When people think of concussions, they have a tendency to think of sports-related injuries. Nowadays, we hear a great deal about it due to what we have seen happen in the NFL. Although, it’s quite common to see this issue in the sports arena, we also see it frequently in other areas such as car accidents, construction sites, falls at work, and even injuries sustained in the house. Some people even tell me that they injured themselves because “I have always been clumsy”. Regardless of what caused the trauma, most patients suffer from memory problems, headaches, dizziness, mental fogginess, and neck pain. For most people, symptoms will resolve after a few weeks. For others, symptoms may continue to linger. Repeated head trauma can lead to a condition called chronic traumatic encephalopathy which causes significant cognitive and psychiatric issues. It is very important to have a formal evaluation which includes a comprehensive physical examination. At times, further evaluation with appropriate imaging and other diagnostic modalities are necessary. If the injury is sports related, athletes will likely need to sit out for a period of time before they can resume play. They should be monitored during this time. The road to recovery can be difficult but there are ways to optimize recovery. 12648975-magnetic-resonance-image-MRI-of-the-brain-Stock-Photo-scan

Please call our office today at 973-928-3288.



Too Sleepy

Excessive daytime sleepiness is otherwise known as hypersomnia.

There are a variety of primary sleep conditions that can cause this symptom. These include such conditions as narcolepsy, idiopathic hypersomnia, obstructive sleep apnea, periodic limb movements of sleep, and behaviorally induced insufficient sleep. Of course, this symptom can also be caused by medications and chronic medical conditions. A thorough sleep evaluation as necessary to assess the cause.


Have your legs ever felt uncomfortable at night?

Restless Leg SyndromeHave your legs ever felt uncomfortable at night? That creepy, crawly, hard to explain feeling? Did you have growing pains when you were younger. These symptoms may be a reflection of restless legs syndrome or RLS. Often at times, this may make it difficult to fall asleep at night, making you exhausted in the morning. At times, you may feel your legs “kicking” you out of sleep. These movements are called periodic limb movements of sleep (PLMS) which can coexist with restless legs syndrome. RLS is essentially what you are feeling and PLMS are the motor manifestations. Sometimes, PLMS coexist without RLS. Both can be associated with low iron stores, kidney or liver dysfunction, or genetic predisposition. Both also have been recently linked to high blood pressure. Many people with RLS will have family members with RLS too. At times, RLS can be confused or misdiagnosed as “sciatica” or neuropathy. Both RLS and PLMS can be treated with medication or natural supplementation. If you feel that you may have this condition, please give our office a call for a consultation.


Does your loved one suffer from memory problems?

Does you are loved one suffer from memory problems?  It may be time for them to see a neurologist.  Alzheimer’s disease is a devastating condition that affects not only the individual but the entire family as well.  It often begins with forgetfulness but then progresses to other problems such as changes in behavior and speech, erratic sleep patterns, difficulty with taking care of themselves, and even forgetting other family members. 

Although there is no cure for the condition, we strive to optimize the patient’s treatment and stabilize their condition. It is also important to realize that not everyone with memory loss has Alzheimer’s.  Many memory issues may be related to poor sleep, medications, stress, depression and anxiety, and a variety of other conditions. Therefore it is important to be evaluated by a neurologist.

When being evaluated for memory loss, it is essential for family members to accompany the patient.  They provide information which is very insightful to the neurologist.  This gives us much better picture of what is going on with the patient.  Many patients with Alzheimer’s believe that they do not have any problems with their memory.  Because of this, it is vital that family members work with the patient in terms of their treatment and care.  By working closely with you’re loved one, you can make a big difference in their lives.

If you or her loved one has a problem with memory, please contact our office to make an appointment.


Why are my hands numb?

Numbness or tingling in your hands? Maybe you were told that you have carpal tunnel syndrome.  People who have this condition normally have numbness and tingling in their hands which can be worsened by activities such as typing, driving, or even using the phone.  Sometimes these symptoms can be painful and awaken you at night.  It is thought to be secondary to nerve compression at the wrist.  An EMG and ultrasound is typically utilized to help further evaluate this condition.  Conservative treatment usually consists of physical therapy as well wrist splints at night. When this fails, more invasive treatments are needed.  Traditional treatments include surgery as well as cortisone injections.

In the office, we utilize a variety of different treatments from injections to laser therapy. Prolotherapy is particularly effective for pseudo carpal tunnel syndrome.   In this condition, loose ligaments cause structures to move and compress the nerve.  Neural therapy may also be combined with this treatment to help decrease inflammation and free the nerve.  It is also important to address the biomechanical dysfunction that exacerbates your symptoms. Other areas of the body may also need to be treated with different modalities in order to achieve effective relief.


Have you ever been told that you snore?

Have you ever been told that you snore? Are you sleepy and tired during the day? Do you have a dry mouth and/or a headache in the morning? Are you suffering from a poor memory?  These may be signs of sleep apnea. Sleep apnea may be obvious when you hear your partner gasp for breathe at night, but this is not the case in many instances. It often goes undiagnosed in many people for years.

In sleep apnea your airway collapses when you breathe in which, in turn, deprives your body of oxygen and causes your heart rate and blood pressure to increase. The consequences of sleep apnea include a significant increase in stroke, heart attack, high blood pressure, diabetes mellitus, poor memory/confusion, depression and even increased risk of cancer.  Because of this, treatment becomes very important.

There are a variety of options for treatment which include the following:  continuous positive airway pressure (CPAP), oral appliance, positional therapy, weight loss, and surgery. To see which option is right for you, make an appointment with our office for a consultation.


What is Prolotherapy?

Prolotherapy is a type of regenerative medicine that has been around for many years. It involves injections that help strengthen ligaments and tendons.  Ligaments are tissues that help keep body parts together such as our arm and shoulders as well as our spine and pelvis. When ligaments or tissues become loose, we feel pain. At other times, we may feel other symptoms such as numbness or tingling. This therapy is utilized for a variety of chronic conditions which include the following: Lower back pain, neck pain, shoulder pain, elbow, hand, and wrist pain as well as chronic hip, knee, foot pain. 

We utilize a dextrose based solution as well as platelet enriched plasma (PRP) for treatment.  These substances are different in comparison to steroids as they promote natural healing.  Steroids, on the other hand, cause degeneration of tissue which ultimately prevents healing.  Many people are unsuccessfully treated with a combination of steroids and non-steroidal anti-inflammatories which also impair healing. 

Recently, I was down in Honduras for medical mission providing prolotherapy to hundreds of patients for a variety of different chronic painful conditions. The patient’s who had treatments for previous problems years ago remarked how their pain simply went away. Because of this, many of their family and friends would come to the clinic. The Honduran people were very grateful for the therapy that we provided them.  I was happy to be a part of this mission which provided such wonderful care.