the vertebra and the spinal cord. Many of the problems that cause back pain are the result of either a herniation or degeneration of the intervertebral disc. Degeneration is a result of wear and tear causing deterioration of the disc. Herniations, or bulging of the disc, are protrusions from the disc that press on surrounding nerves, causing pain or numbness.
If I undergo DRX9000™ treatment, how long does it take to see results?
Most patients report a reduction in pain after the first few sessions. Typically, significant improvement is obtained by the second week of treatment.
How long does it take to complete DRX9000™ treatment?
Treatment sessions last 30 minutes. Protocol consists of 20 treatments over the course of 6 weeks, as determined by the physician.
Do I qualify for the DRX9000™ treatment?
While many patients will qualify for treatment on the DRX9000™, there are inclusion and exclusion criteria.
INCLUSION CRITERIA:
- Pain due to herniated and bulging lumbar discs that has lasted for more than four weeks.
- Recurrent pain from a failed back surgery that has lasted more than six months.
- Persistent pain from degenerated disc not responding to four weeks of therapy.
- Patients available for four weeks of treatment protocol.
- Patient at least 18 years of age.
EXCLUSION CRITERIA:
- Appliances such as pedicle screws and rods
- Pregnancy
- Prior lumbar fusion less than six months ago
- Metastatic cancer
- Severe osteoporosis
- Spondylolisthesis (unstable)
- Compression fracture of lumbar spine below L-1 (recent)
- Pars defect
- Pathologic aortic aneurysm
- Pelvic or abdominal cancer
- Disc space infections
- Severe peripheral neuropathy
- Hemiplegia, paraplegia, or cognitive dysfunction.
Are there any side effects to the DRX9000™ treatment?
Most patients do not experience any side effects. In some instances, there have been some mild cases of muscle spasm for a short period of time.
What is an Epidural Steroid Injection?
Epidural Steroid Injection is a shot of Cortisone, a powerful anti-inflammatory steroid into the area that surrounds the spinal cord and the nerves that extend from it, called the epidural space. Epidural Steroid Injections are a common treatment option for chronic neck and lower back pain. They have been in use since 1952 and are still an integral part of the non-surgical management of sciatica and lower back pain.
What is the goal of the injection?
The steroid injected reduces the inflammation or swelling of the nerves in the epidural space. This may reduce pain, tingling, numbnes and other symptoms caused by nerve inflammation or swelling.
How is the injection performed?
It can be performed several ways including the patient sitting up, lying on the side or on the stomach. After a local skin anesthetic is applied to numb the injection site, a spinal needle is inserted into the epidural space. To ensure accuracy and safety, our physicians perform the procedure under fluoroscopic (x-ray) guidance, using a contrast agent to confirm needle placement. Local anesthetic and corticosteroid anti-inflammatory medication are delivered into the epidural space to shrink the swelling around nerve roots, relieving pressure and pain.
How long does the injection take?
The whole procedure takes approximately ten to fifteen minutes.
How many injections will I need?
Up to three injections may be given within a six-month time frame. Usually, the injections are performed two to three weeks apart. A set of three injections is the norm; however, you may gain considerable relief after the first or second injection. In that instance, further injections may not be necessary.
Will I be put out for this procedure?
No. This procedure is done under local anesthesia. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate. The amount of sedation given generally depends upon the patient’s tolerance.
What are the expected results?
Epidural injections are very effective in providing pain relief. The benefit from these injections will typically occur two days following the procedure. In conjunction with chiropractic and physical therapy, many individuals enjoy a pain free lifestyle.
Trigger Point Injections:
What are Trigger Points?
A trigger point is an irritable, painful, taut muscle band or palpable knot in a muscle that can cause localized pain or referred pain. Referred pain from trigger points can mimic pinched nerves in the neck or lower back. They can occur from direct muscle injuries, poor posture, repetitive strain, or secondarily from spinal conditions such as a herniated disc. Myofascial pain syndrome is a chronic pain condition in which there may be several trigger points limited to a particular area of the body. The pain and spasm associated with trigger points can lead to a vicious pain cycle in which pain causes more spasm and spasm causes more pain.
Myofascial pain syndrome is not to be confused with fibromyalgia. Myofascial pain syndrome is a regional or localized pain syndrome in contrast to FMS (fibromyalgia syndrome) which is a widespread musculoskeletal pain syndrome
What are Trigger Points Injections?
Trigger point injections are injections of local anesthetic medication, saline, or cortisone into the trigger points. The basis for a trigger point injection is to relax the area of intense muscle spasm. By relaxing the muscle spasm, blood flow to the area is improved thus allowing the washout of irritants. Trigger point injections are an important part of treating myofascial pain syndrome and, in some cases, fibromyalgia. Many times multiple injections are performed in series. Trigger point injections can be done in an office setting or in an outpatient setting under IV sedation.
What should I expect after the injection?
You may experience soreness, bruising, or even an increase in pain for a few days until your body has time to recuperate from the injections. Pain can be relieved by alternately applying moist heat and ice for a day or two. In most cases, stretching exercises and physical therapy are performed following trigger point injections.
What is Facet Joint Injection?
A facet injection includes both a long-lasting corticosteroid and an anesthetic numbing agent. The drugs are delivered to the painful facet joint, either inside the joint capsule or in the tissue surrounding the joint capsule. Each vertebra has four facet joints, one pair that connects to the vertebra above(superior facets) and one pair that connects to the vertebra below(inferior facets) Corticosteroid injections can reduce inflammation and can be effective when delivered directly into the painful area. The pain relief can last from days to years, allowing you to improve your spinal condition with physical therapy and an exercise program.
Who is a candidate for Facet Joint Injections?
If you have neck, arm lower back, or leg pain(sciatica) stemming from inflammation of the facet joints you may benefit from a facet injection. Typically, it is recommended for those who fail to respond to other conservative treatments, such as oral anti-inflammatory medication, physical therapy or chiropractic care. The doctor may wish to perform the injection as a diagnostic test to determine if the facet joint is causing your pain. Facet injections may be helpful in treating inflamed facet joints caused by Spinal Stenosis, Sciatica, Spondylolysis, Herniated Disc or Arthritis.
How long does the injection take?
Depending on the number of facet joints being treated, the brief procedure may last fifteen-thirty minutes followed by a recovery period.
What can I expect after the injection?
Most patients can walk around immediately after the procedure. After being monitored for a short period, you can leave the office. Someone must drive you home. Typically patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and taking a mild analgesic. The doctor will follow up with you seven to ten days after the procedure to ask about your symptoms and the level of pain relief obtained.
What is Radio Frequency Lesioning?
Radio Frequency Lesioning is a procedure using a specialized computer controlled machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for six to nine months (can be as short as three months or as long as eighteen months). RF lesioning is used when other conservative therapies such as physical therapy, chiropractic care, rest and oral anti-inflammatory medications have failed. RF is only considered after a diagnostic (local anesthetic) block has been shown to be of benefit, but of short duration.
Am I a candidate for Radio Frequency Lesioning?
Radio Frequency Lesioning is offered to patients with:
- Mechanical neck or low back pain due to facet joint disease
- Occipital neuralgia (Headaches)
- Abdominal (visceral) pain responsive to splanchnic nerve block, Discogenic Pain (Low Back Pain), Nerve Root Pain (Radiculopathy / Radiculitis) (Arm or Leg Pain)
- You must have responded well to local anesthetic blocks, to be a candidate for Radio Frequency Lesioning.
How long does the proceedure take?
Depending upon the areas to be treated, the procedure can take from about twenty minutes to a couple of hours.
How is it actually performed?
Since nerves cannot be seen on x-ray, the needles are positioned using bony landmarks that indicate where the nerves usually are. Fluoroscopy (x-ray) is used to identify those bony landmarks. A local anesthetic (like Novocaine) is injected to confirm proper placement. After confirmation of the needle tip position, a special needle tip is inserted.
When the needle is in good position, as confirmed by x-ray, electrical stimulation is done before any lesioning. This stimulation may produce a buzzing, tingling, pain, or pressure sensation or may be like hitting your "funny bone”. Because we also do motor stimulation testing, you may also feel your muscles jump or twitch. You need to be awake during this part of the procedure so you can report what you are feeling. The tissues surrounding the needle tip are then heated when electronic current is passed using the Radio Frequency machine, for a few seconds. This "numbs" the nerves semi-permanently.
What should I expect after the procedure?
Initially there will be muscle soreness for a few days after the procedure. Ice packs will usually control this discomfort. After that time, your pain SHOULD be gone or lessened significantly.
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RESEARCH
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TESTIMONIALS
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