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Chiropractic adjustments are performed to treat a wide variety of conditions, including (but not limited to):

  • Arthritis

  • Bursitis

  • Carpal tunnel syndrome

  • Chronic muscle pain and stiffness

  • Headaches

  • Most Musculoskeletal Injuries

  • Nerve disorders

  • Tendonitis

  • Pain and stiffness in the spine, pectoral girdle, pelvic girdle, upper and lower extremities

  • Repetitive Strain Disorders

  • Sciatic pain

  • Scoliosis

  • Sports-related injuries

  • Whiplash and other traumatic injuries

Dr. Gorky F. Massache is an Authorized Healthcare Professional of TEMPUR-PEDIC. Our office can help you buy the perfect mattress, for a perfect nights sleep. Please visit for more information. 

Chiropractic Manipulative Therapy


The Doctor of Chiropractic is a specialist in spinal musculosketal disorders. He or she is expertly trained to diagnose and treat the many musculosketal injuries that may occur on the job or in your daily life.
Upon injury, the individual often alters the normal position or flexibility of the spinal vertebrae. Chiropractic treatment is designed to restore normal alignment and thus minimize pain and suffering. Gentle manipulative therapy or an "adjustment" is often effective in rapidly returning the injured person to a productive status. The Doctor or Chiropractic can also provide guidance with advice designed to reduce work-related injuries, proper lifting procedures, and therapeutic stretching exercises.

What do Chiropractors do?

Chiropractors diagnose and treat spinal misalignments that can occur from lifestyle or injuries causing pain, discomfort and degenerative conditions.


Who do you treat?

Our practice treats patients from a full spectrum. Our patients range from seniors to infants, as well as expecting mothers, little league sports injuries to professional athletes, auto-related injuries, and hard-to-treat conditions that other healthcare providers were unable to help. Our team of multi diciplinary physicians will work together to get you out of pain and back to your life.

Custom Foot Orthotics


Our office has the latest digital thermal scan to make precision foot orthotics.

  • Sport Specific Orthotics

  • Leg Legnth inequality

  • ​Fallen Arches

  • ​Flat Feet

Cool Sculpting


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Pain Management


Pain management (also called pain medicine or algiatry) is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. Pain sometimes resolves promptly once the underlying trauma or pathology has healed, and is treated by one practitioner, with drugs such as analgesics and (occasionally) anxiolytics. Effective management of Chronic (long term) pain, however, frequently requires the coordinated efforts of the management team.

Medicine treats injury and pathology to support and speed healing; and treats distressing symptoms such as pain to relieve suffering during treatment and healing. When a painful injury or pathology is resistant to treatment and persists, when pain persists after the injury or pathology has healed, and when medical science cannot identify the cause of pain, the task of medicine is to relieve suffering. Treatment approaches to chronic pain include pharmacological measures, such as analgesics, trycylic antidepressants and anticonculsants, interventional procedures, physical therapy, physical exercise, application of ice and/or heat, and psychological measures, such as biofeedback and cognative therapy.

Comprehensive Spinal Care



Employing the latest research coupled with years of experience our patients benefit with the best care from a team of specialist. We first begin with a comprehensive evaluation with possible diagnostic imaging ordered to confirm you problem. We will then manage your case from non invasive Chiropractic Manipulative Therapy, Physical Therapy Modalities, Soft issue mobilization to minamally invasive Spinal Injections, pain management, to invasive spinal surgeries. Whatever your specific spinal problem we are able to help you and / or refer you to the physician who can. The majority of our patients only require Chiropractic or soft tissue mobilization. For those patients that require more invasive care you have selected the right Practice.

Manipulation Under Anesthesia


Spinal manipulation under anesthesia is a procedure that primarily originated with the osteopathic profession and has been utilized for the treatment of spinal pain since the late 1930s. Documentation regarding the success and value of manipulation under anesthesia has been recorded in the osteopathic literature since 1948 when Clybourne reported in the Journal of American Osteopath Association a success rate of 80-90% which has been maintained to this day. In the last two decades, the emphasis regarding manipulation in osteopathic education has greatly decreased. Therefore, the osteopaths that had been adequately trained in manipulation are coming to the close of their careers or have retired. Because of the need for continuance of this procedure, the focus for the performance of spinal manipulation under anesthesia has now shifted to chiropractors and their expertise in spinal manipulation skills. Indication For Manipulation Under AnesthesiaSpinal manipulation under anesthesia is a procedure that is intended for patients that suffer from sometimes acute, but mostly chronic musculoskeletal disorders in conjunction with biomechanical aberrancies. These individuals have also been minimally responsive to previous conservative therapy. Etiology of their pain can be disc bulge/herniation, chronic sprain/strain, failed back surgery, myofacial pain syndromes in conjunction with those listed below. The procedure is extremely beneficial for the patient that has muscle spasm accompanied with pain and terminal joint range of motion loss. These types of patients typically respond well to manipulation/physical therapy/exercise, but their relief may only be temporary (days to weeks).


To ensure good results with a procedure of this type, one of the most important considerations is patient selection. Indications:

  1. Bulging, protruded, prolapsed or herniated discs without free fragment and are not surgical candidates

  2. Frozen or fixated articulations

  3. Failed low back surgery

  4. Compression syndromes with or without radiculopathies caused from adhesion formation, but not associated with osteophyic entrapment 

  5. Restricted motion, which causes pain and apprehension from the patient

  6. Minimally responsive to manipulation and adjustment when they are the therapy of choice

  7. Minimally responsive pain, which interferes with the function of daily life and sleep patterns, but which falls within the parameters for manipulative treatment

  8. Minimally responsive muscle contraction, which is preventing normal daily activities and function 

  9. Post-traumatic syndrome injuries from acceleration/deceleration or deceleration/acceleration types of injuries, which result in painful exacerbation of chronic fixations

  10. Chronic recurrent neuromusculoskeletal dysfunction syndromes, which result in a regular periodic treatment series, that are always exacerbation of the same condition

  11. Neuromusculoskeletal conditions that are not surgical candidates but have reached MMI especially with occupational injuries

Neuro Physiology Testing


An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction. Nerve conduction studies measure how well and how fast the nerves can send electrical signals.

Nerves control the muscles in the body with electrical signals called impulses. These impulses make the muscles react in specific ways. Nerve and muscle problems cause the muscles to react in abnormal ways.

If you have leg pain or numbness, you may have these tests to find out how much your nerves are being affected. These tests check how well your spinal cord, nerve roots, and nerves and muscles that control your legs are working.

Physical Therapy Modalities


A modality is a type of electrical, thermal or mechanical energy that causes physiological changes.

It is used to relieve pain, improve circulation, decrease swelling, reduce muscle spasm, and deliver medication in conjunction with other procedures. Typical types of modalities include electrical muscle stimulation, ultrasound, heat, ice, and traction.

Ultrasound (US)

  • High frequency sound waves that produce a form of deep tissue heating

  • For relief of pain and muscle spasm

  • Promotes circulation

  • Relaxes tight muscles/soft tissue – prepares tissues for stretching


  • Use of ultrasound to drive in topical medications through the skin

  • Medications are usually a form of cortisone and xylocaine

  • For treatment of localized inflammations, eg. Heel spurs, tendonitis

Electrical Stimulation

  • Use of different forms of electrical current through surface electrodes that cause muscles to contract and relax

  • For relief of muscle spasm, pain and swelling

  • For muscle re-education and strengthening


  • Use of electrical current to drive topical medications through the skin

  • For treatment of localized inflammation, scar softening, reduction in joint calcium deposits


  • A longitudinal pull or distraction of spinal segments for the relief of nerve irritation (radicultis) or muscle spasm by use of a machine on the cervical (neck) spine with the use of a neck halter or lumbar (low back) spine with the use of a pelvic belt attached to a patient lying down

  • Can also be done manually

Transcutaneous Nerve Stimulation (TENS):

  • Use of low voltage electrical current through surface electrodes that overrides the sensation of pain

  • Small unit (slightly larger than a beeper) worn throughout the day for pain control that the patient can apply a needed

Moist Heat (Hydrocollator)

  • Produces a deeper heat than a dry heating pad

  • Increases circulation, reduces swelling, relaxes muscles/soft tissue, prepares tissue for other treatments


  • Use of “ice packs” or “ice massage” in acute injuries and for pain relief (acute or chronic)

  • Reduces swelling, inflammation, muscles spasm


  • A form of heat using paraffin wax and mineral oil

  • Usually applied to hands or feet where other applications of heat are difficult

Sports Medicine & Rehabilitation


Dr. Massache is a certified sports physician and certified professional level fitness trainer. He is an avid runner, rock climber, Soul Cyclist, weight lifter. His office has the Synergy Rehabilitation System used by many professional athletes. He is an advocate to get you back to working out or on the field as quickly as possible. 

Epidural Spinal Injections


An epidural spinal injection is a non-surgical treatment option that may provide either short- or long-term relief of radiating back pain.
When spinal nerves become irritated or inflamed due to a degenerative condition in the spine that is causing nerve compression, such as a herniated disc or spinal stenosis, the result may be severe acute or chronic back pain, as well as pain, numbness and muscle weakness that extends elsewhere into the body, such as the hips, buttocks or legs. Before your doctor considers spine surgery to relieve these symptoms, he or she will most likely recommend one or more non-surgical treatment measures. An epidural spinal injection is one of these options.

What Is An Epidural Spinal Injection?
An epidural spinal injection involves delivering anti-inflammatory medication – typically a steroid combined with an anesthetic – directly into the area around the irritated spinal nerves that are causing the pain. This area is called the epidural space, and it surrounds the sheath-like protective membrane – or dura – that covers the spinal nerves and nerve roots. Steroids reduce nerve irritation by inhibiting production of the proteins that cause inflammation; the anesthetic blocks nerve conduction in the area where it’s applied, numbing the sensation of pain.

Why Do I Need This Procedure?
An epidural spinal injection may be done either for diagnostic or therapeutic reasons:

  • By injecting medication around a specific nerve root, your doctor can determine if that particular nerve root is the cause of the problem.

  • When administered for therapeutic reasons, a spinal epidural injection may provide long- or short-term relief, anywhere from a week to several months. In some instances, an epidural spinal injection may break the cycle of inflammation and provide permanent relief.

It’s important to note, however, that an epidural spinal injection is typically not considered a “cure” for symptoms associated with spinal compression. Rather, it’s a treatment “tool” that a doctor can use to help ease a patient’s pain and discomfort as the underlying cause of the problem is being addressed through a rehabilitative program such as physical therapy, or while the patient is considering his or her surgical treatment options.

How Is An Epidural Spinal Injection Administered?
Many hospitals and medical centers have pain management physicians who perform epidural spinal injections for conditions such as spinal stenosis, disc herniation and arthritis in the facet joints of the spine. The types of physicians who administer these injections include physiatrists, anesthesiologists, radiologists, neurologists and surgeons.

An epidural spinal injection is generally done on an outpatient basis, either at your doctor’s clinic or local hospital or medical center, and the procedure typically involves:

  • Delivering a mild sedative via an intravenous (IV) drip for relaxation (if desired);

  • Positioning the patient to give the doctor clear access to the area of the spine to be treated. Depending on the location of the spine to be treated, this may involve lying facedown or on your side on an operating table, or sitting up in a chair.

  • Wiping the skin with an antiseptic to clean the area where the epidural needle will be inserted;

  • Injecting a local anesthetic to numb the injection site;

  • Directing a small needle using fluoroscopy (a type of x-ray guidance that allows your doctor to monitor the placement of the needle) into the epidural space;

  • Injecting a small amount of contrast dye to confirm that the needle is placed properly, and that the medication spreads to the area where it’s needed;

  • Injecting the steroid/anesthetic medication into the epidural space; and

  • Removing the needle from the epidural space, wiping the injection site with an antiseptic and covering it with a bandage.

The procedure typically takes 15-30 minutes. After the procedure, you’ll be monitored for about 30-60 minutes in the recovery room. You should not drive following your injection; please have an adult driver available to take you home and to do any errands you may need that day. You also should avoid any strenuous activities for the rest of the day following your procedure. Your doctor also will have more specific after-care instructions for you; please follow his or her directives carefully to maximize your recovery potential.

How Long Will It Take Me To Recover?
After your injection, you may experience some numbness in your arms or legs. This is a temporary side effect associated with the anesthetic component of the injection, and it typically subsides within 1 to 8 hours. Your pain also may increase over the following 24-48 hours; it generally takes 24-72 hours for the pain-relieving benefits of a spinal epidural injection to take effect.

If your injection resolves your pain for a short period of time, you may be interested in another injection. Most doctors, however, limit the number of steroid injections they will give within a certain period of time – three per year is a common guideline. Most spine surgeons do not believe that repeated and frequent injections are a good way to manage a spine problem in the long-term. Rather, if an injection helps to relieve the pain, at least temporarily, it may indicate that surgery will be successful in helping to obtain a permanent solution for the pain.

Are There Any Potential Risks Or Complications?
As with any procedure, there are always certain risks involved with epidural steroid injections. Potential complications may include:

  • Bleeding or infection at the injection site

  • Pain during or after injection

  • Post-injection headache

  • Reaction to injection medication

  • Nerve injury, including spinal cord injury and quadriplegia

  • Bladder dysfunction

  • Fluid retention

  • Respiratory arrest

  • Epidural hematoma (a collection of blood outside a blood vessel caused by a leak or injury)

  • Spinal cord infarction (occurs when one of the three major arteries that supply blood - and therefore oxygen - to the spinal cord is blocked)


Complications are not a common occurrence; however, because they are potentially much more severe in the cervical spine than in the lumbar spine (low back), many physicians recommend oral steroids instead of cervical epidural spinal injections because of these risks.
Additional risk factors to consider before having an epidural spinal injection include:


  • If you regularly take platelet-inhibiting drugs such as aspirin or NSAIDS (non-steroidal anti-inflammatory drugs), you may be at increased risk for bleeding.

  • If you have a serious or active infection, steroids can lower your body’s resistance to and ability to fight it.

  • If you are hypersensitive to or are allergic to certain medications, you may have a negative reaction to the drugs used in the injection. Please provide your doctor with a list of your allergies and any other medications you are taking.

  • If you are ill or have a chronic medical condition, please discuss the risks of a cervical epidural spinal injection specific to your condition with your doctor. Patients with diabetes, for example, may experience an increase in blood sugar after an injection. Patients with congestive heart failure, renal failure, hypertension or significant cardiac disease may develop problems due to the effects of fluid retention several days after an injection.

  • If you are pregnant, inform your doctor. Fluoroscopic x-rays pose great risk to a fetus at all stages of development.

Please consult your physician for a complete list of indications, warnings, precautions, adverse effects, clinical results and other important medical information that pertains to an epidural spinal injection.

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