Flatiron Spine and Rehabilitation

11/11/2015

07/14/2015

I had suffered from headaches for years - pretty much daily I was waking up in pain, and keeping Excedrin in business. By my 3rd session with Dr. Prisco, my headaches were gone. Gone! That was about 6 months ago. I occasionally will still get a tension headache, but they are down to 1-2 times a month tops, as opposed to every day. I honestly didn't think they'd ever go away.

I highly recommend Dr. Prisco. His adjustments were subtle and very effective, not the massive cracking and neck twisting that you might associate with chiropractors. And, to boot, just a really friendly guy.

Joan C. - NYC

06/06/2012

Chiropractic Before Surgery for Low Back Pain

by editor on May 14, 2012

By Dr. Richard J. Vahl, MSc, DC, Ph.D, DAAPM, CCSP, CCIOHP. & Dr. James B. Vahl, CPT, BSc, DC, CART, CSGT, ACSM.

The renowned University of Pittsburgh Medical Center (UPMC) Health Plan affiliated with the university’s School of Medicine, has adopted landmark guidelines for the management of chronic low back pain as of Jan. 1, 2012 similar to what was pioneered by W. H. Kirkaldy-Willis, M.D. FRCS (E), FRCS (C), FACS, FICC (hon) (Managing Low Back Pain, & Spinal Manipulation in the Treatment of Low-Back Pain) back in the 1970′s and 80′s.

Candidates for spine surgery must receive prior authorization to determine medical necessity, which includes verification that the patient has “tried and failed a 3-month course of conservative management such as Chiropractic Spinal Manipulative Care prior to being considered for back surgery.

Spinal manipulation, is one of the oldest forms of therapy for back pain, has mostly been practiced outside of the medical profession. Over the past decades, there has been an escalation of clinical and basic science research on manipulative therapy, which has shown that there is a scientific basis for the treatment of back pain by manipulation. Most family practitioners and other physicians have neither the time nor inclination to master the art of manipulation and therefore should wish to refer their patients to a skilled practitioner of this therapy like a Doctor of Chiropractic. Results of many spinal manipulation studies of patients with low back pain have been presented with many satisfactory results without every having surgery. The physician who makes use of this resource by referring to Manipulative Therapy Providers like Chiropractors will provide needed relief for many patients with back pain.

These references are in PubMed. This may not be the complete list of references from this article.


■Frymoyer JW, Newberg A, Pope MH, Wilder DG, Clements J, MacPherson B. Spine radiographs in patients with low-back pain. An epidemiological study in men. J Bone Joint Surg Am. 1984 Sep;66(7):1048–1055. [PubMed]
■Foley RK, Kirkaldy-Willis WH. Chronic venous hypertension in the tail of the Wistar rat. Spine (Phila Pa 1976) 1979 May-Jun;4(3):251–257. [PubMed]
■Farfan HF, Kirkaldy-Willis WH. The present status of spinal fusion in the treatment of lumbar intervertebral joint disorders. Clin Orthop Relat Res. 1981 Jul-Aug;(158):198–214. [PubMed]
■Currey HL, Greenwood RM, Lloyd GG, Murray RS. A prospective study of low back pain. Rheumatol Rehabil. 1979 May;18(2):94–104. [PubMed]
■Unsworth A, Dowson D, Wright V. ‘Cracking joints’. A bioengineering study of cavitation in the metacarpophalangeal joint. Ann Rheum Dis. 1971 Jul;30(4):348–358. [PMC free article] [PubMed]
■Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. [PubMed]
■Terrett AC, Vernon H. Manipulation and pain tolerance. A controlled study of the effect of spinal manipulation on paraspinal cutaneous pain tolerance levels. Am J Phys Med. 1984 Oct;63(5):217–225. [PubMed]
■Korr IM. Proprioceptors and somatic dysfunction. J Am Osteopath Assoc. 1975 Mar;74(7):638–650. [PubMed]
■Akeson WH, Amiel D, Woo SL. Immobility effects on synovial joints the pathomechanics of joint contracture. Biorheology. 1980;17(1-2):95–110. [PubMed]
■Mathews JA, Ytes DA. Reduction of lumbar disc prolapse by manipulation. Br Med J. 1969 Sep 20;3(5672):696–697. [PMC free article] [PubMed]
■CHRISMAN OD, MITTNACHT A, SNOOK GA. A STUDY OF THE RESULTS FOLLOWING ROTATORY MANIPULATION IN THE LUMBAR INTERVERTEBRAL-DISC SYNDROME. J Bone Joint Surg Am. 1964 Apr;46:517–524. [PubMed]
■Nwuga VC. Relative therapeutic efficacy of vertebral manipulation and conventional treatment in back pain management. Am J Phys Med. 1982 Dec;61(6):273–278. [PubMed]
■Morrison MC. The best back to manipulate? Ann R Coll Surg Engl. 1984 Jan;66(1):52–53. [PMC free article] [PubMed]
■Brunarski DJ. Clinical trials of spinal manipulation: a critical appraisal and review of the literature. J Manipulative Physiol There. 1984 Dec;7(4):243–249. [PubMed]
■Evans DP, Burke MS, Lloyd KN, Roberts EE, Roberts GM. Lumbar spinal manipulation on trial. Part I–clinical assessment. Rheumatol Rehabil. 1978 Feb;17(1):46–53. [PubMed]
■Coxhead CE, Inskip H, Meade TW, North WR, Troup JD. Multicentre trial of physiotherapy in the management of sciatic symptoms. Lancet. 1981 May 16;1(8229):1065–1068. [PubMed]
■Weber H. Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine (Phila Pa 1976) 1983 Mar;8(2):131–140. [PubMed]
■Jayson MI, Sims-Williams H, Young S, Baddeley H, Collins E. Mobilization and manipulation for low-back pain. Spine (Phila Pa 1976) 1981 Jul-Aug;6(4):409–416. [PubMed]
■Roberts GM, Roberts EE, Lloyd KN, Burke MS, Evans DP. Lumbar spinal manipulation on trial. Part II–radiological assessment. Rheumatol Rehabil. 1978 Feb;17(1):54–59. [PubMed]
■Doran DM, Newell DJ. Manipulation in treatment of low back pain: a multicentre study. Br Med J. 1975 Apr 26;2(5964):161–164. [PMC free article] [PubMed]
■Kirkaldy-Willis WH, Farfan HF. Instability of the lumbar spine. Clin Orthop Relat Res. 1982 May;(165):110–123. [PubMed]

Tagged as: back pain, back surgery, chiropractic, Chiropractic before surgery for low back pain, chiropractic manipulative therapy, low back pain, spinal surgery

03/26/2012

I have been seeing Dr. Prisco for a couple of years now and he has a wonderful approach to wellness, nutrition and ergonomics. I wear a heavy belt at work all day and I am sitting most of the day which causes me discomfort and pain in my lower back. Dr. Prisco relieved my lower back pain in a very short amount of time and gave me tips on posture and nutrition which helped me a lot . I see Dr. Prisco once a week and he accepts my insurance. He is highly recommended by me for any back pain or general wellness.

John G.
East meadow, NY

02/08/2012

NE Patriots and NY Giants: The Essential Role of Chiropractic Care to Super Bowl XLVI
Press Release Add comments .Feb 02
2012.

The Foundation For Chiropractic Progress released a press release yesterday highlighting the the role that chiropractic has played for the two teams that will be involved in Super Bowl XLVI:

CARMICHAEL, Calif. – Feb. 1, 2012 – As the New England Patriots and New York Giants prepare to play on the biggest stage of all for football fans – the XLVI Super Bowl, February 5, 2012, Indianapolis, Ind. — the Foundation for Chiropractic Progress, a not-for-profit organization dedicated to raising awareness about the value of chiropractic care, points to the role of the team Doctors of Chiropractic (DCs) in optimizing functionality, endurance and overall conditioning. Dr. Michael Miller of the Patriots and Dr. Robert DeStefano of the Giants explain that chiropractic is fundamental to the consequences of jarring impacts, enhancing body mechanics and joint motion while improving structural balance vital to preventing and addressing many common injuries.

“Professional athletes rely greatly on the coordinated efforts of the entire healthcare team, comprised of athletic trainers, rehabilitation specialists, physical therapists, orthopedists and chiropractors,” says Dr. DeStefano. “With the exception of 24/7 availability, preparing for Super Bowl is no different than the regular season. As injuries present themselves, we work systematically to provide the athlete with the care needed. In the end, we hope for quick recovery and high-level performance.”

Dr. Miller, who notes that the Patriots have dedicated their season and championship wins to Myra Kraft, the late wife of the team’s owner Robert Kraft, adds, “Most of our players will get adjusted prior to games to adequately prepare their bodies for battle. Several times during the playoffs, incidents occurred that required chiropractic care and, subsequent to sideline treatment, players were able to return to action the following play. We expect to have the same efficiency going into and during the Super Bowl.”

Viewed by both teams as a valuable healthcare component, chiropractic care is commonly used to address neuromusculoskeletal strain injuries, including neck pain, low back pain, strains to the hamstring and quadriceps, and certain whiplash injuries. Additionally, it provides treatment for other extremity problems, such as temporomandibular joint dysfunction (TMJ), carpal and tarsal tunnel misalignments, and shoulder, elbow, knee and ankle tribulations.

Being involved with the Patriots for over 30 years, Dr. Miller knows first-hand that the players appreciate the service he provides, and he is excited to enter another Super Bowl together, sharing, “As we get closer, I’m reminded of a mantra from head coach Bill Belichick who says, „Do your job. If done well, it will reap rewards.‟ I wish both teams health through this next game and may the best team WIN!”

To learn more about professional football and chiropractic, visit the Professional Football Chiropractic Society, an organization that encompasses chiropractors from all 32 NFL teams, including Dr. Miller and Dr. DeStefano, which provide the highest quality chiropractic to the elite athletes.

01/14/2012

I have been a hairdresser for 23 years and have periodic, but ongoing neck and back issues from standing all day. Dr. Prisco happened to be right on my block and I feel so lucky to have found him! Not only do I find the adjustments very helpful, his gentle nature and approach to the body as a whole makes each visit therapeutic in so many ways. He always asks me if I am doing my stretching or exercises that he gives me and treats me like a person and not just a patient. He always takes the time to talk or explain things to me so I understand what is going on. I would recommend him highly to anyone seeking chiropractic treatment.

Christine B.

Manhattan, NY

01/14/2012

This is my first ever review. I felt compelled to write something about my experience with Dr. Prisco. I was having on and off lower back stiffness after i worked out, jogged, played golf for about a year or so. It was not excruciating pain, just the inability to be as flexible and comfortable as I need to be. After two sessions with Dr. Prisco, I feel 100% better. It was my first time to a chiropractor so I was a little nervous and skeptical. He made me feel very comfortable throughout my sessions. He was gentle and very knowledgeable. He showed me stretches and exercises to continue on a daily basis. I have played numerous rounds of golf and have had no back issues. Not to sound dramatic, but the adjustments he made and the guidance he has given me has really changed my life. I feel so much better since I went to him.

Justin D.

Manhattan, NY

01/10/2012

Dr. Prisco is practically a magician. I injured my back 2 years ago jumping on a rebounder, and it was extremely painful to sit, walk or do any exercise. I was pretty desperate for relief, and a close friend recommended Dr. Prisco. I kid you not, after one session, I felt 90% better and then a few days later...100%. Kind of a miracle since I was in pain for so long. He did very gentle, subtle adjustments, used a machine that released electromagnetic impulses into my lower back, and then placed a special surgical tape along my lower back that I was instructed to keep on for a few days. I felt amazing at the end of that week, and a year later, I still feel great! I definitely need to be careful to not re-injure myself, but I truly feel that session triggered the healing process for me. I would wholeheartedly recommend him!

Amanda B.

01/04/2012

January 3, 2012, 11:00 am
For Neck Pain, Chiropractic and Exercise Are Better Than Drugs
By ANAHAD O'CONNOR

Tony Cenicola/The New York Times
What’s the best treatment for neck pain?Seeing a chiropractor or engaging in light exercise relieves neck pain more effectively than relying on pain medication, new research shows.

The new study is one of the few head-to-head comparisons of various treatments for neck pain, a problem that affects three quarters of Americans at some point in their lives but has no proven, first-line treatment. While many people seek out spinal manipulation by chiropractors, the evidence supporting its usefulness has been limited at best.

But the new research, published in The Annals of Internal Medicine, found that chiropractic care or simple exercises done at home were better at reducing pain than taking medications like aspirin, ibuprofen or narcotics.

“These changes were diminished over time, but they were still present,” said Dr. Gert Bronfort, an author of the study and research professor at Northwestern Health Sciences University in Minnesota. “Even a year later, there were differences between the spinal manipulation and medication groups.”
Moderate and acute neck pain is one of the most frequent reasons for trips to primary care doctors, prompting millions of visits every year. For patients, it can be a difficult problem to navigate. In some cases the pain and stiffness crop up without explanation, and treatment options are varied. Physical therapy, pain medication and spinal manipulation are popular options, but Dr. Bronfort was inspired to carry out an analysis because so little research exists.

“There was a void in the scientific literature in terms of what the most helpful treatments are,” he said.

To find out, Dr. Bronfort and his colleagues recruited a large group of adults with neck pain that had no known specific cause. The subjects, 272 in all, were mostly recruited from a large HMO and through advertisements. The researchers then split them into three groups and followed them for about three months.

One group was assigned to visit a chiropractor for roughly 20-minute sessions throughout the course of the study, making an average of 15 visits. A second group was assigned to take common pain relievers like acetaminophen and — in some cases, at the discretion of a doctor — stronger drugs like narcotics and muscle relaxants. The third group met on two occasions with physical therapists who gave them instructions on simple, gentle exercises for the neck that they could do at home. They were encouraged to do 5 to 10 repetitions of each exercise up to eight times a day. (A demonstration of the exercises can be found at www.annals.org).

After 12 weeks, the people in the non-medication groups did significantly better than those taking the drugs. About 57 percent of those who met with chiropractors and 48 percent who did the exercises reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group.

A year later, when the researchers checked back in, 53 percent of the subjects who had received spinal manipulation still reported at least a 75 percent reduction in pain, similar to the exercise group. That compared to just a 38 percent pain reduction among those who had been taking medication.

Dr. Bronfort said it was a “big surprise” to see that the home exercises were about as effective as the chiropractic sessions. “We hadn’t expected that they would be that close,” he said. “But I guess that’s good news for patients.”

In addition to their limited pain relief, the medications had at least one other downside: people kept taking them. “The people in the medication group kept on using a higher amount of medication more frequently throughout the follow-up period, up to a year later,” Dr. Bronfort said. “If you’re taking medication over a long time, then we’re running into more systemic side effects like gastrointestinal problems.”

He also expressed concern that those on medications were not as empowered or active in their own care as those in the other groups. “We think it’s important that patients are enabled to deal with as much control over their own condition as possible,” he said. “This study shows that they can play a large role in their own care.”

Annals of Internal Medicine is internal medicine's premier, highly cited journal for scholarly research, evidence reviews, and guidelines for patient care.