A. Identification of the immediate cause of pain:

B. Diagnosis of Sensitized Spinal Segment (SSS):

3. Treatment: Concentrate on the sensitized spinal segment corresponding to the immediate cause(s) of pain (MTrPs, TsP, and muscle spasms) and the associated supraspinous/interspinous ligament nociceptive irritative focus. The injection techniques to be described desensitize the dorsal horn, eliminate the SSS and eradicate the peripheral pain generators.

INJECTIONS: for immediate and long-term relieve of pain: Alternative methods to desensitize the segment
post injection physical therapy:

A. Modalities – heat or cold; electric stimulation (sinusoid surging and tetanizing currents)

B. Exercises - Relaxation exercises followed by stretching:
C. Specific postural correction: Loss of cervical and/or lumbar sacral lordosis, extension and flexion deficiencies.

4. Diagnosis and removal of perpetuating and etiological factors:


Prof. Fischer

Marta Imamura
M.D. Physiatrist (CV)

Giampaolo de Sena
M.D. Physiatrist (CV)

Bryan O'Young
M.D. Physiatrist (CV)

Mark Young
M.D. Physiatrist

David Cassius
M.D. Physiatrist (CV)