Therapeutic Interventions

Physical Therapy

Neurological physical therapy focuses on the rehabilitation of individuals with neurological disorders or injuries. It aims to enhance movement, functional ability, and quality of life by addressing impairments in motor control, balance, strength, and coordination. Our trained physical therapists use a variety of evidence-based techniques to restore function and independence. The therapy often includes exercises, manual therapy, assistive devices, and patient education to help individuals regain their ability to perform daily activities.

Neurological physical therapy is indicated for patients with conditions that affect the nervous system, including: Stroke , traumatic brain injury (TBI), spinal cord injury, Multiple Sclerosis (MS), Parkinson Disease, and peripheral neuropathy, among other conditions. Our approaches at West Wilshire Neuro center around the following techniques:

Diathermy

Electric currents (radio and sound waves) used to generate heat in layers of your skin below the surface.

Strengthening Exercises

Focused on improving muscle strength in affected limbs.

Gait training

Exercises to improve walking ability, often with assistive devices.

Posture and Mobility Exercises

To improve spinal alignment and movement patterns. Balance and Coordination Training: To reduce falls and improve functional mobility.

Electric muscle stimulation (EMS)

Non-invasive therapy that uses electrical currents to activate muscles.

Myofascial release (MFR)

Massage therapy technique that uses gentle, constant pressure to relieve pain and tightness in the body’s myofascial tissues.

Therapeutic ultrasound

Non-invasive procedure that uses ultrasound waves to treat pain and other conditions.

Infrared light therapy

Non-invasive treatment that uses light to treat pain and inflammation, and to promote healing.

Soft tissue release

Massage technique that can help reduce pain and muscle tension.

Benefits include:

Improved mobility, increased strength and endurance, enhanced balance and coordination, greater independence, and prevention of secondary complications (such as muscle contractures, pressure ulcers and joint stiffness).

Nerve Blocks & Trigger Point Injections

Peripheral nerve blocks and trigger point injections have long been used to treat various headache and pain disorders. These procedures offer quick relief and are generally safe, effective, and well-tolerated. The medications that are typically used include a local anesthetic and corticosteroids to reduce inflammation. These are injected with a small needle directed toward nerves in the scalp, such as those located in the back of the head, temple area, and above the eyebrows.

Nerve Blocks

Nerve blocks work by desensitizing overactive pain signals from the nerve to the brain. The local anesthetic numbs the area for several hours, providing relief while reducing pain intensity. Results can last from several days to weeks, with increased effectiveness with repeated treatments. Types of nerve blocks include the following:

Occipital Nerve Block

Targets the greater and lesser occipital nerves, treating pain in the back of the head. It is effective for conditions like occipital neuralgia, migraines, chronic daily headaches, cervicogenic headaches.

Supraorbital Nerve Block

Treats supraorbital and supratrochlear nerves, addressing pain around the eye, forehead, eyebrow, and scalp. It’s used for supraorbital neuralgia, migraines.

Auriculotemporal Nerve Block

Targets the auriculotemporal nerve, which innervates the temples and jaw, helping relieve pain in the jaw, ear, and temple, areas related to TMJ disorders.

Trigger Point Injections

Trigger point injections treat muscle pain in the neck and shoulders, which often contribute to headaches. These use lidocaine and corticosteroid medication to alleviate muscle tension.

Botox Treatment

Botox injections in the scalp and neck can prevent chronic migraines by blocking pain signals, and has been shown to be effective for chronic migraine prevention. Read more about Botox injections below.

Botox Injections

Botox, a purified form of botulinum toxin, is used to treat conditions such as chronic migraines, dystonia, and spasticity. It does so by blocking nerve signals that normally cause muscle contractions. For migraines, it is injected into the head and neck, reducing the frequency and severity of headaches. For dystonia, Botox targets specific muscles to relieve abnormal movements. Lastly, for spasticity, Botox helps relax tight muscles, improving function and ease of movement. Botox treatments typically begin to take effect within a couple of weeks and last from 3 to 4 months. Potential side effects include muscle weakness or localized pain, although it is generally safe.

Botox for Migraines

Botulinum toxin type A (Botox) is approved for the treatment of chronic migraines, which are defined as headaches occurring on 15 or more days per month, with at least 8 of those days being migraines, lasting for more than 4 hours. Botox injections for migraines are typically administered around the head and neck, including the forehead, temples, back of the head, neck, and shoulders, and repeated every 12 weeks.

Chronic Migraine

Patients who experience frequent and debilitating migraine attacks that have not responded adequately to other preventive treatments.

Refractory Migraine

Individuals who have tried multiple oral migraine preventive medications without significant relief.

Migraine with Medication Overuse

Patients who overuse acute medications (e.g., triptans, NSAIDs) and have developed a chronic daily headache pattern.

Quality of Life Impact

When migraines significantly impair daily function and quality of life, preventing work, social activities, or other important daily tasks.

Botox for Dystonia

Dystonia is a movement disorder characterized by involuntary muscle contractions, resulting in abnormal postures, twisting, or repetitive movements. Botox can reduce these contractions by temporarily paralyzing overactive muscles in conditions such as:

Cervical Dystonia (Spasmodic Torticollis)

Affects the neck muscles and causes abnormal head positioning, pain, and spasms.

Blepharospasm

Involuntary contraction of the muscles around the eyes, causing uncontrollable blinking or closure of the eyelids

Focal Hand Dystonia (e.g., Writer’s Cramp)

Involuntary muscle contractions in the hand or forearm that interfere with writing or other precise hand movements.

Oromandibular Dystonia

Involuntary muscle contractions affecting the jaw, mouth, and face, leading to difficulties in speaking or eating.

Botox for Spasticity

Spasticity refers to muscle stiffness or tightness resulting from an upper motor neuron lesion or neurological condition. Botox is commonly used to reduce this excessive muscle tone in a variety of conditions, including: Stroke, cerebral palsy, Multiple Sclerosis (MS), Spinal Cord Injury, and Traumatic Brain Injury (TBI).