“The dictionary is the only place that success comes before work. Hard work is the price we must pay for success. I think you can accomplish anything if you’re willing to pay the price.”
– Vince Lombardi

Physical Therapy


See also:

Heat and Cold Therapy

Inversion Therapy

Massage Therapy

Muscle Release

Myofascial Pain

Trigger Point Therapy for Myofascial Pain


Personal Training

Genovive – Sample Nutrition & Fitness Report



 Definitions and Terms Related to Pain


Key to Links:

Grey text – handout

Red text – another page on this website

Blue text – journal publication


Physical Therapy Evaluation

The purpose of the physical therapist’s assessment as detailed below is three fold:
1. To provide the physical therapist an opportunity to examine you to see how your condition has affected the range of motion of your spine and joints, your muscle strength and even possibly your balance.
2. To instruct you in home exercises that you can do to improve these conditions and reduce your pain. For those patients engaged in Accurate Clinic’s chronic pain management programs, these services by the physical therapist are free as part of the pain management program.
3. To evaluate your muscles for the presence of painful areas called “ trigger points.”  Trigger points are areas in muscle that can be severely painful, triggering pain when touched or pressed, triggering pain when the affected muscle is stretched, contracted or otherwise moved. Also, the trigger point can refer pain to other locations so that while the pain may originate in a trigger point in the lower back, the pain can be perceived in the buttocks or thigh area. Trigger points frequently develop as a consequence to a spine or disc injury and can often be the actual source of pain inaccurately diagnosed as disc or sciatic pain. Diagnostic errors of this type have not uncommonly led to unneccesary and unsuccessful spine or disc surgery. If the physical therapist identifies the presence of trigger points, a safe and effective treatment plan can be advised and initiated as part of our chronic pain management program.
Please schedule an appointment with the physical therapist at your earliest convenience. The time needed for the assessment is usually 30 minuts or less.

What the Physical Therapist Assesses

Muscle Strength:
Individual muscles are tested when the therapist puts the patient’s body in specific positions that isolate a specific muscle. The patient has to push against the resistance provided by the therapist, and the amount of force a patient can generate is given a grade between 1 & 5.
Neck, low back, and limb movements are all measured using a tool called a goniometer. This tells the therapist and physician where the patient has movement limitations.
Combined Movement Testing:
These are movement patterns that the therapist puts the patient through based on where the patient’s injury is. The therapist analyses the movements and looks for abnormal movement patterns and painful arcs of motion.
Accessory Joint Mobility Testing:
This is when the therapist moves the patient’s joints without any help from the patient to test the glide of each joint. This allows an assessment of what problems each joint may have.
The therapist feels the patient’s m
uscles for spasm, tenderness to touch, tightness and trigger points.
Myofascial Pain Assessment:
Pain derived from muscle and surrounding tissues including the presence of trigger points. Trigger points  are areas in muscle that are sources of significant local and referred pain.
When the physical therapist’s assessment is completed, the therapist applies the findings to create a plan regarding what tissues and structures are involved in the pain. This provides the therapist with the means to guide and instruct the patient in aspects of body mechanics that will give the patient insights and methods to reduce their pain. These methods may include alternative ways of performing certain activities as well as specific stretching and strengthening exercises tailored to meet the individual needs of the patient.
Treatment options advised may also include Trigger Point Therapy directed at reducing the pain associated with trigger points and muscle. The therapist discusses these results with the patient at the end of the assessment and a full report is sent to the patient’s physician. The assessment session allows the patient to gain an understanding of the overall condition of their musculoskeletal system. It is also an excellent opportunity for the patient to ask questions regarding the physical management of their pain. This includes questions about sleeping positions and pillow placement, lifting, carrying and maneuvering in one’s home.


  1. HEP2Go.com
  2. Spine-Health.com
  3. WhyIExercise.com



Physical TherapyOverviews


Physical Therapy –  Fibromyalgia

  1. Benefits of a self-myofascial release program on health-related quality of life in people with fibromyalgia: a randomized controlled trial. – PubMed – NCBI – 2017
  2. Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled … – PubMed – NCBI – 2011
  3. Effectiveness of different styles of massage therapy in fibromyalgia – A systematic review and meta-analysis – 2015
  4. Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults – 2017

Physical Therapy –  LBP: Disc Pain

  1. LITERATURE REVIEW ON PERTINENT Imaging Findings for Discogenic Back Pain – 2015
  2. Lumbar disk prolapse – Response to mechanical physiotherapy in the absence of changes in magnetic resonance imaging. Report of 11 cases – 2008

Physical Therapy –  Myofascial Pain

  1. Comparison of two different techniques of electrotherapy on myofascial pain – PubMed 2002
  2. Expert consensus on the diagnosis and treatment of myofascial pain syndrome- 2021
  3. The Case for Comorbid Myofascial Pain—A Qualitative Review – 2020
  4. Myofascial Trigger Points Then and Now – A Historical and Scientific Perspective – 2015
  5. Trigger Points – An Anatomical Substratum – 2015
  6. A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia – implications for differential diagnosis and management – 2018
  7. Clinical implication of latent myofascial trigger point – PubMed -2013

Physical Therapy – Transcutaneous Electrical Stimulation (TENS)

  1. Transcutaneous electrical nerve stimulation (TENS) for chronic pain – an overview of Cochrane Reviews – 2019
  2. Transcutaneous electrical nerve stimulat
    ion (TENS) for neuropathic pain in adults – 2017
  3. Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults – 2017
  4. Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain – 2019
  5. Comparison of two different techniques of electrotherapy on myofascial pain – PubMed 2002
  6. Effectiveness of transcutaneous electrical nerve stimulation for the treatment of migraine – a meta-analysis of randomized controlled trials – 2018
  7. Effects of Transcutaneous Electrical Nerve Stimulation on Proinflammatory Cytokines – Systematic Review and Meta-Analysis – 2018
  8. Efficacy and Safety of a Stimulator Using Low-Intensity Pulsed Ultrasound Combined with Transcutaneous Electrical Nerve Stimulation in Patients with Painful Knee Osteoarthritis – 2019
  9. The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain – a protocol for a meta-analysis of randomised controlled trials (RCTs) – 2019
  10. Transcutaneous Electrical Nerve Stimulation Reduces Movement‐Evoked Pain and Fatigue – A Randomized, Controlled Trial-2020
  11. Transcutaneous electrical nerve stimulation for acute pain – PubMed – 2015
  12. Neuromodulation for Pain Management in the Inpatient Setting – A Narrative Review – 2021
  13. Transcutaneous electrical nerve stimulation, acupuncture, and spinal cord stimulation on neuropathic, inflammatory and, non-inflammatory pain in rat models – 2020
  14. Transcutaneous Electrical Nerve Stimulation – 2020
  15. Using TENS for pain control – the state of the evidence – 2014
  16. An ICON Overview on Physical Modalities for Neck Pain and Associated Disorders – 2013
  17. Myofascial Pain Syndrome – A Treatment Review – 2013
  18. Transcutaneous electrical nerve stimulation (TENS) for chronic pain ‐ an overview of Cochrane Reviews – 2019
  19. What is the effectiveness and adverse event data of transcutaneous electrical nerve stimulation (TENS) in reducing pain in adults with chronic pain? An overview of Cochrane Reviews – 2020
  20. Electrotherapy for neck pain – PubMed – 2013


Emphasis on Education


Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.


For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.


Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.


For more information, please contact Accurate Clinic.


Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

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