The Practice

Office Visits

The goal for each patient is to diagnose and explain the source of pain, treat the cause, speed healing, improve fitness, and prevent future injuries.

A first visit lasts between 45 and 60 minutes, depending on complexity. Dr. Swedan reviews a pain and injury history, medical history, life and work activities, physical activities, as well as expectations for future activities (be they an upcoming vacation, athletic or work event). During a thorough musculoskeletal, neurological, and postural examination, she formulates her plan for diagnosing the cause of pain and determining how to most efficiently treat it. The treatment plan is reviewed and modified with the patient so that it is achievable and most effective.

She provides very specific recommendations about treatments that will provide a non-surgical path to recovery. Her prescriptions include a combination of avoiding painful activities, adding strengthening exercises and appropriate stretches, medications, and physical therapy or home exercise. She may also suggest in-office treatments, such as cold laser and injections. Her recommendations are developed in collaboration with each patient and tailored to their goals and preferences.

If testing such as X-Rays or MRIs are recommended, we will obtain the insurance authorization as quickly as possible and give you results usually within 24 hours. If another specialist is needed to assist in care or diagnosis, Dr Swedan will facilitate quick and efficient access to the best specialists available.

To provide you with the highest level of care, Dr. Swedan does not participate in any insurance plans. You will be provided with a fully coded insurance-ready receipt to submit to your insurance company.

Injections and Pain Relieving in Office Treatments

Patients are often referred to Dr. Swedan by physical therapists or physicians specifically for trigger point injections. Most commonly used is a combination of cortisone and anesthetic medications to provide both instant and lasting pain relief along with decreasing inflammation and motion restriction. This allows faster recovery and return to normal activity. Dr. Swedan also offers biopuncture (injections of steroid alternative products including Toradol, Traumeel and Zeel) To minimize procedure pain, she uses a topical freezing spray and as small a needle as possible. For those who do not like needles, iontophoresis patches can be applied which use electrical stimulation to infuse the cells with dexamethasone. Cold laser, shock and TECAR are additional pain relieving treatments as described below.

Exercise Prescription and Injury Prevention

Both during and after injury treatment, Dr. Nadya makes a point to review your exercise program, progressing it as you heal. Both short and long term pain prevention includes addressing issues such as shoes, equipment, alignment, and movement patterns. Her knowledge of gym equipment and exercise trends allows her to understand the modifications needed to promote healing. Physical therapy is often part of her prescription, although it is individualized and specific. Dr. Swedan has established long term relationships with top level physical therapists in New York and is in frequent contact with them to follow a patient’s progress. Follow up visits usually includes exercise review to ensure effectiveness. Her philosophy: “Less is more” reinforces efficiency of movement, correct positioning, avoidance of pain, and use of appropriate resistance types such as weights or bands. She also is happy to speak with personal trainers or other fitness providers to keep each patient on track.

Cold Laser

Cold laser, also known as laser light therapy and low level light therapy, is an FDA approved non-invasive healing treatment. Cold laser is painless and without side effects. Results occur within 24 hours and include reduced muscle spasm, decreased inflammation, improved scar tissue, and regeneration of healthy cells. The healing is due to light penetration of injured cells where it excites photons at the mitochondrial level. Cold laser penetrates to at least 6 cm, allowing even the hip joint to heal. The Chattanooga Vectra Genisys laser used in this practice also includes infrared treatment, another type of healing light that warms tissues and increases circulation. Cold laser can heal muscle and ligament issues including coccyx pain, plantar fasciitis, finger sprains, meniscus tears, frozen shoulders, labral tears, and hamstring tears. Recommended treatment is weekly for five weeks.

Winback Back3 TECAR

Winback TECAR is an FDA approved painless noninvasive device that provides instant pain and tight muscle relief. Over time, Winback relieves muscle cramps, reduces scar tissue, and improves range of motion. Treatment time varies between 6-15 minutes and provides instant and long-lasting results. One treatment is wonderful, repeat treatments increase effectiveness.

The Winback3 is specifically recommended for the following : Tendinopathies inflammation of tendons created by injury or overuse Neuropathies inflamed, damaged or irritated nerves Contractures stiffening of muscles, tendons and joints limiting motion Myofascial Restrictions fascia and connective tissue tightness Trigger Points tender inflamed muscle that radiate pain Edema swelling Scar Tissue and Fibrosis thickened scars both superficial and deep

Winback TECAR incorporates electromagnetic waves including radiofrequency and electrical stimulation. Healing occurs through increased circulation to improve soft tissue oxygenation and nutrition, lymphatic stimulation to flush out toxins, fibroblast regeneration of collagen and fascia, and heat production to decrease pain and muscle tension. TECAR (a Spanish acronym: Tranferencia Electica Capacitiva Resistiva,) is otherwise known as Capacitive Resistive Electric Transference therapy. Note: Precautions for TECAR Therapy are electrical implants (pacemakers. Insulin pumps, spinal cord stimulators), over areas of infection, blood clots or active cancer, loss of sensitivity to warmth, in pregnancy, and over growth plates in children.

Stortz Masterpuls One

This acoustic radial pressure wave device is a type of Extracorporeal Shockwave, or ECSW. Shockwave works by breaking down damaged, scarred tissue and allowing increased circulation to stimulate healing. ECSW is renowned for treatment of tennis elbow, plantar fasciitis, achilles tendonitis and bursitis. It is also relieves the tightness and pain of muscle sprains and spasms including the neck, shoulder, upper and lower back, hips, lower legs, and ankles. Treatment takes less than 10 minutes. The sensation is described as “very strong massage” or “being hit by tiny rubberbands.” There is usually immediate pain relief. ECSW therapy is intended for repeat treatments although often 1 is effective. It can also be combined with other therapies. Because the Masterpuls uses acoustic (sound) waves, there are no contraindications. The device and treatment are FDA approved and codable for insurance reimbursement.