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  • Writer's pictureAndrew Invanchenko M.D.

The What vs. With What

"Much better. I just don't understand how you do it. I've gotten the same treatment with different doctors: manipulation, massage, acupuncture and physical therapy all for nothing! And at your clinic only after two visits, I can move around like I'm young again!"

Above is a typical conversation we frequently hear at our rehabilitation center. Our secret is that we concentrate our energies on what we treat, not with what. I can demonstrate this difference with a simple conversation I had with a colleague early in my career.

Me: "Mike, what are we treating?"

Mike: "First, we'll try a massage and an ultrasound."

Me: "You don't understand. I'm not asking what procedure to use, but what to treat."

Mike: "Well, if the ultrasound doesn't work, we'll try acupuncture and electro-stimulation."

Me: ...

As it turns out his way of thinking was not unique; in fact, it is widespread and prevalent in most medical centers in America. The idea is that the treatment method is a cure in itself : pills, acupuncture, massage bed CERAGEM, VAX-D, etc. In this context doctor finds the cure when he finds and applies the right procedure.

The "Cure" by Trial and Error

Consequently, doctors from this school of thought often treat not the source of pain; rather they use the procedure that is most convenient. Something tried and true. Like the proverbial drunkard that searches for the lost keys under the streetlight because "this is where the light is."

If one procedure fails, try another... Something should work eventually, and it often does! Why? Because the human body always strive to repair itself the same way gravity will always send a heavy cart down a hill. But sometimes the cart might get caught on a rock or falls into a ditch. Usually, pushing it out just calls for a bit of pressure, in the form of electro-stimulation, massage, or bed rest. But if the cart is firmly stuck, then pointless, zealous tugging is irrational and can lead to long-term stagnation.

Our "Buttons," and How to Push Them

We have many patients with history of streetlight effect treatments. We get the "dead end case" patients, whom other healthcare providers prodded, and stimulated without success. In each case, we find the exact individual blocks and trip wires that keep the patient from getting better. We analyze every joint, every muscle, and seek out their trigger points. These points act as a computer keyboard -- press the right buttons and you turn on the right program. The problem is that the keyboard is a bit broken down, so you need a certain kind of flair and experience to hit them in just the right way.

If it works, the muscles relax and allow for careful decompression to relieve pinched nerves. Press the wrong button, and the muscles will either not respond (see superficial massage) or wedge together tightly (see rough manipulation). This kind of therapy is a double-edged sword that can indeed help but can also, just as easily, be harmful

In order to improve your health, it is vital to deal with qualified, highly trained specialists that have an inherent talent for and plenty of experience with intricate and complex therapy. Only they can find your individual trigger points and press on them in just the right way to send you on the road to a better health!


Ivanchenko M.D. Pain and Rehabilitation Center is dedicated to improving the quality of life for patients.​Our emphasis is on the integrative medicine and nonsurgical comprehensive decompression of acute and chronic pain arising from spinal problems, sports, accidents, work related injuries or other conditions.



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