A Life Care Planner evaluates patients with disabilities or chronic health conditions in order to outline the needs created by the disability. The life care plan (LCP) is a dynamic document based upon published standards of practice, comprehensive assessments, data analysis and research which provides an organized and concise plan for current and future medical needs and costs for individuals who have experienced injury or have chronic health care needs.

Life care plans have historically been utilized in a variety of settings and situations including litigation (personal injury, medical malpractice, dissolution, employment, etc.), managed care and workers’ compensation cases.

A Medical Cost Projection (MCP) determines future medical care based on the patterns of care in the medicals and anticipated outcomes, and identifying the costs for future care. Medical Cost Projections are much more abbreviated when compared to a Life care Plan (LCP) report. A Medical Cost Projection is typically completed when the referral is attempting to understand the medical damages in the case. Medical Cost Projections are completed on an uncomplicated case where the future care is straightforward or when there is limited future medical care. Medical Cost Projections can be customized to the specific requests of the referral.

A narrative report is a brief summary of specific events experience by a patient that have led to chronic disability.

The purpose is to provide a concise report in order to identify these events so as to conclude a causal relationship between the accident and the patient’s physical and functional loses.

Dr. Seidenberg is available as an Expert Witness for the legal and insurance communities.

Dr. Seidenberg is available for standards of care peer review and for the review of medical records.

Our skilled therapists are dedicated to providing the highest standard of physical therapy utilizing state of the art equipment, the latest innovative treatment techniques, patient education and a one-on-one hands on approach to obtain the best possible results for our patients.

Stiff and painful joints are treated while surrounding muscles are strengthened to support the body in proper alignment. The results are better mobility, flexibility and pain-free movements.

Our comprehensive approach includes:

• Tailored therapeutic exercises
• Manual therapies such as joint and soft tissue mobilization and manipulation
• Neuromuscular re-education
• Flexibility and strength training
• Modalities including electrical stimulation and ultrasound
• Post op rehabilitation
• Body mechanics and Ergonomic education
• Fall prevention and balance training
• Manual muscle energy techniques
• Custom home exercise programs

Sports medicine services include a comprehensive specialized program for the elite athlete or the weekend athlete of all ages and abilities. Individual evaluation and treatment include a detailed history, physical exam and biomechanical assessment. Treatment plans include a combination of physical therapy, manual medicine, joint and soft tissue injections, diet and nutrition recommendations, ergonomics and lifestyle modifications and other non surgical modalities.

Our integrative approach focuses on a combined preventive, complementary and alternative program to common musculoskeletal problems.

Lifestyle assessments include diet and supplementation recommendations, fitness and conditioning programs, addressing sleep, work and stress management.

Traditional Massage
Traditional massages are excellent when you need a little stress relief and relaxation. When you have tight, “knotted” muscles, however, therapeutic medical massages may be warranted.

Deep Tissue Massage
Deep tissue massage targets the deepest layers of muscle and connective tissue. Our massage therapist uses slower strokes and friction techniques across the grain of the muscle. Deep tissue massage is used for chronically tight or painful muscles, repetitive strain, postural problems or recovery from injury. Some people can experience some “muscle soreness” for 1-2 days post deep tissue massage.

Trigger Point Massage
A trigger point massage is used to alleviate the source of pain through cycles of isolated pressure and release, thereby releasing constricted areas.

Trigger points are tiny knots that develop in a muscle when it is injured or overworked. These spots are painful at their site and can also cause “referred pain” in other areas. Trigger point injections can relieve aches and pains caused by these trigger points.

Trigger point injections are performed under ultrasound guidance and use a mix of a local anesthetic and normal saline to help stop muscle pain. This technique helps deactivate the trigger point, increase local blood flow and flush toxins out of the muscle.

Prolotherapy/PRP
Prolotherapy and PRP uses injections to jump start tissue repair and promote healing.

PRP (Platelet Rich Plasma)
PRP injections use the patient’s own blood to promote the healing of tendons, ligaments and joints. After the patient’s blood is centrifuged, the activated platelets are injected into the abnormal tissue, releasing growth factors that recruit and increase the proliferation of reparative cells. Because PRP is given to optimize an initial inflammatory response of healing, anti-inflammatory medications should be stopped at the time of PRP treatments.

Prolotherapy (Proliferative Therapy)
Prolotherapy stimulates formation of new collagen tissue to strengthen the destabilized joint and decrease pain. Prolotherapy uses a series of injections to a ligament, tendon or painful joint to fuel the body’s own healing process and begin regeneration of the injured tissue. When ligaments or tendons are stretched or injured, the attached joints can become unstable and add stress to the area, which can lead to pain and degenerative changes.

What is injected?
Prolotherapy injections use natural substances including dextrose, calcium saline, and sarapin, in addition to a local anesthetic that triggers a healing response.

Where can prolotherapy be injected?
Treatment areas include mid and lower back and neck pain caused by degenerative disc disease, arthritis and sacroiliac joint instability and dysfunction. Other injection areas include the shoulder, hip, knee, ankle, and foot. Essentially any joint, ligament or tendon complex may benefit from Prolotherapy in order to help stabilize the area, minimize symptoms, and decrease pain.

How often do I need these treatments?
Treatments are done in a series of 4-6 sessions, approximately 1 month apart. Treatment frequency and plans are individualized based on a patient’s injury and responsiveness.

Botox Injections
Botox injections involve inserting a small amount of botulinum toxin to the desired area which temporarily paralyzes any muscle activity.

Cosmetic Injections
Frequently used to reduce the appearance of facial wrinkles, Botox injections may also be applied to decrease severe muscle spasms that lead to cervical dystonia, excessive sweating (hyperhidrosis), muscle contractures due to spasticity, and help treat chronic headaches.

Hyperhidrosis Treatment
Hyperhidrosis is considered to be abnormal or excessive sweating and perspiration. Botox is injected into the axilla region to greatly reduce and eliminate embarrassing hyperhidrosis.

The Iovera treatment is an FDA approved way to block pain. The procedure uses the body’s natural response to cold to immediately reduce pain without drugs, other systemic therapies, or surgery.

By targeting sensory nerves, the Iovera treatment temporarily interrupts the pain signaling pathway, providing pain relief until the nerve regenerates.

With the treatment tip inserted into the targeted region, a cycle is performed. When the cycle is finished, the smart tip is removed and inserted into the next treatment site. Results are immediate so you will know when the Iovera treatment has received desired results.

Results from the treatment can be felt immediately and can last anywhere from 3- 6 months depending on the patient.

Based on the principles of biomechanics and movement, chiropractic medicine uses manual techniques to release pressure on nerves and joints in order to eliminate pain and restore joint function.

Treatment includes:

• Applied kinesiology
• Spinal adjustments
• Active release techniques
• Soft tissue mobilization and myofascial release

Acupuncture, a Chinese form of complementary treatment, involves the application of specialized needles, or electrical stimulation, to various points on the body to help alleviate pain and treat certain medical conditions. Based on the theory that chi, or energy, flows within your body through pathways called meridians, acupuncture is used to unblock the flow of chi and help restore natural balance.

Current theories on the mechanism of action include:

Neurotransmitter Theory
Affecting higher areas of the brain which causes the release of beta-endorphins and enkephalins which can influence the immune and antinociceptive systems.

Autonomic Nervous System Theory
By stimulating the release of norepinephrine, acetylcholine and other types of opioids, thereby affecting changes in cell turnover rate, normalizes the autonomic nervous system and reduces pain.

Gate Control Theory
By activating non-nocioceptive receptors that inhibit transmission of nocioceptive signals in the dorsal horn, there by “gating out” painful stimuli.

Biofeedback involves training a patient to use his or her mind to control various physiological symptoms. It is often used as a relaxation technique that helps relieve pain caused by muscle spasms, decreases stress and anxiety, and improves sleep.

During a session, a therapist attaches electrical sensors to different parts of the patient’s body and monitors the body’s physiological responses, such as temperature, heart rate, and muscle tension. Using visual and verbal feedback, patients are trained to change and control certain physiological reactions which maybe contributing to his or her symptoms.

Orthotics is an externally applied device or shoe insert that is used to modify a structure. This may provide a more biomechanical and anatomical alignment and can be used to improve function and decrease stressors that are contributing to pain.

Healthy eating provides energy to support your mood and maintain your weight. Small adjustments in one’s diet or weight can reduce inflammation that contributes to pain, stress, and poor sleep, as well as many metabolic diseases including cardiac disease, diabetes, thyroid disease, and chronic fatigue.