Category Archives: Treatment and Recovery

We know that Oahu traffic can be pretty horrendous.  School drop-off time, rush hour, and even when headed to the beach on the weekends:  it can seem like we are fighting a battle behind the wheel.

Most people are probably not aware of the effect of driving on our spinal health.   Dr. Arthur White’s book The Posture Prescription describes studies in which people who drive for 20 minutes or more to work are far more likely to have back and neck pain than those who do not.  The reasons are unclear.  It may have as much to do with the auto’s vibrations during highway driving as much as the prolonged sitting.  Either way, the negative effects of driving on the spine are profound.

Most of us don’t have the luxury of living next door to our work!  And some of us even must drive on the job (delivery workers, bus drivers, etc).  So we all need to do everything possible to keep our spine protected while driving.


In general, car seats cause the pelvis to rotate backwards, causing the spine to go into excess flexion.  This forces the upper spine including the chest and shoulders go into a slumped position, thrusting the head and neck in front of the body’s line of gravity.  The neck is kinked in this position which accelerates any disk degeneration or arthritis.  What is worse is that over the years, this posture becomes a habit, intensifying the damage.

If your car has an adjustable lumbar support, use it!  Experiment to find what position maintains the best alignment for your spine.  If your car doesn’t have this, you can easily attain the right posture by having a small lumbar pillow in the hollow of the seat.


Driving is a perfect time for isometric abdominal exercises that strengthen the core and spine.  You can take advantage of especially long boring stretches of road to improve your muscle tone.  The Posture Prescription describes neat exercise called “The Dorsal Glide.”  To do this, you simply move your head as far forward as possible to a count of 5, keeping the chin parallel to the ground, and then pull it back slowly for another count of 5, as though you were a clucking chicken.  This can release a lot of strain.

Shoulder shrugs are also helpful while driving and are very helpful for those of us who carry a lot of tension in our necks.  Do do a shrug, draw your shoulders up towards your neck and hold a forced posture.  Then pull down on your shoulders by engaging the Latissimus muscles (along the sides of the rib cage) and feel the difference in the elongation of your neck.  Repeat as often as needed.  Pinched nerve pain from muscle spasm is often made better by this maneuver.

If you prefer a more passive type of exercise, you can do stretching at every stoplight or whenever you are stuck in traffic, not moving.  You can keep both hands on the wheel and tilt your head slowly left and right, bringing your left ear to your left shoulder, and right ear to right shoulder.  For a stronger stretch, use your right hand to reach over your head and cradle your left ear, and gently pull towards your right shoulder.  You will feel the muscle pull and it should feel good, and not too intense.

So even if you are stuck in the car for a long time, there are still things you can do to help your spine.  Fit bodies have fit spines!  And the fit driver is a more alert, and safer driver too – an excellent collateral benefit.

Here at Oahu Spine and Rehab our goal is to make you the healthiest version of  yourself, contact us today if you have any questions.

References:  Arthur White, MD The Posture Prescription, 2001 Three Rivers Press, New York


foot pain kailua

Do you have constant foot pain? Can’t wear your favorite pair of shoes? Generally speaking, there are three types of arches: low, high and medium. Among the general population, 60% has a medium arch, 20% has a high arch and 20% has a low arch. People who have either high or low arches face a slightly elevated risk of foot pain. Fortunately, there are many ways to effectively combat that increased risk.

The easiest way to reduce the risk of foot pain is to wear the right kind of shoes. Because most of the population has medium arches, most shoes on the market are designed for them. If you experience foot pain when putting on a shoe try to avoid wearing that shoe unless you are able to purchase a good set on insoles.

A podiatrist or physical therapist can help you with orthotics to help support your arches appropriately and disperse the shock as you walk, so you achieve proper body alignment, prevent injuries and maintain a healthy and active lifestyle. And while it may not as easy or fun as buying shoes, keeping in shape is an effective way to minimize foot pain.

If you are experiencing pain in your arches, OSR is able to determine the cause and plan a course of treatment. We will examine your gait, joint mobility, flexibility, strength and balance to determine whether you have plantar fasciitis, an inflammation of the foot muscles, or something more significant, such as a broken bone, sprain or heel spur.

If it does happen to be plantar fasciitis, it can be treated through physical therapy, nonsteroidal anti-inflammatory drugs (if your physician approves), muscle relaxants, and muscle strengthening and stretching. The other conditions will require more extensive treatment. Physical therapy for high or low arches may include:

  •     manual therapy for the foot
  •    deep tissue massage
  •     stretches to the plantar fascia and surrounding muscles
  •     strengthening exercise to decrease the strain
  •     instruction on proper shoe fitting and selection

People with medium arches should not think that a slightly reduced risk of foot issues will somehow protect them. Most foot injuries are not caused by the shape of a person’s arch but by the stresses they put on their feet. These recommendations are just as appropriate for those with medium arches as those without them. Regardless of the size, shape, height or length of a person’s arch, it is important that you treat your feet well. Avoid shoes that are too small or have no arch support. If you’re still having trouble come visit Oahu Spine and Rehab and we can create your treatment plan together.

Contact Us if you have any further questions or would like to book an appointment or call 488-5555.

Strain or Sprain?

Strain and sprain are both terms that you hear most often in professional sports games like football and soccer. This is because strains and sprains are two of the most common conditions because they’re the easiest injuries to acquire. A sprain is when you injure a ligament, that connects the end of one bone to another. A strain is when you injure a muscle or tendon which is what attaches the muscle to the bone.

Sprains and strains can happen in any muscle or ligament, which means that the severity depends on the location. The most common being an ankle sprain, sometimes requires crutches, a boot, or physical therapy depending on the severity of the sprain. Your primary care physician and the physical therapists here at Oahu Spine & Rehab can both assess your injury and come up with the best treatment plan possible to get you back to full health.

OSR physical therapists and medical team all agree that the best at-home remedy for sprains and strains is R.I.C.E., Rest, Ice, Compression and Elevation. Resting and avoiding activity is recommended for the first 24-48 hours after a sprain or strain. It’s also important to ice every 1-2 hours right after your injury to bring swelling down. Compression is important to support the injured body part in order to prevent further swelling and injury, this should be done for at least two days. Elevation is also to avoid more swelling, keep the injury elevated above the heart.

Here in Kailua, we see patients from young to old from athletes to marines.

We offer these services:

Chiropractic Care

Diagnostic Evaluation

Durable Medical Equipment

Injury Rehabilitation Exercise Programs

Massage Therapy

Pain Management

Physical Medicine

Physical Therapy

Weight Management

Call us today to set up your complimentary consultation at 488-5555!

The importance of disclosing the proper medical information to your massage therapist.

Do you ever wonder why your massage therapists are asking about what medications you take, or the status of your blood pressure? You come into OSR to relax for your one-hour therapeutic massage and then you get bombarded with personal questions that have no correlation with a massage, right? Well, actually your medical information means more to your massage therapist than you might think.

Telling your massage therapist about your medical history; including previous surgeries, injuries, allergies, and medications is actually quite imperative to your massage treatment. Our therapists at OSR custom design each client session to the individual’s needs and requests. The information you provide helps us tailor your massage to you; determining the appropriate depth of pressure to use or deciding if a massage would be beneficial or not. For example, as of a few months ago, our therapists offer cupping during longer massage sessions. If a client has high blood pressure or history of blood disorders and does not inform their therapist, cupping could potentially cause much more harm than good.

Massage therapy is great for the immune system. It increases circulation, moves fluids, and does wonders for the body. But, if you have cold or flu symptoms, or are running a fever, receiving a massage could actually make the symptoms much worse. When ill, your immune system is already working in over-drive. Flushing the system with a massage can flood the body with infection, exasperate symptoms and increase recovery time. Not only can it effect you negatively, you also run the risk of getting your therapist ill as well. If feeling under the weather, also inform your therapist and reschedule your appointment for a later date.

So what should you inform your therapist about? Anything that you might tell your doctor. Let them know about your blood thinner medication, or that you took aspirin an hour ago, or that you are on antidepressants and if you have metal screws in your knee.  Tell your therapist what areas you are having issues with, and your goal for the outcome of the massage. Tell them why you think you might be having pain in certain areas, whether it’s from repetitive use from playing baseball twice a week, or from holding your 25 pound toddler on your hip all day. All this information helps us in determining your care session to insure you are getting the most benefit from your massage here in Kailua without causing any harm to other areas of the body.

Here at Oahu Spine & Rehab in Kailua, our massage therapists are dedicated to making your massage as enjoyable and beneficial as possible. This means that they will avoid doing anything that would cause you further pain or worsen your condition. The best way for us to help you whether trigger point or massage, is for you to communicate with us as much as possible. To schedule a massage or to get more information, contact us at 488-5555!



Botox is widely known for its use in cosmetic procedures for skin firming and skin smoothing, but not everyone knows that there are tons of other health and wellness uses for Botox. Alongside cosmetic procedures, the health benefits of Botox are outstanding. Here are a couple FDA approved medical uses for Botox:

Chronic Migraines:

Botox for migraines is a newer concept in the last couple of decades after Dr. William J Binder found that his Botox patients claimed to suffer from fewer headaches after their Botox treatment. Generally if you are getting migraine Botox treatment then you will get anywhere from 31 injections to a little bit higher, and they are injected on your head and neck and generally last for around three months.

Excessive Sweating:

Although this may seem like a cosmetic issue, there is actually a condition called severe primary axillary hyperhidrosis that causes extreme sweating. Not only can this be humiliating, but it can also cause stress and social anxiety. Physicians that were administering Botox noticed reports that their patient’s faces were perspiring much less after Botox treatment. Because of this, the FDA approved Botox treatment for this condition in 2004. Not only is it used for excessive armpit sweating, but also for sweaty hands and feet.

Over-Active Bladder

Many women suffer from an overactive bladder postpartum and some even deal with leakage around five time per day. Botox can offer relief from leaks by relaxing the muscles that are constantly contracting in the bladder so that the leaks are more few and far between.

Coming Soon-

Other off-label uses that are currently not FDA approved but are under trials, are the use of Botox for abnormal heartbeats, depression, temporomandibular joint disorders (TMJ), severely cold hands, cleft lip scars, and neck and jaw spasms.

Coming soon, Oahu Spine & Rehab will be offering Botox in Kailua to our patients! We are excited to utilize the amazing cosmetic and health and wellness benefits of Botox right here in our windward side integrated health center. With the combination of our medical team and our physical therapists, we will have the best information and treatment plans available for you whether you are looking to use Botox for wrinkles or for your health. If you would like more information or to make an appointment at OSR, call 488-5555.

Recommended Reading




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What is acupuncture?

Acupuncture consists of the insertion of stainless steel, pre-sterilized and disposable filiform needles into the skin at specific points usually to a depth of one-half to one inch depending on the location of the body and the individual.  Typically, several acupoints are selected and the needles are left in from 20 to 40 minutes.  Stimulation can be done by rotating the needles manually or attaching electrodes to send a weak electric current through the needles (electroacupuncture). OSR is here to be your resource for acupuncture in Kailua.

Cupping is a traditional Chinese medical technique of applying a glass jar to the skin and creating a vacuum over specific points on the body.  This vacuum can remain stationary or be moved from one point to another. It is a great way to treat respiratory conditions, chronic illness and muscle pain.  It is also known for it’s detoxifying affect on the body as a whole.  It is also commonly used to lessen the appearance of cellulite.


How does acupuncture work?

In Chinese medicine, proper physiological function and health depend on circulation of vital nutrients (blood, body fluids, Qi , and other substances) through a network of “channels” or “meridians”.  This network connects every organ and part of the body, providing balance, regulation, and coordination of physiological processes.  It is understood that pain and disease result when the flow of Qi and blood through the body is disrupted or blocked.  This may be due to pathogens, trauma, medications, emotional instability or lifestyle factors such as overwork, poor diet, lack of rest, and stress.

Acupuncture stimulates appropriate points in the body in order to help restore balance and encourage the natural healing process innate in each of our own bodies.

The biomedical explanation of acupuncture is related primarily to the nervous system.  When needles are inserted, the peripheral nervous system reacts and sends a message to the central nervous system, which in turn responds by signaling and mediating the release of hormones, chemicals, and neurotransmitters.  These substances control tissue and organ function as well as moderate pain perception.  In addition, acupuncture promotes blood and lymphatic circulation throughout the body.


Acupuncture can help with:


-Sleep Disorders                                           -Immune System support

-Musculoskeletal Issues                                  -Prenatal & Postpartum Health

-Hormonal Imbalances                                   -Smoking Cessation

-Digestive Disorders                                       -Pain Management

-Fertility                                                        -PMS/Menopause

-Respiratory Conditions                                 -Depression/Anxiety

-Dermatological Issues                                   and more…


Here at OSR we strive to exceed our patient’s expectations of achieving better health and a higher quality of life. If there is anyway that we can help you do this, contact us, we would love to make you the best version of yourself.



Do you suffer from chronic or severe pain in your jaw? Are you someone that grinds your teeth or clench your teeth? Every wonder why sometimes when eating, speaking or even yawning is sore or find your jaw making a clicking popping like noise or even “getting stuck”? Well it is very possible you suffer from  a jaw disorder called temporomandibular disorder or most commonly known as TMJ.

TMJ includes the temporomandibular (TM ) joints that are  located on each side of your jaw and this hinge-like joint is what allows us to eat, speak, yawn and controls all opening and closing of the mouth. Any issues that prohibit these muscles, joint and bone from working as it should – is call TMJ.

Some common symptoms people with TMJ suffer from are; facial or neck pain when eating, speaking or opening your mouth widely, locking of your jaw, clicking or popping sound with movement of your mouth, swelling on the side of your face, headaches, toothaches, dizziness and earaches.

It is still unknown of what causes this misalignment and there is still no single cure for it. The three most popular recommendations are medications such as muscle relaxants or aspirin to help with the muscle aches, a night guard to wear while sleeping, or learning relaxation techniques to help control muscle tension within  the jaw.

As a massage therapist here at OSR in Kailua, it is common for me to come across a lot of tension in the jaw area. Let me share with you a simple technique to help reduce muscle tension using a self massage technique.

First, place your fingers just in front of your ears, slide them down just a few fingertips length.

Second, clinch your teeth you will feel the masseter muscle pop out. This is the muscle you will be massaging.

Third, using your fingertips,  apply as much pressure as you can tolerate comfortably and massage your jaw muscles using circular motions. Make sure to alternate sides.


As someone who also suffers from chronic jaw pain this, this may not be a “cure” for TMJ, but if you’re looking for quick relief or a way to incorporate a daily therapy technique, massage is definitely recommended. Next time you have an appointment at OSR, mention to your massage therapist that your jaw is feeling tight and we can help show you the technique to try at home. Not to mention, our chiropractors and physical therapists specialize in TMJ and can set you up with an entire treatment plan here at our integrated health center. To make an appointment today, call 488-5555 or contact us here!


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Anterior pelvic tilt (APT) is a condition that occurs when the front of the hips rotate too far forward and downward. It is also known as lower crossed syndrome. The common physical presentations are protruding abdomen and buttocks, and an increased low back arch (lumbar hyperlordosis). Refer to the figures below.


pelvic 1

We also frequently see a compensatory forward head carriage, loss of the cervical curve, and increase of the thoracic curve (upper crossed syndrome).

Beside presenting a poor posture, APT can be a source of significant low back pain. The increased lumbar curve puts significant pressure on the structures of the low back. This includes the discs, nerves, muscles, and joints. Along with pain, APT can cause premature wear and tear degeneration.

The most common causes of APT are thought to be muscle imbalances and malalignment of the pelvis and lower extremities (legs and feet). This would include weak abdominal muscles, gluteal muscles (buttock muscles) and hamstrings, and tight hip flexors (psoas, quads- especially rectus femoris), as well as tight low back muscles (erector spinae). Genetic predisposition can be a contributing factor.

The best treatment protocol is an integrated approach, to include, strengthening the weak muscles, stretching and massage to the tight muscles, and alignment of the bony structures. With our group of healthcare professionals here at OSR we will be working together to insure the best results for each patient. With a combination of physical therapy, chiropractic care, and massage therapy, along with our many modalities in our office, we can help ease your pain as quickly as possible. If you are suffering from anterior pelvic tilt or hip pain in general, call us today at 488-5555!

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With the start of high school sports, the hot topic seems to revolve around concussions. When do you pull an athlete from play? Who makes the diagnosis and who gets to clear the athlete to return to play? These are the questions that arise at all levels of competition whether it be from parents, teachers, coaches or administration.  Every level of competition has their own protocol but the majority of my experience came at the high school level. Some feel that high school athletic trainers have to be more in tune with recognizing signs and symptoms as they generally have less resources in regards to access to other professionals of the medical team readily available.

In my experiences at the high school level, state legislature will create rules as to who may diagnose concussions and who may clear the athlete to return to play.  Here is a general scenario as to how I treated a concussed athlete from time of injury to return to play.

Whether it be at practice or during a game, if any athlete sustained an injury to the head or body that caused any concussion-like symptoms (headache, disorientation, nausea, personality change, pupil size, balance deficits, tinnitus, memory problems, etc.) they were immediately removed from play and evaluated by the athletic trainer and/or medical doctor. The athlete then would go through a series of concussion tests involving symptom checklist, balance and cognitive testing. After putting the athlete through the testing and if any results suggest a concussion, the athlete is then removed from the game or practice and not to return until he/she has had a formal evaluation with an approved medical provider (M.D., P.A, N.P. and D.O.).

After the visit to the medical provider, if the diagnosis reports a concussion the athletic trainer/school administration will follow up on any restrictions whether it be athletics related or in the classroom. Usually the athlete will have to report back to their medical provider for clearance once their symptoms have resolved and no special classroom accommodations are needed. At this point, it did not mean athletes may immediately return to sports. The athletic trainer would then implement a return to play protocol ensuring they could tolerate the stresses of what their sport requested. The protocol entailed starting light cardiovascular (Bike, Treadmill) work to get the heart rate up and then re-evaluate symptoms before and after. If they come back 24 hours later and have remained asymptomatic they move on to the next day. Each day basically added more cardiovascular work, light exercise/lifting and functional training but still with no contact. After a few days of increasing activities monitored by the athletic trainer and assuming the athlete has remained asymptomatic, the athlete was allowed to participate in a practice with no contact and the final day would be to attend a full contact practice with no restrictions. If the athlete returned the following day after participating in a full contact practice with no symptoms and no restrictions from the academic/administration side, the athlete was formally cleared to return to play.

On average, the protocol lasted about 5-10 days. Some athletes went weeks in the protocol without being cleared due to having symptoms after a protocol day. For example, if an athlete finished protocol day 3 and came back the next day with symptoms, he/she would not participate and come back once his/her symptoms were gone and repeat the protocol day 3. There are always different circumstances with every athlete but the whole idea of the return to play protocol is to ensure the student athlete’s safety and making sure the brain has healed and has been given the appropriate time to rest. The athletic trainer’s job is to get the athlete back to play but without putting them at risk for further injury. Here at Oahu Spine & Rehab, we are able to do a concussion examination as well as help make sure that the athlete is able to return to play safely. Give us a call today at 488-5555 to make an appointment.

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Migraines are severe, painful headaches that occur due to alterations in chemicals and nerve signals in the brain leading to abnormal activity.  The cause of migraines are largely unknown, which makes it complicated to properly and effectively treat.  Common contributing factors may include: family history, allergies, previous head trauma, eye or ear disorders, irregular sleep or exhaustion, dehydration, hypertension, hormonal changes, and stress.  They usually occur on one side of the head, and are characterized by mod to severe throbbing pain, light and/or sound sensitivity, nausea, and decreased function or tolerance to regular activity.  These symptoms can last up to 72 hours depending on severity and cause.

Migraines currently remains an important public health problem.  According to Medical News Today, about 12% of all Americans ranging from ages 15-55 experience migraines.  That’s 36 million Americans!  Women are more commonly affected than men, and occur predominantly during their reproductive years, though reasons are unknown.   Migraines and headaches are the leading causes of outpatient and ED visits, and according to the National Headache Foundation, fewer than half of all migraine sufferers are properly diagnosed.

Some people can detect the onset of migraines prior to onset.  This “warning prodrome” occurs where the person experiences an aura of sensory disturbances such as flashes of lights, blind spots, dizziness or tingling in the arms and legs.  People who suffer from migraines can use these warning signs as a way to prevent a full blown attack by taking the necessary actions to minimize its symptoms.  Some common treatments include use over-the counter medications, drinking plenty of water, and rest.  Some studies also show acupuncture, physical therapy, and massage to be effective in the treatment and prevention of migraines.  Here at Oahu Spine & Rehab, our entire team is able to give you help in order to stop your pain. If you have ever experienced the dread of a debilitating migraine, come visit OSR and get some treatment! Call today for an appointment at 488-5555!

Recommended Reading



Gardener, H. Hypertension and Migraine in the Northern Manhattan StudyEthn Dis. 2016 Jul 21;26(3):323-30. doi: 10.18865/ed.26.3.323.

Magee, David J.  Orthopedic Physical Assessment: Fifth Edition, Pgs. 85-90.  Saunders Elsevier.  St. Louis, Missouri 2008

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