Chiropractic
This patient-centered, non-invasive, hands-on method of care utilizes gentle manipulations, focused on your spine, joints, muscles, and nervous system. Our chiropractic care is an evidence based, wholistic approach that looks at the whole person as a system. Chiropractic is a central and integral component to many of our patients care plans in our multi-disciplinary approach. However, not all patients are able to receive the same type of chiropractic adjustment or treatment. Fortunately, due to the extensive level of training and decades of experience that Dr. Culliton possess, he is capable of safely treating a wide variety of patient classes and conditions where others may not. Dr. Culliton has treated patients over 100 years of age to professional athletes, post-surgical cases to traumatic injuries. In fact, he is often the choice of local professionals, skilled operators, high level politicians to other physicians in need of care.
Acupuncture
Along with working with the actual physical structure of the body, Valley Physical Medicine uses acupuncture to aid our patients’ recoveries. Many people have heard of acupuncture or seen pictures of people covered in acupuncture needles, and that can seem pretty intimidating! The ways movies show acupuncture often spread more fear than knowledge about this ancient and effective treatment method.
Traditional acupuncture has been used in the East (like China, Japan and Korea) for thousands of years. While the words and explanations they use to explain the causes and effects of treatment are different from how we talk about it, they are no less effective! We like to take a Western Medicine approach to our understanding of acupuncture, while giving the most effective treatment possible. We tell patients that acupuncture works by hitting the “reset button” on how the brain talks to the body, encouraging stress relief, healing of dysfunction, emotional release and disease resistance. In a rough analogy, the acupuncture needle a practitioner puts in acts as a lightning rod or distress signal for the body, asking for energy or attention to be sent to the area that needle corresponds with. In this way, acupuncture helps guide the body to release negatives and to increase healing.
At Valley Physical Medicine, we actually use two different types of acupuncture. We use traditional Chinese acupuncture – what we call Meridian Therapy – and Auriculotherapy, or ear acupuncture. Both types have had a great effect for our patients.
Trigger Point Injections
Trigger point muscle spasms are painful! They hurt all by themselves and they cause the body to be unbalanced, pulling on the skeleton, causing nerve impingements resulting in even more pain. Frequently patients come in and have a tender point that hurts when they push on a particular spot. That is often an active trigger point in the muscle. The difference between a tender point is that a trigger point will radiate, while a tender point’s pain stays local.
There are several ways to relieve trigger points. The most effective and direct way is with trigger point injections. This is a small injection directly into the knot of muscle itself. It is hyper-focused and actually uses three different mechanisms of action, all in the same treatment, for the fastest, most directed and reliable way to relieve trigger point problems.
In Dr. Ruminski’s method of trigger point injection at Valley Physical Medicine, we start by physically finding the trigger point by palpation. By finding the knot where there should not be one, and with patient feedback, we isolate the largest trigger point(s). After finding the correct spot, we clean the site with alcohol and put a very small needle right into the trigger point, and fill it with some lidocaine. It sounds really simple, and it is. The ways this simple treatment works are amazing. The needle going into the muscle does most of the work; the needle interrupts the muscle spasm that is not listening to the brain, telling it to relax just by being there, like dry needling. The second part is adding lidocaine into the trigger point. That numbs the point so the spasm is no longer painful. The third way it helps is by using liquid lidocaine to separate those tissues that are in spasm so that they can’t continue to spasm, so it’s a threefold treatment.
The studies on trigger point injections show they are very effective, and the gold standard is to have them twice a week for four weeks. What we find is that each time a patient has trigger point injections, the medical team is able to find the worst ones and alleviate them. For a person in chronic pain, most have trigger points on top of trigger points, and it takes several visits to work from the worst to the least of these muscle spasms. Each time one is relieved, the patient moves more easily and with less pain. Most patients come in after the first injection and are absolutely thrilled with the treatment because they have gotten relief enough to be able to move better and sleep. Many times, we do not have to go through all the four weeks, as patients begin to recover on their own after a few sessions and we are able to work with other modalities like chiropractic or decompression to speed their recovery.
Joint Injections and Medication Prescriptions
Our medical team often uses a combination of the least invasive, non-addictive prescription medications and injections to quickly not a only relieve your pain but resolve the underlying dysfunction causing it. Our Providers are highly skilled in both intramuscular injections as well as both small and large joint injections. This expert technique, needle and structure placement can make a big difference in patient outcome.
Diagnostics
The clinic offers on-site radiographic examinations. These are mostly spinal specific, but extremities are often imaged in the course of examination.
More advanced diagnostic imaging may be needed in some cases. Our doctors are well versed in the utilization of MRI, CAT Scan and diagnostic US as well as other advanced diagnostics like NCV/EMG.
Braces (Durable Medical Equipment)
Most of the treatments offered at Valley Physical Medicine focus on correcting a joint or tissue to improve function. However, one key component that many treatment programs fail to address is the need to support the joint while the patient heals and to prevent reinjury. Following current research and observing our own patients, we have found that patients who use durable medical equipment heal faster, stay better longer and need us less often than those who skip this support!
Simply put, durable medical equipment (or DME) is any piece of equipment or object that a patient puts on their body that can be used again and again and again. At the office, we use a limited, but powerful set of DME to fit a patient’s needs. These include osteoarthritis knee braces to help off load the knee when weight bearing, lumbar support orthotics that offer pain relieving support to the low back. Thoracic bracing that helps patients stand more upright forma flexed, hunched over posture. To custom scoliosis bracing to help alleviate the pain and deformity form this abnormal spinal curvature.
Many of these braces are covered under most insurance plans. Valley Physical Medicine is way to add feedback, reminding the wearer to take it easy and adding some bulk to the joint to restrict movement. the real power of the dMe we use comes when patients have rigid supports included in the correct places. our patients understand that they are getting bracing to have support in place so their body can continue to heal. We don’t want to treat you and have you go out the door and hurt yourself immediately again. these braces are of a higher quality than what can be found at a drugstore, and the price reflects that. However, the value per dollar is also much higher! When someone gets a good medical quality brace, they can use it to recover from their current injury rather than suffering for months from re injury and setbacks. Additionally, these braces are designed to last for five years, so if patients have the need again, they can immediately give themselves support and start getting out of pain, even before they get in to get treatment!
Cervical and Lumbar Decompression
This is often referred to as our non-surgical disc treatment.
Herniated or degenerative discs are a common condition treated at Valley Physical Medicine, that causes thousands of people to be in pain every year. Many people choose the only option they are offered – spinal fusion surgery – to get out of pain. With all respect to the great surgeons, back surgery is rife with complications and poor outcomes. Even when it works well, the vertebrae above and below the fusion begin to deteriorate more quickly since they now take all the motion and pressure of movement that used to be spread across that entire section of the spine.
There is a NON-SURGICAL solution that can help people avoid unnecessary back surgery, get out of pain and return to an active life: Spinal decompression therapy.
When we talk about spinal decompression, we are talking about actually removing the pressure, the weight of the world, from a patient’s back on a controlled basis, in a controlled relaxed position. We aren’t just trying to stretch the muscles of the spine. What we’re doing is decompressing and relieving pressure on the spinal structures themselves. This treatment stretches the ligaments holding the spine, the vertebra and the discs in between them, not just the muscles supporting those structures. With a light, controlled, interval stretch, the muscles and ligaments are able to relax enough to allow the discs to rehydrate, taking the pressure off the nerves of the spine and back.
Our spinal decompression table allows us to lay a patient down with a harness that is attached to a computerized motor. The computer monitors the motor, the angle of pull, the pounds of pull as well as the time of each decompressive pull applied. Patients are often surprised how relaxing this is as they expect a stronger, more violent pull than they experience in this advanced computerized system. This is because most of those tension receptors are in the muscle, that this advanced computerized process does not activate.
Decompression therapy is often just a part of a multi-faceted approach that may also include prescription medications, injections, acupuncture, chiropractic care, support bracing and rehab.
Injury Specific Rehab
Loosening muscles and aligning joints of the spine are all key components we use to help our patients improve their lives and get out of pain. For pain relief to last, patients must make changes to improve their range of motion and build muscle strength. This is so they do not reinjure themselves two weeks after finishing treatment!
At Valley Physical Medicine, we help our patients gain range of motion and strength in multiple ways that can be reduced to two approaches – active therapy at the office and movements that patients keep practicing at home. At the office, there are several tools and modalities that we use to help patients prepare for life beyond constant high-level pain. Our providers will use omnidirectional vibration plates to in balance, coordination of movements, increase oxygenation to the tissues and strengthen the core. The rumble of the vibe plate system is often heard in the office, as patients stand on it, giving them micro-instabilities, increasing blood flow and building strength in the body. Gua sha (also called the Graston Technique) is used to loosen fascia, ligaments, tendons and musculature. This technique helps loosen ligaments, tendons and muscles with a stiff, but not rough, scraping/rubbing motion with lotion. This technique does great work loosening tight tissues and restoring range of motion to patients. Each of these techniques is gentle and highly effective.
Often during a visit, patients are taught simple movements and exercises for flexibility and strength. One of the truisms of Valley Physical Medicine is that “motion is lotion,” or in other words, moving will allow a person to move more and more efficiently. After a musculoskeletal injury, the body needs to be able to move and to strengthen itself again, just to get back to where it was before. After muscles are held in spasm or suffer an injury, they lose strength, and sometimes they have to rely on the surrounding muscle to do the job they are supposed to do. These exercises give the muscles the ability to do the workload they should, allowing the whole body to function better! These movements and exercises are an important part of a patient’s recovery. Patients are even sent home with homebased exercises to work on during and after their recovery.