Conquering Neck Pain Seminar 11/14/2012

By David Coletta, MPT, CMPT
david@excelptmt.com

“Conquering Neck Pain”

Self Help Techniques and Treatment Options

Presented by David Coletta, MPT, CMPT, Certified Manual Therapy Specialist

 

Wednesday, November 14, 2012

6:30pm-7:30pm

Bozeman Public Library Community Room

Community Education Series – free and open to the public

                                                                                                      

What You Will Learn:

  • How neck pain develops and becomes chronic.
  • What the anatomic sources of neck pain are.
  • How a specialized physical therapist utilizes manual therapy, patient education, exercise, and dry needling techniques to treat neck pain.
  • How improving posture can alleviate neck pain.
  • Which exercises are most effective in self-treatment of neck pain.
  • Other self-treatment techniques.
  • There also will be time at the end of the seminar to speak with David regarding your specific neck problem.

David Coletta, MPT, CMPT specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. David received his masters in physical therapy from Mount St. Mary’s College in Los Angeles, California. He enjoys finding long-term solutions for his patients — solutions that involve a fine-tuned combination of manual manipulative therapy and a targeted exercise program that address even the most difficult patient presentations.

 

A considerable amount of David’s advanced training has occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he is working towards his Orthopedic Clinical Specialist (OCS) certification with the American Physical Therapy Association.

Be Part of a Headache Research Study

By David Coletta, MPT, CMPT
david@excelptmt.com

Excel Physical Therapy Participates in a Research Study on Cervicogenic Headaches

 

Seeking Research Study Participants

Headaches can cause lost time from work, visits to multiple physicians, and a general loss in quality of life.  The major categories include migraine headaches, tension headaches, TMD headaches, and cervicogenic headaches.  While cervicogenic headaches are not the most common type of headache, the prevalence in the general population is estimated at 15%.

Cervicogenic headaches are defined as one sided, or one side dominant, head pain, which is caused by a neck problem.  Other symptoms include stiffness in the neck, decreased range of motion in the neck, increased headaches with neck movements or poor cervical postures, and a possible history of trauma.  Although physical therapy can be effective in treating tension headaches and TMD related headaches, cervicogenic headaches have shown, in multiple studies, excellent response to manual therapy.  Mechanical joint and muscle restrictions in the neck lead to a referral of pain into the head (cervicogenic headache).  Manual therapy based physical therapy utilizes hands-on techniques to restore muscle and joint mobility, eliminating the head pain. 

Interestingly, research indicates that manual therapy success in treating cervicogenic headaches does not depend on chronicity. Cervicogenic headache patients can benefit from manual therapy treatments whether the symptoms have been present for 20 days or 20 years!  As a manual physical therapist for 15 years, my success rate with treating cervicogenic headaches has been very high. Our research from this study hopes to clinically show which manual therapy techniques are the most effective for treating cervicogenic headaches.

Excel Physical Therapy is enrolled as a clinical site in a national research study to determine the best manual therapy techniques to treat cervicogenic headaches.  There are several other clinical sites throughout the United States also collecting data on real patients being treated in a physical therapy environment.  Mobilization or manipulation of the neck and upper back are the two manual therapy variables in this study.  Mobilization is a joint “popping” technique and mobilization is a joint “stretching” technique. 

The Treating PT at our clinical site is skilled and trained in performing both spinal mobilization and manipulation.  One treatment group will receive only manipulation and the other treatment group will receive only mobilization and exercise.  We anticipate that both groups will benefit from the manual therapy treatments, but the magnitude of improvement is part of our research question.  Both groups will have 6 physical therapy visits over 2 to 4 weeks.

We are looking for patients to be part of this study – To be included:

  • patients must have one side dominant head pain, pain in the neck or the base of the skull that is felt to project into the head, and at least one headache per week for at least 3 months. 

  • Patients cannot be included in the study if they have a history of stroke, high blood pressure, high cholesterol, diabetes, heart disease, peripheral vascular disease, smoking, or whiplash injury to the neck in the last 6 weeks. 

  • Patients are not being offered free treatments in this study.  As with all of our patients, cost for physical therapy services will follow our normal fee schedule and we are happy to bill your insurance or provide you with a payment plan.  In most cases, a doctor’s prescription is not required to receive physical therapy services in Montana.  Excel Physical Therapy is a preferred provider for many insurance companies as well.

 

Please contact me if you meet the criteria for this study or if you have any questions.

David Coletta, MPT, CMPT -Treating Physical Therapist

david at excelptmt.com (insert the @ sign in your email message)

406-556-0562

Headaches Can Be a Pain From The Neck - May 3, 2012 Seminar

By David Coletta, MPT, CMPT
david@excelptmt.com

“Headaches Can Be a Pain From the Neck”

Self-Help Techniques and Treatment Options

Presented by David Coletta, MPT, CMPT, Certified Manual Therapy Specialist

 

As featured on KBZK TV, “Montana This Morning” with Jeff Kelly

 

Thursday, May 3, 2012

6:30-7:30pm

Bozeman Public Library Community Room

Community Education Series – free and open to the public

 

What You Will Learn:

  • The various types of headaches that originate from

    neck problems

  • Understand why you are suffering from headaches.

  • Learn what to do when you experience headache pain with simple exercises, treatment options and suggestions to self-treat.

  • Q&A session to follow.

David Coletta, MPT, CMPT specializes in the treatment of back and neck pain, spinal issues, whiplash, headaches, TMJ/jaw pain, and postural dysfunctions. David received his masters in physical therapy from Mount St. Mary’s College in Los Angeles, California. He enjoys finding long-term solutions for his patients — solutions that involve a fine-tuned combination of manual manipulative therapy and a targeted exercise program that address even the most difficult patient presentations.

 

A considerable amount of David’s advanced training has occurred through the North American Institute of Orthopedic Manual Therapy (NAIOMT). He has completed advanced certification in manual therapy (CMPT) with NAIOMT, and he is working towards his Orthopedic Clinical Specialist (OCS) certification with the American Physical Therapy Association.

Lumbar Spinal Stenosis in the Aging Spine

By David Coletta, MPT, CMPT
david@excelptmt.com

Lumbar Spinal Stenosis in the Aging Spine

Lumbar Spinal Stenosis (LSS) is a clinical diagnosis made by taking a careful history, utilizing physical tests, and analyzing spinal imaging, such as MRI.  Symptoms of LSS include low back pain and weakness, cramping, pain, or fatigue in one or both legs.  Such symptoms are brought on usually by walking and relieved by sitting or forward bending.  MRI evidence of LSS will reveal a narrowing of the central spinal canal and/or narrowing of the intervertebral foramen on either side of the spine.  In both cases, spinal nerves become affected, leading towards neurogenic claudication.  Neurogenic Claudication is a condition where the stenosis, or site of narrowing that leads to compression, causes disturbed blood flow to the spinal nerves.  Eventually, the spinal nerves become dysfunctional in their attempt to control the muscles of the lower extremities, and the above symptoms ensue.

Symptoms of LSS include low back pain and weakness, cramping, pain, or fatigue in one or both legs.

Studies reveal that as many as 80% of subjects, age 70 or older, have MRI evidence of LSS.  However, many of the same subjects do not have the clinical condition of LSS, because they don’t suffer from the physical complaints that match this diagnosis.  The stenosis that is found with the imaging can be considered a normal part of aging in the spine.  The discs and joints in the low back will naturally break down, causing bone spurs and disc bulges.  Such protrusions into the passageways of the spine don’t always lead to symptoms that are the hallmark of LSS.

As a physical therapist, many of my older patients will arrive with an MRI that will show severe degenerative breakdown of the lumbar spine.  Sometimes they will also have a prescription from their doctor with diagnosis of LSS.  But a careful physical therapy evaluation is always done to determine if the clinical condition of LSS truly exists or does the patient have low back pain or leg symptoms coming from a degenerative or arthritic lumbar spine, with neurogenic claudication.  The physical therapy treatment will be somewhat different in either case.

Physical therapy interventions to treat LSS include hip stretching and back strengthening exercises, cardiovascular exercise, joint mobilization to the lumbar and thoracic spine, and patient education to alter aggravating activities.  Another important part of treating LSS patients is reassurance.  Research reveals that patients with mild to moderate LSS will improve with time.  Another study showed that long-term results, comparing physical therapy to lumbar spine injections in LSS patients, were equal when looking at pain reduction and functional mobility.  If you suffer from LSS, then physical therapy can be a safe, cost effective, and conservative place to start on a path towards improving your quality of life.

 

If you suffer from Lumbar Spinal Stenosis, then physical therapy can be a safe, cost effective, and conservative place to start on a path towards improving your quality of life.

Headaches Can Be a Pain From the Neck

By David Coletta, MPT, CMPT
david@excelptmt.com

Headaches Can Be a Pain From the Neck

by David Coletta, MPT,CMPT

Headaches can take on many forms and be the source of major disability in the general population.  20% of all visits to a Neurologist in the United States are made because of headache complaints.  Major classifications of this diagnosis include migraines, tension headaches, and cervicogenic headaches.  As a physical therapist, specializing in the evaluation and treatment of musculoskeletal dysfunctions, I am particularly familiar with the cervicogenic headache.

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TMJ Dysfunction – What is it and how can it be treated?

By David Coletta, MPT, CMPT
david@excelptmt.com

TMJ Defined

Temporomandibular Joint (TMJ) Dysfunction is a disorder of the joint where the jawbone meets the skull or the muscles surrounding that region. People suffering from TMJ Dysfunction complain of popping or locking in the jaw, pain in the face with eating or opening the mouth, and headaches. TMJ Dysfunction can be further classified into joint dysfunction, myalgia, or a combination of dysfunction and myalgia. Myalgia is simply defined as intra-muscular pain. Pure joint dysfunction of the TMJ involves popping in the jaw, pain coming from joint structures (bone, cartilage, disc, ligaments, joint capsule), and a predictable and measureable loss in mouth opening or closing range of motion. Myalgia in the TMJ region relates to inflammation and dysfunction in the muscles surrounding the TMJ. These muscles can cause local facial pain, neck pain, headaches, and changes in how the jaw is actively moved. Combined joint dysfunction/myalgia of the TMJ is the most common presentation and can include all of the elements in the individual disorders previously described.

TMJ Dysfunction – What is it and how can it be treated?

By David Coletta, MPT, CMPT
david@excelptmt.com

Underlying Causes

It is important to explain some the underlying reasons for TMJ dysfunction. The most obvious cause is a serious blow to the face or jaw, disturbing the normal biomechanics of the joint.  However, more common causes include chronically poor posture, stress-induced grinding of the teeth or clinching the jaw, malocclusion of the teeth (high or low tooth), and neck pain or trauma to the spine.  My experience has been that over 90% of patients that I treat, with the diagnosis of joint dysfunction or myalgia of the TMJ, present with dysfunctions of the neck.  These patients require a careful evaluation of the neck and treatment that includes joint mobilization or manipulation, soft tissue massage, and exercise to improve posture and restore pain-free jaw active range of motion.

TMJ Dysfunction – What is it and how can it be treated?

By David Coletta, MPT, CMPT
david@excelptmt.com

Treatment

As with any orthopedic problem, the most important step in treating TMJ Dysfunction is to obtain the proper diagnosis by a specialist. Some physical therapists, dentists, and medical doctors are specialty trained in TMJ Dysfunction. Myalgia is the easiest presentation to resolve and treatment can involve simple self-massage exercises, range of motion exercises, nonprescription anti-inflammatory medication, and ice/heat to the face. Treating joint dysfunction of the TMJ involves exercises to re-educate joint motion and fabrication of an oral appliance (acrylic splint) to fit over the teeth, altering joint motions and forces. I would suggest that only specialist dentist fabricate an oral appliance. These devices are expensive and often have to be remade when a dentist who does not understand the intricacies of TMJ fabricates them. Combined joint dysfunction/myalgia requires the combination of treatment approaches.

"David is great and extremely knowledgeable. Excited to begin treatment with him again."  --Bozeman Patient

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