This week Dave Anselmo welcomes Dr. Zho a Pain Specialist in Woodbury, NJ. Dr. Zhou started out in Chine as a orthopedic surgeon before moving to the United States where he owns his own practice and teaches at the University of Pennsylvania. Dave and Dr. Zho talk about the different pain management therapies and how both Dr. Zho and Dave work together to get your orthopedic problems under control.
COMMERCIAL: [00:00:04] It’s time for the Cross Keys Physical Therapy show with your host, Dave Anselmo. And now here’s Dave.
Dave Anselmo: [00:00:12] Welcome to another Cross Keys Physical Therapy show. This show is sponsored by Cross Keys Physical Therapy. We have two locations to serve you. One in Pennsville, New Jersey, at 181 North Broadway. And the second one is where we’re actually airing from in Washington Township, which is at 151 Fries Mill Road, University Executive Campus Building 600, Suite 1. Please stop by. We’ll be here from five to six one solid hour and we have a lot to go through tonight. Once again, my name’s Dave Anselmo. I am a physical therapist and owner of Cross Keys Physical Therapy and host of today’s show. First, a little bit about me. I am a graduate of Thomas Jefferson University. As a physical therapist, I help patients and injuries and chronic pain conditions to regain their range of motion, regain their strength, manage their pain and improve their quality of life. Ok. Over the past thirty two years, I’ve had the honor of treating and meeting many patients, and I’ve treated them for so many different things from neck, back, shoulders, elbow hands, hips, knees, ankles that gives on spinal conditions, such as holding this herniated post, spinal fusions, as well as concussions and vertigo and stroke conditions, just to mention a few. Let me just say this if you are in need of a physical therapist, experience does matter and that’s what I’m talking about. Experience matters. So if you have anything, we have a lot of experience here at Cross Keys Physical Therapy. Like I said, I have 32 years of experience in treating so many different types of diagnosis. We are experienced and quickly help the patients recover as quickly as possible, returning to the activities that they are living and or sports activities.
Dave Anselmo: [00:01:51] Let me go through a little bit about my goal with this radio show. As always, I talk on many shows it is to educate my listeners about what physical therapy can do and help them to recover, as well as I want to educate the people and listeners about how your family doctors, your specialists like orthopedic surgeons, podiatrist and pain management doctors worked also to help you and how physical therapists and these other specialist doctors work together and a common goal of getting you better. Let’s get into that. My co-host for today, we are lucky to have a pain management doctor, one through Linqiu Zhou, so let’s talk about that. So I’m going to go through a little bit with your bio, and I have a little bit. I want you to explain a little bit about where you come from. Dr. Zhou is a pain management specialist in Woodbury, New Jersey. He has over 37 years of experience in the medical field. He has graduated. He was a graduate of China Medical School in 1984. He’s affiliated with medical facilities such as Inspira Medical Center and Woodbury and Jefferson Cherry Hill Hospital. Dr. Zhou, thank you for coming. But also, I want to tell you, you’re not just a, I say, a pain management specialist. Your history, how you got here. I think it’s the very history I want to talk about. I want you to tell the people how everything happened to get you here.
Dr. Zhou: [00:03:05] Thank you, David. Invite me for today’s talk as you know, and I was an orthopedic surgeon in China. I came to the United States while I was retraining as a rehabilitation doctor called Rehab Doctor at Jefferson. I’m sorry about the University of Pennsylvania. Then, I did my pain fellowship at Jefferson and became my solo practice in the Woodbury area. However, I still teach at the University of Pennsylvania. Well, I’m a clinical professor at the Jefferson Department of Rehabilitation Medicine. I will give, you know, all the international talk. I also published a lot of publications regarding my clinical experience and also basic science research.
Dave Anselmo: [00:03:59] That’s phenomenal about the great background. Very helpful. Actually, I think we have a phone call already, so that’s what this is all about. We ask people to call in here, doctors out and ask questions to you and myself as well and to tell their history about, I mean, if they have an issue or experience in physical therapy that they want to talk about educating the people about what they have and what they did. And so it can help them because maybe they’re sitting home and have the same symptoms and don’t know what to do. So let’s talk about the first caller. Thank you for calling. You’re on Cross Keys Physical Therapy. Your question, please.
Maxine: [00:04:29] Good afternoon, David, for you.
Dave Anselmo: [00:04:31] Thank you. Your name, please.
Maxine: [00:04:34] Mike
Dave Anselmo: [00:04:35] Hey, Mike, how are you doing?
Maxine: [00:04:36] You’re good. Listen, I just wanted to call in and let people know that over the 20 some years I’ve known you, I’ve been in your office probably three or four times from car accidents and surgeries or pretty severe. And you’ve put me through every one of them. And there was talk about me never moving my neck again. I’m moving my neck. It was about me not being able to walk right and I’m walking right. There are not many people out there, whoever is listening has the talent that David has. There just isn’t any. He knows what to do, where to go. I mean, I couldn’t do it, but I have a headache and the headache is gone. He ever got stinging down my legs. It’s clear that there’s not much that I can say that David doesn’t know because he knows pretty much everything and his talent is time and his patience is unmatched by anybody. I’ve been in business since 1988, and I’ll tell you there’s not many people like David. Just the other day, I was told, I love you, Dave. Thank you very much.
Dave Anselmo: [00:05:50] Thank you very much, Mike, for calling in. They bring tears to my eyes, but I must say it’s what I love to do and you know, I treat everyone the same. It’s a passion to get people better, and I think, thank you very much for calling in. I really appreciate the phone call and backing you. Give me everything that keeps you going. So thank you very much, Mike, for calling in once again. I appreciate that, and it’s a good thing for the patients to understand. You know, not not every physical therapist is the same. I mean, experience doesn’t matter, like I mentioned earlier. You know, like I say, I have 32 years experience. There’s not many things that I haven’t seen, and I think it’s definitely helped me as well as I think I get it. I haven’t mentioned that I am a manual therapist, so I do a lot of things at my hand. I think it’s really important that you have someone that knows what they’re doing in reference to not only treating you the way you need to be treated, but also has the skills levels to do with what they had to do. So thank you for calling again, Mike. So let’s get back to Dr. Zhou, let me let me put the numbers out there for our callers and reference to calling in or show area code 856-626-0400, I’m opening lines up to our callers. Once again, we have Dr. Linqiu Zhou. He’s a pain management specialist, and my name’s Dave Anselmo. I’m a physical therapist and Cross Keys Physical Therapy, so please call in and ask the question. Or once again, like Mike just did tell your story about what physical therapy is done for you. It doesn’t have to be someone from Cross Keys Physical Therapy. It could be any facility. Just tell your story, because I think it’s important that patients understand what physical therapy can do for them. So, Dr. Zo, let’s talk about this first question. I want to ask you What does pain mean to you?
Dr. Zhou: [00:07:27] As we know and a lot of patients suffering the pain, especially chronic pain conditions as a pain, especially, we all always treat the pain a serious, you know, pain not only affecting patients daily activities and also if the patient quality of life, sometimes they can call them mental distracted. So therefore it is very important to deal with their pain patients appropriately. And first of all, a lot of patients, because they are paying a lot of concern as a pain physician, always make a good diagnosis, make their treatment options for patients and resolve their concerns and also for the long term to prevent the pain that will occur in the future.
Dave Anselmo: [00:08:18] That’s very good, very good. I always say to my patients that when they have pain, pain to me means it’s your body’s alarm system, OK, just like you have an alarm system at home and not when you have the alarm system going, you need to address it. You can’t just ignore it. I think pain to me, when someone has pain, it’s telling them that something’s going on. They have something going on that’s creating pressure on that nerve impingement, compression or something that I need to address. They can’t ignore it. The longer they ignore that symptom of pain, which is all it. Again, I believe our alarm system through our body that the more complications they may have in the worse it gets, the more information they get, the more problems they have, the more compensation they start getting into. I tell people when they have pain, they need to address it as fast as possible. Do you agree with that?
Dr. Zhou: [00:09:04] Yeah, a hundred percent agree with that.
Dave Anselmo: [00:09:05] That’s great. That’s great. Ok, so next thing I got to ask you a question about people coming to me and ask me what it means. I always tell them that as a pain management specialist, what factors would you need to see to use injections over medications or medications or injections? Because patients always ask me, Oh, why do I need to go on medication? Why would I want pain management? Why do I need pain injections? What makes you determine which one is the best for them again?
Dr. Zhou: [00:09:32] And for all the patients that, first of all, need to make a good diagnosis or. That diagnosis was causing the pain. We treat the underlying problem, we do not just treat a face, the patient’s pain, you find the underlying problems. Then based on the underlying diagnosis or underlying pathology, then we will deal with the patient, you know. Some patients require injections. Some patients may require medications. Some patients may look like their physical therapists. Again, it is very important, you know, to make a diagnosis to differentiate what is a pathology first and not a patient had, you know the anxiety of the pain. A lot of concern. You really do not know the underlying pathology. You gave in to the pain. Pills may not, you know, they treat. The underlying part will be called a long term side effect for the. Just give them medication. Excellent.
Dave Anselmo: [00:10:37] So it all really starts on your evaluation. You need to evaluate the patient to find out what’s going on with them first. That’s where it starts. I agree the same thing with physical therapy. When someone comes to us, you know, we look at the script, we look at this, but we really evaluate these patients to find out what is important to them and what is medicine. We customize our treatment plan based on what we see and what’s important to the patient. So we treat each patient as an individual, whether they come in before whatever it may be. We don’t just look at that prescription. I mean, it’s really, really important that you treat them as individuals as they are. So thank you for that. Next thing I’m going to ask you a question is what are some of the most common reasons people come to see you with pain? What are the most common things
Dr. Zhou: [00:11:17] As we know, lower back pain, there’s to the common cold as the second most common to see a physician across the board. So therefore chronic pain, especially chronic back pain, including lower back pain, is the most common to see the physician.
Dave Anselmo: [00:11:40] Very good. Very good. So we’re going to take a quick commercial here and go on so we can get a caller on the line. So let’s take the caller right now first. Welcome to Cross Keys Physical Therapy your name, please, and then your question for myself or Dr. Zhou.
Maxine: [00:11:56] Yes. Hello. My name is Maxine Butler Pressley. How are you? Good.
Dave Anselmo: [00:12:00] How are you doing, Maxine? Thank you for
Maxine: [00:12:01] Calling. I’m doing well. You’re welcome. I’m a patient and I’m just calling with a testimony and also a question. Basically, I’ve suffered with chronic pain since the age of 14, and I’ve been through numerous therapy. I’ve been through pain management also. I’ve also had many injections and physical therapy, numerous counts. But one thing that I found that has been very helpful is aquatic therapy. And Dave, you’ve been very instrumental in helping to get my pain not completely gone, but you do get it under management and I really do appreciate that. I just want you to, if you wouldn’t mind, just could you explain the difference between the lens therapy and the aquatic therapy for me? I have extremely limited mobility along with excessive pain and hypersensitivity. Yes, I know the benefits you have. I just feel like there should be so many more people that’s doing aquatic therapy as well as land therapy. If you could just explain some more of the benefits.
Dave Anselmo: [00:13:18] Well, thank you for calling Maxine. Yes, I will. And I guess I should have mentioned that that’s one of the specialist things, especially that we have here at Cross Keys Physical Therapy. We not only do land. We also have aquatic therapy where we have a full 20 by 30 aquatic therapy pool, which is customized for our patients. And we love to use it for some very different reasons. But for you yourself, I hope you don’t mind me. Explain a little bit about yourself here. Yeah, but you have some fibromyalgia, which is very, very massive, major inflammation going through your body where it affects a lot of 18 points, then you have like 15 points. They say if you have 12, you’re diagnosed with fibromyalgia, you’ve had it for quite a long time and you’re doing quite well with it. We decided to put you in the water because for two reasons: one, on land you have a lot of compression, you have a lot of gravity coming down on you, and it’s really, really tough on your body and your joints. You become very inflamed a lot sooner than the average patient, a lot more severe with activities as well with stress. So we put you, we put her in the pool to decompress the spine and decompress all the other joints.
Dave Anselmo: [00:14:21] Because we know in the water our water is ninety four degrees. So it helps that one increases the blood flow to decompress the body because normally we put you in the water at waist level, it decreases the compressive forces by 50 percent. We put you at shoulder level, it decreases by 70 percent. At neck level, we decrease it by 90 percent. You’re basically weightless in the water and. It’s so important when someone likes you because it gets you to be able to move and move a lot more faster and helps increase the blood flow anytime you increase blood flow into the area and we’re able to start strengthening, it helps you so much more. So it’s very effective and it has helped you a lot. And I really appreciate the phone call and I appreciate the backing and reference to what we’ve done for you because I think it’s really important that people don’t realize that you have fibromyalgia. I mean, aquatic therapy is very important. It can be very helpful for you. So once again, thank you so much for calling in, and I appreciate that phone call and the support you have given me at this point.
Maxine: [00:15:15] Oh, you’re so welcome. Thank you for everything. I’ve just got to tell you about being in the pool. It’s liberating for me because I can do things in the pool that I could never do on land, and I just really appreciate that I’ve actually found your place because it’s like finding a diamond in the rough for me. So thank you very much.
Dave Anselmo: [00:15:36] Thank you very much and thank you very much. And all of the people know that not only when she gets in the pool, I mean, you have you have residual. I mean, it helps her after she gets out, she’s able to do so much more. It’s not just in the pool that she can move. She leaves. It helps to decrease the inflammation. She’s able to do more. She’s able to do more strengthening exercises that she could not do on land that would actually make her inflammation worse. So it’s very effective in so many ways, and I see her getting stronger and stronger and stronger, and it allows her to be able to do more things in a functional manner as returning back to her activities of daily living. And that’s what physical therapy is all about. We want to increase the patient’s range of motion and increase their strength, as I mentioned earlier, and return them back to as many activities as they possibly can their adults as fast as we can, as safely as we can over a short period of time as we can. So thank you again for calling in. I really appreciate that. So let’s go to a commercial. We want to go to commercial fast, but I think we’re going to get at the numbers as fast as possible to other callers that can call in so they can talk to Dr. Zhou as well as myself.
COMMERCIAL: [00:16:35] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They address back, neck, athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away and participates in a broad spectrum of insurance plans. 856-374-3703 in Washington Township and 856-678-8000 Pennsville. Listen, ninety two point one.
Dave Anselmo: [00:17:50] And we’re back and thank you for Cross Keys Physical Therapy. My name’s Dave Anselmo. I’m a physical therapist at Cross Keys Physical Therapy and owner of Cross Keys Physical Therapy, and we have the honor of having Dr. Linqiu Zhou with us today. He’s an MD. He’s a specialist in pain management. He’s from Woodbury, New Jersey. He has an office. His office is at 730 North Broad Street, Suite 100, Woodbury, New Jersey. And let me give you a phone number on that. First, the area code 856-202-5331. Dr. Zhou his phone number is 856-202-5331. Let me just say a little bit about this, though, not as though he’s now. He’s a specialist. He’s very good at what he does. I have sent several patients to him and everyone comes back very happy because he has a little bit of reputation, though this. I like to say you have a little name here, which we call one shot Zhou, I like to bring that to your attention. How did you get that name?
Dr. Zhou: [00:18:49] Thank you, David. As we know, because of my background, I was an orthopedic spine surgeon and then I trained as a rehab doctor and also pain management. Because for all the patients, you need to make a good diagnosis before you put a needle to someone. When you have a good diagnosis, like hunting deer, you know where the anchor, the the target, then you go to your special technique because of my special training. So I always put the needle on white spot and therefore get a good outcome. Again, one more important thing is you also educate a patient, you know, know their problems, learn to let patients go to them more exercises, for example, to follow up physical therapy program therefore can or more or good outcome because a good patient give me the name one shot Zhou.
Dave Anselmo: [00:19:45] Well, I think it fits. It really does fit. Like I said, I’ve used a doctor so many times over the years and all my patients come back very, very happy because it pretty much I mean, one shot. It’s all it takes being an orthopedic surgeon doctor, Dr. Zhou, you really know the body a lot better than the average pain management specialist. I think that that puts you several steps ahead of some of these pain management specialists in the area because you know the body so well and it really shows in reference to somebody you do. And one thing about another thing that you do is that you utilize your profession and the right way. You give the injections or whatever may be and utilize the understanding to decrease their pain levels. But you follow up with that by following them and giving them physical therapy because you realize how important exercise is after the purpose of which we talk. A little about that is about the purpose of decreasing their pain and giving them the medications. We’re giving them injections to pair them so they can get physical therapy, because a lot of times these patients are in so much pain, they don’t know what to do, they don’t know how they’ll turn and relevancy and they come in. They’re so weak, they don’t know what to do because they’re in so much pain for such a long period of time that they get weaker and weaker and weaker. And then when you give them and you take care of them, the other, whether be an injection or given medication, it allows them now to get into an exercise program in physical therapy. And that allows us to help to give them more stability and get them back on their feet again and return to back to the activity of living. So I want to thank you for that because I think a lot of I have to admit, a lot of pain management doctors do not do that. I mean, they pretty much put them on medications and let them go on their own. I mean, they just don’t understand the next step. And the reason for giving them the injection is important and getting them back to return because these patients don’t do that if they don’t get that next level.
Dr. Zhou: [00:21:23] Exactly. And because you’re sometimes injecting medication when off and your patient, you know, does not do the exercises or physical therapy and medication cannot wear until cannot less than medication where the pain will come back. And again, you know, say a lot of things are even pain medicine by mouth because it cannot last too long. Therefore, it’s very important to follow up. And, you know, the exercise program including, you know, the physical therapy with detoxing and also aquatic therapy as well.
Dave Anselmo: [00:22:00] Very good. Like I often tell stories from time to time, and one just goes to my mind right now, I had a patient just two weeks ago come into me that had a lateral tracking of the knee, has had several treatments, had medications put on medications, have gotten three months of consecutive injections, but never got sent to physical therapy and realize that what I say to them that they really is because of the fact that they never really addressed the cause of the problem. And that’s exactly what you really have had a step ahead because you are addressing the cause, because if I send them to physical therapy now, I address them all, evaluate them. And I realize this patient had a lateral tracking of their knee where the patella is hitting on the lateral condyle and tearing up the cartilage behind the patella. And if you just keep getting injections, yeah, it helps temporarily, like you said earlier, because it just decreases the inflammation, but you’re not addressing the cause. Now the cause is basically being that patella gliding laterally, hitting on a condyle. We need to address that. We need to balance that knee out or that’s going to continue to go on and on and on. So addressing the cause of why they have the pain is so important, and that’s something that you’re addressing when you do your evaluation, correct?
Dr. Zhou: [00:23:06] You know, it’s another physician, you know, always a lot physical therapy precautions as a physician always make a good diagnosis and then you know where they are therapy, we can send to an aware what kind of modality and what kind of exercise we need to put our the precaution let her to guide physical therapy can do the better job.
Dave Anselmo: [00:23:30] That’s very good. Well, thank you very much. So when you give a cortisone injection, how long of relief do you expect and when would you determine the length of relief to be as?
Dr. Zhou: [00:23:45] As we talk about, you know, the cortisone is a steroid, sometimes you cannot last too long. We inject the patients on death. Usually we combine the steroid with a local anesthetic like lidocaine. The first step, you know, lidocaine usually lasts like 6 to 12 hours. As we had an experience like a dental procedure, you numb the nerve for several hours. Then we bring the steroid to kick-in usually. And after 24 hours steroids’ kick-in and we start to work. Usually lasts for a week, but still depends on the patient’s pharmacology. The medication cannot last forever. Therefore, every patient of the injection always has a follow up and you know that some kind of exercises, such as a physical therapy or weed reduction programs, you know, is a modality link unless their steroids can last longer. Otherwise, after they’re steroids wear off and the pain we are coming back. So our job is, you know, to make a patient feel better than patients. The ease involved doing exercises that involve physical therapy.
Dave Anselmo: [00:25:00] Oh, great, great. Now my question to you basically is there’s a lot about how much cortisone you put in. Is it based on anything on how long the patients had the inflammation or how much information they have in their joint that you know, the life they might have it for a month or if they might have it for five months? Does that make a difference in reference to how quickly they’re going to recover after that injection?
Dr. Zhou: [00:25:19] You know, it depends on the patient’s pathology. Again, you know, some patients for acute injury or, you know, mild also arthritis one lidocaine less. You won’t care less a couple of months, a couple of years if pain follows the instruction to a patient per year for the severe osteoarthritis that if this cannot last too long, however, your patient can follow the physician’s recommendation, for example, you know, weight reduction program and strengthen muscles. Some patients can last for a long time as well. So everyone presents the clinical presentation differently. The outcome is different.
[00:26:02] Well, you just mentioned weight decompression. Now that’s what leads right into aquatic therapy. I mean, that’s what it’s all about when you have a system like that to have an injection, especially to the lower extremities. I mean, aquatic therapy is a perfect place for them to be after getting an injection because it allows us to be able at one get to get the joint moving as quickly as possible that once again, like I said, the water is 94 degrees is it’s definitely helps to increase the blood flow and helps them move at that inflammation a lot faster. And it allows us to start on the rehab a lot quicker without having any type of compression on the joint, which will bring back more inflammation and compression on that joint and allows us to start on a strengthening as quickly as possible and so effectively. And I really that’s that’s a great point that you just said in reference to their deconditioning. A lot of these patients, they do that.
Dr. Zhou: [00:26:46] I want to add one more thing because some patients, you know, say, for example, like a knee, hip osteoarthritis patients have mobility dysfunction. You send a patient for land therapy or walking exercises, and both the physician likes and the patient cannot walk. Even though you know you want to send your other injections, you feel better because the injection cannot last forever. Therefore, you can send a water therapy because the weightless, as we mentioned, weightless in the water. And I also feel more comfortable and therefore patients can get more confidence for physical therapy programs and therefore can gain the, you know, the first step you know, to you for the long term recovery.
Dave Anselmo: [00:27:34] All right, thank you. Thank you. Once again, Dr. Zhou Dr. Zhou has his office at Woodbury New Jersey address at 730 North Broad Street, Suite 100 Woodbury, New Jersey. His phone number, again once again is 856-202-5331. Dr. Zhou, which we highly recommend in reference if you have a problem with pain and really don’t know what to do. Doctor Zhou, do they do it should they come to you? Or if that or take an orthopedic surgeon first? Or are they going to family if they have a lot of pain? Or can they come right to you?
Dr. Zhou: [00:28:12] The patient, sometimes they let me call my office because a patient can check the website and, you know, see a lot of patients with a recommendation that could be your referral. I’m sorry. I’m sorry. Both the patients are also referred by family physicians as spine surgeons. And also other specialists are also for physical therapy as well as we know and the most of the patients they have. The acute injury they scared allegedly do not know underlying pathology the most time to call their orthopedic surgeon for surgeon for evaluation. But most of the time you do not need to go to see a surgeon until you’re sure you have a broken bone. And because an orthopedic surgeon, they are very busy and then most of the time they are in need of surgery for, for example, for lower back pain, 90 percent 80 to 90 percent patients will resolve the symptom in two two months. So therefore, if you have a patient who has a problem like an injury, bad pain or mild joint injury, I recommend seeing that, you know, the pain specialist. All we have is a doctor like me, and because I’m a rehab background and pain doctor for further evaluation, we treat a patient until you know your patient did a surgery to not delay the referral surgeon. But most of the patients we treat without surgical intervention, we can resolve the problems.
Dave Anselmo: [00:29:49] That’s important. I mean, that’s that’s what it’s all about, right? We were always trying to prevent surgery. I mean, that’s what physical therapists are to our main goal. And obviously, that’s one of your goals, right? I mean, especially when you see neck problems and especially spine problems. And I think that’s the number one thing that people fear. I mean, they’re worried about having their spine operated on because of obvious reasons they’re worried about. You know, so many things can go wrong. I mean, you’re dealing with the spine. The spine is very, very particular in reference to, you know, the spinal cord. It’s your controller. I mean, it’s your brain or your nervous system. So you really, really need to be specific in reference to and what Dr. Zhou has, you have 37 years of experience thought this out. I think that that’s quite amazing. And not many patients really understand how important experience is when it comes to when you’re having someone dealing with giving injections into your spine. You really need to know what you’re doing. I mean, you really have to be specific and have a name one shot Zhou. So that’s all I have to say. I mean, I really have a lot to say about that. So we’ll take a quick question. We’ll take a quick commercial here. We’ll go right back to you. And once again, we have Dr. Linqiu Zhou from Woodbury, New Jersey, a spine specialist and pain specialist. So we’ll get right back. And my name’s Dave Anselmo. I’m a physical therapist and Cross Keys Physical Therapy will be back for your questions right after this commercial
COMMERCIAL: [00:31:05] Cross Keys Physical Therapy and sports medicine center celebrating 30 years of excellence. Our programs are designed to ensure prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back, neck, athletic, orthopedic and joint replacement rehabilitation therapy, and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away and participates in a broad spectrum of insurance plans. Two eight five six three seven four three seven oh seven in Washington Township and eight five six six seven eight eight thousand in Pennsville.
[00:32:11] Was it ninety two point one?
Dave Anselmo: [00:32:24] Welcome back to the Cross Keys Physical Therapy show. My name’s Dave Anselmo. I’m a physical therapist and owner of Cross Keys Physical Therapy. We have two locations to serve you. One in Pennsylvania, one Pennsville, New Jersey, at 181 North Broadway and the other one in Washington Township at 151 Fries My Road. You can go to our website if you want to find out locations, obviously. CrosskeysTherapy.com. Once again, it’s CrosskeysTherapy.com. You take the local generic. Is all the information that you may need in reference to our locations and what we do and reference to all, all the diagnoses that we do treat as well? Once again, we have Dr. Linqiu Zhou on the show today. He’s an M.D.. He’s a pain management specialist. His office is at 730 North Broad Street, Suite 100 Woodbury, New Jersey. His phone number? Let me put that out there again, doctor. So it’s area code 856-202-5331. And our callers, I want to call in the area. The number to call in is at area code 856-626-0400. Please give a call in and ask your questions to Dr. Zo myself. You can ask questions. We’re obviously just to call in and tell your story about what physical therapy has done for you in reference, because I really do believe this.
Dave Anselmo: [00:33:41] The reason I’ve done this show is because I realized that a lot of people out there that are in pain about this, and really don’t know what to do, don’t know the direction to go in. And they really need to have a direction, I think, than people calling and giving their story. And they’re sitting home. Hey, that sounds like me. I mean, and they realize that, hey, maybe physical therapy can help them. Or maybe they need to see a spine specialist first or a pain management specialist because they don’t know what to do. So that’s basically what the show is all about. And I really want to appreciate and thank you for coming on today. I’ve been dealing with you for many years and you’ve done such a great job for all our patients, and I really think it’s important that people know that now when you when you have people that come in with pain, when they give them injections, it when be do you have a lot of them returned because they maybe they didn’t get the results they want? Or sometimes you maybe don’t hit the right spot. Do you have that happen from time to time? And what do you have?
Dr. Zhou: [00:34:37] Yes, as we know, and they are the causes of the pain that different pathologies sign is the current neuropathic pain and neuropathy pain is being used or nerve damage such as, you know, the diabetic neuropathy or like a spinal cord injury or herniated disc. At least a pinched nerve called neuropathic pain or other pain is called a receptive pain. These are from tissue damage such as a knee like knee, also arthritis or fractures or tendonitis because of different pathologies, you know you’re not treated differently. Of course, you know, some patients may not fit the, you know, for specific injections, for example, like a diabetic peripheral neuropathy. You cannot, you know, inject a specific nerve, you know, because the whole body is damaged. These patients usually, you know, manage in a different way. Some patients do the injection, for example, severe knee arthritis. And if patients give an injection because of severe arthritis or severe injury, we usually try a one or two injection that is not a working combination for physical therapy. Then patients need surgery with the same patient for surgery. Therefore, we do see that some patients’ injection patterns don’t work, so it is a patient. I know the patient injection does not work, then we need a follow up, the different options.
Dave Anselmo: [00:36:11] Okay. Well, I mean, some things you understand, sometimes that people get injections or put on medications is a possibility that maybe they’re not following the instructions that you give them after they get the injections, something they of course, they feel so good, OK, and they get an instant relief. So they go and do things too fast or do things too to maybe irritate. And they don’t realize that because obviously the injection is decreasing inflammation and then they continue to maybe do you often ask the patient to ice their knee down or ice their joint down there to get the injection? Or maybe they don’t do that.
Dr. Zhou: [00:36:41] Correct, that, you know, a lot of patients out there, you know, their pain, resolve they forget that you know that the pathologist. So therefore, we need to always, you know, emphasize, you know what your patient needs to do their homework and not just for the physician. Just then, you know, give them one pill. So very, very important for, you know, the exercise program to follow the physician’s recommendations.
Dave Anselmo: [00:37:04] Well, like I said, or the possibility is, like I mentioned earlier for it, maybe the cause hasn’t been addressed. Obviously, the injections sometimes help and sometimes it doesn’t. And Reverend could be the fact that it really does help. But the cause is not being addressed in reference to, like maybe like I was talking earlier about that lateral patella. I mean, they go in, they feel great after the injection, so they go and start doing the activity and they don’t realize that they have that popping now because it’s being masked because of either the medication or the injection, and they continue once that wears off and all of a sudden it comes back. And the reality is it could actually be actually worse after that because the fact that they don’t realize the cause hasn’t been addressed. And I think that’s something that’s really important. And as you do such a great job, I don’t think it happens to me because you do an evaluation afterwards, I mean, before, before you do everything. So I think that’s really very important not to for you. Obviously, doctors say you do such a great job. Well, listen, we have a caller on the line, so let’s get to the caller. Listen, this is a Cross Keys Physical Therapy show, right? Caller, yes, your name.
Joe: [00:38:07] This is Joe calling. I have a question for the doctor. If he does PRP injection, yes.
Dr. Zhou: [00:38:18] Yeah, hi. Thank you for calling. PRP is a new therapy. Is that yeah, you get a patient’s blood and then you then get the injection to the tendons or joint. This is a new technology based on the same literature. This can accelerate that tissue healing. For example, the tendonitis or all the joints, I do some PRP. However, PRP is a sign insurance even does not cover, and the insurance is treated as experimental. So that still depends on the patient’s condition.
Dave Anselmo: [00:39:05] So basically, what you say is they don’t pay for it.
Joe: [00:39:07] But one of my questions is is it covered by insurance? I have Cigna insurance and I have Medicare A and B now. Would that be covered under any of those?
Dr. Zhou: [00:39:21] And there are some commercial insurance that are very difficult to get approved. You normally are required, you know, conservative treatment or other treatments such as cortisone injections or medication management, the Motrin’s nonsteroidal anti-inflammatory medication. Also failed a physical therapy and cortisone injection. Sometimes commercial insurance is very difficult to get approval.
Dave Anselmo: [00:39:54] Now you say they don’t approve because it’s experimental stuff.
Joe: [00:39:57] That was my question whether it would be covered or not.
Dr. Zhou: [00:40:01] You can come here, we can get you under. Sometimes it’s just so hard. It’s so hard to get approval because of all the insurance. And nowadays they want to save the money, you know, even single joint injections. You deny it like an epidural injection they deny. Sometimes we feel very frustrated because it ensures a. We know what the patient wants, but we can all care that you know what a patient you know really can offer for a patient because of an insurance denial.
Joe: [00:40:36] Well, that was my main question because they consider it experimental, correct and not approved, and they won’t cover it. That’s that.
Dave Anselmo: [00:40:48] Well, Joe, the best thing for you to do. Obviously, in this situation, I always tell my patients, call your insurance. Okay. Yeah. Call your insurance and ask them if they cover it. Yeah, that would be the best thing for you to do. Call them and ask them. And where up the front, you know, do. But Dr. Zhou, in reference to If you do, you do do it. I mean, have you? What’s your experience been with PRP?
Joe: [00:41:10] In fact, I have. I think I have ligament damage in my foot, in my ear. It still hurts. And I started, you know, I fell off a bicycle and twisted it, and it just nagged at me. The pain just nags on.
Dr. Zhou: [00:41:29] Ok, so even, you know, you can’t call. Yeah, you do, too. No, my you know, they come, let me evaluate you, and maybe we can address the problem before and due to the treatment conservatively, then we have enough evidence to convince your insurance to get approved for PRP.
Dave Anselmo: [00:41:50] Right? They don’t want this to get worse and worse and worse now. Doctor’s office. I’ll give you his address as well as a phone number. Joe, let me give you a phone number so you can just call. His number is area code 856-202-5331. Call him Monday and try to get scheduled off, I think that’s a great option for you. And this way you can get headed in the proper direction for your treatment.
Joe: [00:42:17] Sounds like the best thing to do. Thank you.
Dave Anselmo: [00:42:19] Thank you. Thank you for calling in, Joe.
Joe: [00:42:21] Okay. Ok.
Dave Anselmo: [00:42:22] Dr. Zhou, we have these issues. And once again, these people got to understand, obviously they have a problem and they have pain not to let it continue to go on the longer they go on. They don’t know what to do. Maybe in his situation, he’s waiting and hearing so much about PRP, what you hear often about PRP. Some people have good results, but some people don’t. You don’t know. And the fact is, you’re absolutely right. The biggest complaint is that insurance companies don’t pay for it and it’s quite expensive. I heard it’s very expensive, very expensive. Yeah. So that obviously is going to hold back on that. But like you say, there’s other options, you know, so try other things first. I mean, that’s not that’s not your first choice, I imagine. Right. It’s not your first choice to go PRP. Some of the other things they could do first, though. No, I definitely recommend you contact Dr. XJO and get you started. Listen, doctors, oh, we have another caller. So let’s get the caller on the line. Welcome to Cross Keys Physical Therapy. My name is Dave Anselmo, a physical therapist and owner of Kowalski’s, and we get Dr. Zo here. So he’s a pain management specialist. And your question, please. Hello. There you go. Hello. Oh, we might have lost that caller. Maybe we’ll get them back in a second here. Ok. Dr. Zhou, like I said, these people, they really there’s a lot of people out there that have pain, and I really appreciate coming on because they just don’t know what to do. And I think you really have answered a lot of questions for these people today and really have given them a direction. So I think it’s really, really important that these people understand that there are so many options that they do have. They never knew they had. I mean, they’re sitting home and they’re in their chairs or driving home from the shore, which is beautiful day to day. And here in your talk, I think is really giving them a direction that they never knew they had. So I appreciate you coming on today and helping us out today with this show. But the next thing I want to talk about is reference to you giving injections into the cervical spine. I mean, that’s something that people are very afraid to do. Is that something that should really be concerned about or?
Dr. Zhou: [00:44:18] Yeah. You know, the cervical spine, a lot of them are risky for a lot of pain physicians. And of course, you know, if a patient did get cervical injections, which do the cervical injections, first of all, we need to make a good diagnosis first and make a good diagnosis. Know where we know where the problem is, where they can put the needle on the problem area. Most of the patients, you know, you do not need to go to a very dangerous procedures site such as, you know, they could go too deep. Again, it’s very important, you know, the anatomy and the pathology before you put a needle on it.
Dave Anselmo: [00:44:59]Very important. Very important. The thing is that I want to ask you a question about this. It’s not like you’re just going in and giving them an injection in this mind. You use an ultrasound as a guidance, correct? I mean, people understand that. Can you explain how that works?
Dr. Zhou: [00:45:12] There are also some guides usually used for the joint and the cervical spine. Both use the X-ray guided furrows. The ultrasound is usually, you know, guided for a superficial nerve tendon or ligaments or the joint for a spine, and that, you know they’re so deep we usually under the fluoroscopy guidance are very safe. The procedures again, and for the cervical spine, usually, you know, they compare the other area, you know, relative risk for some physicians, even some physicians even afraid to put a needle to the cervical spine.
Dave Anselmo: [00:45:53] I agree. And but but there’s really I mean, you’re called one shot Zhou, there’s a reason for that doctor. So, so and I treat I’ve seen many of your cervical spine patients and you send them over to. They do such a great job and just that they really, really do well. So but they’re not you’re not guessing when you get this injection. That’s my point. You have it. You’re doing an ultrasound, then say, you know exactly where you’re going and you know where you’re putting it. So you know how deep you’re going. I mean, so it’s pretty much a scientist, right?
Dr. Zhou: [00:46:21] Yeah, you can say that, you know, because of a cervical spine, you ‘re very dedicated and they’re very precise injections and you need to put the targeted nerve targeted and you do not make any mistake. It’s very dedicated.
Dave Anselmo: [00:46:42] Very good. So that’s the cervical spine. So my question is, basically, is that different from the lumbar spine? Do you use the same technology or do you use a different technology when you’re talking about doing the lumbar spine?
Dr. Zhou: [00:46:52] Yeah, the technology, you know that the skill is almost the same. However, you need more but be cautious, you know, they evolve more and they’re paying more attention. And again, I need a lot of patient education as well, and they’re doing the procedure. You know, the patient usually is the patient. There are certain positions, you know, we always take care of, you know, for very serious cervical epidural injections.
Dave Anselmo: [00:47:17] There you go. Ok, go there. So. So let’s talk a little bit about that. I mean, someone comes in, they say they have, they have neck pain and usually these patients have neck pain. They also have something called radical apathy that people don’t know what that is. Basically the tingling, sometimes a little numbness or a little pain, not even the cervical spine, but it’s going down the arm, going into the arm, going down into their fingers and so forth. These are things that you see quite often.
Dr. Zhou: [00:47:39] Oh yeah. And you know, as we know, the cervical spine connects to the brain and that stress is the spine. Cervical pathology can cause a lot of the symptoms. Some patients, you know, pinched nerves. We can call the pain radiating into the arm. We call cervical ridiculous apathy. Even some patients only have neck pain. Some patients may just have the headache because a cervical spine is based on an enemy of the top cervical spine that small nerves can cause in the headache we call cervical tension headache. I deal with patients all the time. You know, a lot of patients are for physicians shopping for patients, going to different doctors also. That diagnosis, if you do not have a good diagnosis, such as the way you call cervical Janet had it, then you cannot get a good outcome. You only know what the problem is, then you put a needle more precisely and then you can solve the problems, right?
Dave Anselmo: [00:48:40] That’s great. Now, most of these patients that have Cervical Radiculopathy, they usually come to physical therapy first, and we do a lot of things in reference to a Mackensie certified. And so we do a lot of exercise to try to push that bulging disc back in and take the pressure off the desk. And sometimes, if it doesn’t work, I’m telling you. Pain management is very, very effective with those patients who do not think they have a choice and do not know they have an avenue to go if physical therapy doesn’t help. Pain management is the next step. I think it’s really, really been effective.
Dr. Zhou: [00:49:09] Yeah, as we know and a lot of the pain physician is anesthesiology background or the PMR background because of my I had a spine background, and I also teach. I also do spinal research. I spend a lot of time educating my patients. You know, how can that be the oldest, the least kind of problem? First of all, I need to make a good diagnosis to explain to the patient, the pathology laying under water, go and walk. What are there for a long term? Is that a treatment to what patients are expecting? So therefore very, very important for my patient? I always spend a lot of time reviewing the imaging study to explain the pathologies and that to tell what a physician’s part physician can offer and what part the patient needed to do their part. So therefore, combining a patient and a physician like team work learning can solve the problems, and you were chosen from a physician and say, Oh, this is me and you fix nothing. Therefore, we always have team work and are very important also leads. The patient didn’t do a lot of exercises below order the muscles we call the core muscles. Therefore, we’re always the same in physical therapy like David. He always he’s teams, and have been doing a very good job from a patient because a lot of patients, each inch of video is different and need to address that differently.
Dave Anselmo: [00:50:44] Great. Great. Thank you. And that’s what we’re talking about. Like I said earlier, how pain management and physical therapy work together and people don’t understand teamwork and it’s all in the common goal. The common goal was to get our patients better, and I think we’ve been very effective at that. Once again, we have Dr. Linqiu Zhou, M.D., pain management specialist. He’s at 730 North Broad Street, Suite one hundred Woodbury, New Jersey once got his phone numbers 856-202-5331, and I’m Dave Anselmo. I’m a physical therapist from Cross Keys Physical Therapy. We have two locations to serve you as well. One in Pennsville and the other one in Washington Township, where we actually are at right now. If you want to get the addresses and the phone numbers, obviously just go to the website. CrossKeysTherapy.com We’re going to take a quick break for a commercial here and we’ll be right back.
COMMERCIAL: [00:51:33] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They address back, neck, athletic, orthopedic and joint replacement rehabilitation therapy, and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck, nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away and participates in a broad spectrum of insurance plans. Two eight five six three seven four three seven oh seven in Washington Township and eight five six six seven eight eight thousand in Pennsville.
[00:52:38] Was it ninety two point one?
Dave Anselmo: [00:52:43] And we’re back, welcome to the Cross Keys Physical Therapy show, once again, I’m Dave Anselmo, I’m a physical therapist and owner of Cross Keys Physical Therapy. You have two locations to serve you, one in Pennsville and one in Washington Township. Go to a website which is CrossKeysTherapy.com. We have nothing Renzo with us today. He’s a pain management specialist and MD. His phone number, if you want to get a hold of him, it’s area code 856-202-5331. Our callers want to call in and ask the question. We got a little bit of time left in this area code 856-626-0400. I can’t thank you enough for coming on because I think we really have helped a lot of people here that are in pain and really don’t know what to do. They’re there. The doctor hasn’t hasn’t given them an answer or they put them on medication and the patients feel that the medication isn’t working. So they just kind of give up. I mean, so they don’t know there’s another option. If so, I’m hoping there’s a lot of people out there right now that realize now that, hey, we have another step, I know there’s other things we could do. Pain management can help these people, and maybe their doctor hasn’t referred them.
Dr. Zhou: [00:53:59] And they we’re not only just giving our pain medicine injections, we are also attained new technologies such as, you know, the spinal cord stimulation, peripheral nerve stimulation and as in some patients such as, you know, the compression fracture, we also went to the vertebral procedure or other new technologies. Recently, I initiated a SI Joint fusion for some patients for chronic back pain. We do have that new technology where we catch up with, you know, the older and you are scientists development and I. We treated different kinds of patients such as, you know, the spine problems, neck pain, lower back pain, thoracic pain, sciatica, peripheral neuropathy, side headache and also the joint pain. You patients do not need surgery. That’s very good. Such as you know, they are carpal tunnel syndrome and the rotator cuff syndrome and the knee also arthritis before they go to the surgery combination that injection medication, especially patient education. Therefore, if we send patients for physical therapy, then a lot of patients may avoid the surgical interventions.
Dave Anselmo: [00:55:17] Excellent. Excellent. Thank you very much. So now I get to. I would like to thank my caller for today. We had several really good callers up as well. Thank you for calling in and supporting this show. Cross Keys Physical Therapy and also like to thank my engineer Tommy T. Behind the scenes without Tommy T. This show will not be possible. So thank you, Tommy, for getting this together and putting us in writing right on line. They think doctors, of course, will be my guest for today. Thank you very much. And this show has been sponsored by Cross Keys Physical Therapy. Once again, go to our web site CrosskeysTherapy.com until then. Next show is next Sunday at 5-6pm. God bless and God bless America.
Dr. Linqiu Zhou, MD
Professional Pain Associates
730 N Broad St Ste 100 Woodbury, NJ 08096