Treatment

Dr. Sammour's exceptional approach has been developed after extensive study and training with different experts in the field of pain management and rehabilitation. He is proficient in musculoskeletal ultrasound testing for joint pathology and nerve entrapment. He has passed the first national examination and was awarded the Pioneer Certificate in Musculoskeletal Ultrasonography, which is very helpful for diagnoses of joint pathology as well as nerve entrapment, and ultrasound guided injection of affected areas without radiation exposure.

Muscle contracture can give rise to pain by its relentless pull on sensitive structures. Those shortened muscles develop active trigger points that gives pain in a distant area whether this is related to the toxic chemicals discovered in those trigger points or the changes happening at the level of the central nervous system (spinal cord and brain) through what's known as central sensitization in which the brain become super sensitive to different stimulation. The usual non-painful stimulus becomes painful as well through neural plasticity (capability of the nervous system to be formed and molded in response to external or internal body factors which involves changes in synaptic efficacy or formation of new synapses etc.). This may explain the wide variety of differences among patients and the challenges we face in management of their ailment since we have very limited tools available to identify such changes. This area currently is under intense research, which is a key area to explain different kinds of symptoms as well in rehabilitation success.

Dr. Sammour's treatment stems from targeting certain motor points in the affected area or body region. Guided by a nerve stimulator to identify the peripheral motor nerve to that specific area and injecting a small amount of lidocaine (local anesthetic), if successful the response is seen immediately in vast majority of patients, and lasts from several weeks to several years. The majority of those who do not respond are usually having other issues, which may require other intervention like spinal injections procedures, or have an advanced spinal pathology that may need surgery. The pain may be related to peripheral nerve entrapment in a distant area, or related to foot biomechanics, (fascial adhesions), faulty breathing patterns, stress, other medical conditions, side effect of medical drugs, etc.

Depending upon the individual, the treatments may include:

Peripheral motor nerve block utilizing nerve stimulator: Lidocaine
Provides relief through interrupting or blocking the signals traveling along the motor nerve, this induces muscle twitch response in the affected area which helps in removing the toxic chemicals, in addition to restoring the muscle length.

Fascial manipulation:
A unique method developed by Luigi Stecco based on identifying certain points in relationship of Fascia to muscles, tendons and ligaments by which practitioner can treat musculoskeletal dysfunctions with specific reference to human Fascial system.

Functional movement screen:
Evaluates problem areas, by watching the patient preform specific movements.

Posture analysis:
Analysis of the spine/posture of the patient to determine the cause of their symptoms.

Intramuscular Stimulation (Gunn IMS), Dry Needling of Trigger Points
Intramuscular Stimulation, Dry Needling restores the length and proper function to the targeted muscles. Needles similar to acupuncture needles are inserted into trigger points, which release the contracted muscle, and provide relief to patient.

Acupuncture
Another modality based on Chinese theories.

Prolotherapy:
Prolotherapy heals damaged or injured tissue by activating the body's natural healing process. The healing process is activated by an injection of a sugar solution along with lidocaine. This injection makes the injured tissue inflamed causing the body to naturally heal the damaged or injured tissue.

Osteopathic manipulation:
Osteopathic manipulation is a series of muscle manipulations and stretches.

Dr. Sammour is proficient in musculoskeletal ultrasound testing for joint pathology and passed the first national musculoskeletal examination and was awarded the Pioneer Certificate in Musculoskeletal Ultrasonography. Ultrasonography is very helpful for diagnoses of joint and soft tissue pathology and ultrasound guided injection of affected areas without radiation exposure. These areas include:

· Shoulder pathology like rotator cuff tear, bursitis and arthritis
· Tennis/golfer elbow
· Hip and sacroiliac joints
· TMJ/headache/neck, shoulder, back, and extremity disorders
· Knee joint
· Wrist joint
· Carpal tunnel
· Trigger finger
· Ankle pain & Morton's neuroma of the feet
· Plantar fasciitis
· Trained also in spine sonography and ultrasound guided procedures of the spine and peripheral nerves


Worldwide Recognition - Dr. Sammour was invited to attend the Interdisciplinary World Congress on low back and pelvic pain held in Dubai on 10/20/2013. He presented his abstract on tail bone pain caused by nerve entrapment in the foot, "Coccydynia Caused By Interdigital Nerve Entrapment". This abstract was recognized by experts worldwide.

Dr. Sammour is one of a small number of distinguished physicians who are trained in the practice of this innovative technique. Even if you already have a primary care physician, Dr. Sammour can still offer an evaluation and further treatment for your problem.