If you’re suffering from shoulder pain you’re not alone. Shoulder pain is regarded as one of the most frequently reported non-traumatic complaints that arise from the upper extremity (neck, arms & shoulder) area. An estimated 27% of Americans suffer from non-traumatic shoulder pain at any given time. And the Harvard Medical Review estimates that "up to 70% of people will experience shoulder pain" at some point. The majority of shoulder pain complaints are attributed to overuse rather than specific trauma. Many patients are surprised to learn that upper extremity pain and injury is the second most common cause of occupational injury claims.

Your shoulder is a unique multi-axial joint capable of complex movement and manipulating heavy loads. Its frequent everyday use to perform complex movements, manipulate heavy loads and perform  repetitive movements during work, sports, exercise and nearly anything we humans do. As such, it is subject to a variety of painful conditions such as adhesive capsulitis (frozen shoulder), arthritides (osteoarthritis, rheumatoid arthritis, polymyalgia rheumatica, etc.), as well as more common issues such as joint instability due to muscle fatigue/weakness, inflammation, impingement syndromes or acute injury.

It’s common that patients report living with the pain and discomfort for too long because they:

• Believe their shoulder pain will just go away if they ignore it long enough;
• Didn’t know they can feel better;
• Are busy and have little time to devote to taking care of themselves;
• Previous treatment didn’t work or didn’t last and;
• Didn’t know who is going to give them the best results.

If not addressed, shoulder conditions may lead to more serious issues such as frozen shoulder or SLAP tears. It’s vital to seek care before your condition evolves into chronic pain and debilitating loss of mobility.

Urgent care is needed if you have sustained a traumatic or injury - especially if there is severe bleeding, potential broken bones, swelling, discoloration, or other acute symptoms.

Shoulder pain may also be a symptom of a heart attack. Call 911 immediately if your shoulder pain:

• Appears suddenly without a reason
• is sudden or sharp
• is accompanied by dizziness
• is accompanied by shortness of breath
• extends or radiates from your chest to the left jaw, arm, or neck
• is accompanied by chest pain or chest tightness

Shoulder injuries are primarily categorized as ‘traumatic’ or ‘overuse’. If your shoulder pain began as a mild ache and/or stiffness, rather than the result of a specific traumatic event, it's most likely an overuse injury.

Overuse shoulder injuries develop over time as the result of repetitive use. Patients typically report ignoring the warning signs at first because the pain and stiffness began mild with the intensity growing over time. You should schedule an examination as soon as possible if you are experiencing any of the following symptoms:

• Continuous shoulder pain lasting more than 3 weeks (if not resulting from trauma)
• Stiffness or pain with shoulder movement
• Numbness in the arm or hand
• Limited or reduced shoulder function
• Ongoing shoulder weakness or fatigue
• Feeling as though the shoulder socket is loose
• If you heard or felt a ‘pop’ that resulted in pain
• If you feel/hear a grinding or tearing sensation when using your shoulder

Conservative, non-invasive and drug-free therapies are recommended as primary treatment approach for soft-tissue shoulder injuries. Chiropractic therapy, physical therapy, rest and strengthening exercises are the recommended treatment method for most shoulder conditions. In fact, the NIH reports that "The effects of surgery plus physiotherapy compared to physiotherapy alone on improving pain and function are too small to be clinically important." This is true in the short term (3 & 6-month check ups) as well as long term follow up (1, 2, 5 and 10-year).

Dr. Dukes and her team use a multifaceted approach to treat shoulder pain that typically employs several of the following techniques:

• Myofascial release
• Stretching
• Functional and strengthening exercises
  
• Scapular mobilization
• Ischemic compression
• Manipulation
  
• Massage therapy
  
• PEMF Therapy
• Cymatic Therapy

Shoulder tendinitis is typically an overuse response to repetitive motion. It’s common among laborers and athletes. Those with that lift with improper form, awkward balance or poor posture are at greater risk because they place excessive stress on shoulder tissues and tendons.

Bursitis can cause stiffness and swelling in addition to a general ache in the shoulder. It may be irritating when you apply pressure to the shoulder or move it. This occurs when the small fluid-filled sacs (bursae) that cushion and protect bones, tendons, and muscles become inflamed. It is most commonly due to overuse due to repetitive motions.
shoulder, injections to reduce more severe inflammation or surgery. Surgery is rarely needed in the treatment of bursitis.

Rotator cuff tears are common and typically occur as a result of wear and tear due to overuse or from sudden trauma. Your arm may feel weak or fatigued and the pain tends to be a dull achy feeling that worsens if you sleep on the affected shoulder.

Frozen shoulder most often occurs because shoulder movement has been limited due to a medical procedure, ignoring a shoulder condition or some other factor that prevented normal shoulder movement over time. The condition gradually worsens, causing pain and potentially extreme joint stiffness with loss of mobility. Recovering mobility typically takes 12 to 18 months of specific therapy. Frozen shoulder symptoms present in three phases (1) Freezing – Concurrent pain and limited range of motion that worsens over time; (2) Frozen – Extreme stiffness often results in highly limited mobility; pain symptoms may be reduced during this stage; (3) Thawing – Mobility slowly improves over time.

Your body is an incredible healing machine. Early treatment and intervention will help avoid more extensive damage as well as improve your healing trajectory.
If you're struggling to find relief, Dr. Dukes can help. She'll listen to you, find the root cause of your pain, then help you chose the best course of care for you.
Call today! ​​(813) 752-2524 Schedule your consultation with Dr. Dukes and experience the difference for yourself.

As a healthcare practitioner, I'm always on the lookout for cutting edge treatment options to help my patients. I was skeptical when I first heard about the results a colleague was getting with  pulsed electromagnetic field (PEMF) therapy.  I wanted to know about evidence-based studies, potential risks and success rates over time before introducing this new procedure to my patients. based on large group studies. So I reached out for details. I was impressed. The studies and testimonials I reviewed convinced me to give it a try. That was over 5 years ago now and I've learned a lot. My patients will concur that PEMF therapy is extremely effective in treating chronic conditions and accelerating healing – particularly when used in combination with more traditional chiropractic therapies.

Know What Your Doctor Didn't Tell You
When patients come to me after struggling to find relief from chronic conditions, they often feel alone. Many report being frustrated with traditional medical approaches. One patient, we’ll call her ‘Meg’, was visibly upset when we first met. She told me that her doctor didn’t take her seriously and even told her the pain was ‘all in her head’.

She’s not alone. Millions of chronic pain sufferers struggle to be taken seriously by their primary care providers. often with little success from traditional medicine. Dr. Karima Hirani's book, "What Your Doctor Didn't Tell You," promotes the use of advanced therapies such as PEMF.
The truth is that people have found symptom relief from Pulsed Electromagnetic Field (PEMF) therapy for a wide range of conditions. And PEMF therapy is considered safe when used within appropriate guidelines because it is non-invasive and drug-free.

PEMF therapy has been shown in several studies to be safe and effective. In a randomized, double-blind, placebo-controlled clinical trial, twice-daily use of a portable PEMF unit was found to produce a reduction in pain severity in patients, showing that regular use of this therapy can help in managing chronic pain. Another study indicated that PEMF therapy is safe for patients with chronic non-specific neck pain. While it didn't provide further benefits in this particular case, the safety of the treatment underscores its potential as an alternative therapy for those dealing with chronic pain.
There are also indications that PEMF therapy could serve as a good early intervention to help accelerate healing while managing pain. Furthermore, some individuals have reported positive experiences with PEMF treatment for pain, despite the fact that it can sometimes take a while to achieve pain relief.
Finally, consumer reports highlight the desperation of many Americans for safe and effective treatments for chronic pain. In this context, PEMF therapy emerges as a promising solution, providing difficult-to-treat pain relief without invasive surgeries or addictive drugs.

How PEMF Therapy Works
PEMF therapy uses low-frequency electromagnetic waves to stimulate cells in the body. This type of therapy is non-invasive and has been found to aid in cellular regeneration, reduce inflammation, and alleviate pain. The therapy works by stimulating the cells' natural vibrations, thereby promoting healing and regeneration.
PEMF therapy works by sending electromagnetic waves into the body. These waves can penetrate deep into the tissue, where they stimulate cells, increase blood flow, and boost cellular repair. As a result, the therapy can alleviate many conditions, including inflammation, joint pain, and wound healing.
Studies have shown that PEMF therapy is a safe and effective way to reduce inflammation. When cells are exposed to magnetic fields, the body's production of nitric oxide increases, which reduces inflammation in the body. Studies have shown that PEMF therapy can reduce inflammation levels in the body by up to 75%.
Another benefit of PEMF therapy is its ability to aid in cellular regeneration. By stimulating cells' natural vibrations, the therapy can help to repair damaged tissue and promote healing. This can be particularly helpful for athletes who suffer from injuries or people with chronic conditions.
PEMF therapy can help alleviate pain and promote healing in various conditions, such as arthritis, fibromyalgia, and neuropathy. By stimulating the body's natural healing processes, the therapy can help reduce pain levels and improve overall wellness.

PEMF Therapy Compliments Traditional Treatment Options
Dr. Dukes has integrated Pulsed Electromagnetic Field (PEMF) therapy into her traditional treatment protocols for years to boost the treatment of both chronic and acute pain conditions. She has found that PEMF Therapy amplifies the effectiveness of traditional chiropractic adjustments effectively, providing more comprehensive patient care and accelerated positive outcomes.
PEMF therapy is simply an additional modality and therapeutic option, like massage or laser therapy, that can complement chiropractic care to improve pain relief, wound healing, and tissue regeneration.
Dr. Dukes knows that integrating PEMF therapy into chiropractic care plans is a a significant step forward in enhancing patient outcomes.

Questions to Ask Before Starting PEMF Therapy
Of course, if you're considering PEMF therapy as part of your treatment, you should ask a lot of questions to help you make an informed decision about whether or not it's right for you. In this article, Dr. Dukes will try to answer each of these questions:

1. What are the potential benefits of PEMF Therapy? Ask about the specific health improvements you can expect from the therapy.
2. What are the potential risks or side effects? While PEMF Therapy has been deemed safe by many health organizations, it's still important to understand any potential risks or side effects.
3. How long does a typical session last and how many sessions will I need? The length and number of sessions can vary greatly depending on the condition being treated.
4. What is the experience like? Knowing what to expect during a session can help ease any nervousness or apprehension.
5. Are there any conditions or circumstances where PEMF Therapy should not be used? Some conditions may not be suitable for this type of therapy, so it's important to discuss your medical history.
6. Is PEMF Therapy covered by insurance? Some insurance companies may cover PEMF Therapy, but many do not. It's important to understand the costs before you begin.
7. What qualifications do you have? Make sure your therapist is properly trained and certified to administer PEMF Therapy.

Remember, it's always important to do your own research and consult with healthcare professionals when considering any new form of therapy.

Benefits of PEMF Therapy
PEMF therapy is a non-invasive therapy has been found to aid in reducing inflammation, alleviating pain and a host of other conditions. It's a safe and effective way to help stimulate healing because it works in harmony with the body's own recovery processes and can help relieve chronic pain safely..

1. Chronic Pain Management: PEMF therapy has been investigated as an alternative treatment for chronic pain. It has shown effectiveness in reducing pain intensity and improving patients' quality of life, particularly in cases of chronic back pain.
2. Reducing Inflammation: One of the most significant benefits of PEMF therapy is its anti-inflammatory effects. Chronic inflammation is the underlying cause of many diseases, including arthritis, fibromyalgia, and even cancer. PEMF therapy can reduce inflammation by increasing the production of nitric oxide, which is a powerful anti-inflammatory agent in the body.

Multiple studies prove the point. A review published in Bioelectronic Medicine discussed the effects of PEMF on inflammatory/immune regulators. It was observed that after PEMF exposure, activated Mesenchymal Stem Cells (MSCs) showed a decrease in proinflammatory cell signaling. Another study published in the Journal of Inflammation Research evaluated the effect of PEMF treatment on programmed resolution of inflammation pathway markers in human cells in culture.

1. Osteoporosis: Multiple studies provide compelling evidence that PEMF therapy can be effective in treating OA, improving symptoms and potentially modifying disease progression. PEMF was found to have clinically significant effects on pain in patients with Osteoarthritis (OA). This suggests that PEMF may be beneficial for certain subsets of patients with chronic, nonmalignant pain. PEMF therapy using low-frequency electromagnetic fields has been employed in the treatment of osteoporosis. It has shown promise in improving bone density in postmenopausal women and individuals with age-related bone loss.
2. Cellular Regeneration: PEMF therapy can help to accelerate the healing process by stimulating cellular regeneration. It can also help to promote bone growth and density. Additionally, it can help to reduce the formation of scar tissue, which can limit mobility and cause chronic pain.
3. Circulation and Oxygenation: PEMF therapy increases blood flow and oxygenation to the targeted area of the body. This improved circulation helps to alleviate pain and promote the healing process. It's also a great way to reduce inflammation, which is a common cause of chronic pain.
4. Cognitive Function: PEMF therapy may also promote neurogenesis - the growth and development of new brain cells, enhance the brain's resilience to damage potentially protecting against neurodegenerative diseases like Alzheimer's and Parkinson's and enhance cognitive function like memory and learning. Research suggests that PEMF therapy may have positive effects on anxiety and depression symptoms because it is believed to promote the release of neurotransmitters and regulate brain activity, potentially leading to mood improvement.
5. Rheumatic Illnesses: PEMF therapy has shown promising results in managing rheumatic illnesses, including osteoarthritis and rheumatoid arthritis. Studies have demonstrated its ability to alleviate pain, reduce inflammation, and improve joint mobility in patients with these conditions.
6. Bone Fracture Healing: PEMF therapy has been utilized as an adjunct treatment in the healing of bone fractures. It accelerates the formation of new bone tissue and enhances the overall healing process.
7. Neurological Diseases: Research suggests that PEMF therapy may have beneficial effects on neurological diseases. While further studies are needed, preliminary evidence indicates its potential in conditions such as multiple sclerosis (MS) and other inflammatory disorders.

PEMF therapy holds promise as a non-invasive treatment option for various medical conditions. From managing rheumatic illnesses and promoting bone fracture healing to aiding in the management of chronic pain and neurological disorders, research indicates its potential benefits. However, it is important to note that further studies are needed to fully understand and establish the efficacy of PEMF therapy in these conditions.

Potential Risks & Side Effects of PEMF Therapy
PEMF (Pulsed Electromagnetic Field) therapy is generally considered safe when the practitioner employs best practices. Even so, some individuals may experience side effects which may include:

1. Fatigue: While PEMF therapy is designed to enhance cell function and improve energy levels, some individuals may experience an initial period of fatigue. This is often due to the body adjusting to the increased activity at a cellular level, and generally subsides after continued use.
2. Sleep disturbances: Some users have reported changes in their sleep patterns following PEMF therapy. The therapy stimulates brain activity, which might cause difficulty in falling asleep or staying asleep. However, these effects usually diminish over time.
3. Loss of energy or interest: PEMF therapy can sometimes lead to temporary feelings of lethargy or a lack of interest in daily activities. This could be part of the body's adjustment process to the therapy.
4. Agitation, weakness, and dizziness: These sensations are typically mild and short-lived. They may occur due to the physiological adjustments the body is making in response to the electromagnetic fields.
5. Increased urination: This might be a result of the body's detoxification process being stimulated by PEMF therapy. The body might be flushing out toxins at a faster rate, leading to an increase in urine production.
6. Mild headaches: This side effect can occur when the body releases stored toxins and waste products due to the cellular stimulation created by the therapy. Drinking plenty of water can help to alleviate this symptom.
7. Uncomfortable increases in circulation: In areas with restricted or reduced blood flow (ischemic tissues), the sudden increase in circulation caused by PEMF therapy might lead to discomfort or a "pins and needles" sensation. This is temporary and should subside as the body adjusts.
8. PEMF therapy can potentially lower blood pressure: so if you already have very low blood pressure, ensure that you inform your provider during your consultation.

As with any therapy, it's important to discuss potential side effects with an experienced healthcare provider before beginning PEMF therapy.

How long does a typical PEMF Therapy Session Last and How Many Sessions will I Need?
A typical Pulsed Electromagnetic Field (PEMF) therapy session tends to last between 15 and 30 minutes and the total number of sessions required to each specific to each patient’s condition, needs and course of care.
Session duration and frequency obviously varies based on the individual patient's condition and the recommended treatment plan. Recently a patient suffering from a lower back injury was treated with one 40-minute session per day, 3 days per week over 12 weeks in conjunction with a variety of other therapies. Another patient finds relief from OA flareups through 20 minute sessions, 2x times per day over 10 days.
In summary, the duration and frequency of PEMF therapy sessions can greatly vary based on individual needs and conditions. Therefore, patients should always to consult with a healthcare provider to determine the most safe, appropriate and effective treatment plan.

What Does PEMF Therapy Feel Like?
Dr. Dukes patients often describe PEMF therapy as a soothing and gentle experience. The therapy involves the use of magnetic pulses that can be adjusted individually, so they do not cause any pain or discomfort. However, during the treatment, you will feel the pulsing of the mild magnetic current as it flows through your body.
PEMF devices come in a variety of shapes from small pads for acute application to full body applicator systems look like a thin mattress. Regardless of the device type, you should not feel any pain during treatment.
As the PEMF system works, you'll feel the pulse. Some patients might find that the areas that require treatment will visibly move as the cells are engaged. This movement is a result of the therapy working on cellular regeneration to resolve injuries and chronic conditions.
The sensation of PEMF therapy is often described with words like "tingling" or "pulsating5". On less intense days, it can feel like a persistent throb stretching along the treated area. It's also important to note that PEMF therapy can typically lower blood pressure, so if you already have very low blood pressure, be certain to let your provider know during your consultation as you may feel lightheaded.

In What Conditions or Circumstances Should PEMF Therapy Not Be Used?

1. Pulsed Electromagnetic Field (PEMF) therapy is generally considered safe, however, there are certain conditions and circumstances where it should not be used or used with caution.
2. Electrical implants: patients with electrical implants should not use PEMF therapy due to the potential for interference with the device's function.
3. Avoid the ears and eyes: PEMF therapy should not be run over the eyes or ears unless directed by a medically trained physician.
4. Pregnancy: The safety of PEMF has not been established during pregnancy therefore Dr.Dukes advises against the use during pregnancy.
5. Breast implants: Never run high-frequency (above 100 Hz) PEMF over a breast implant.

Always discuss your full medical history and any potential concerns your have no matter how small. Your healthcare provider wants to provide you with safe, excellent care and needs as much information as possible to make that happen.

PEMF Therapy Facilitates Greater Patient Outcomes
PEMF (Pulsed Electromagnetic Field) therapy and chiropractic therapy are two distinct methodologies that, when combined, can potentially offer an enhanced healing experience. Both aim to promote the body's natural healing processes, through non-invasive, drug-free and proven effective therapies.
PEMF therapy uses electromagnetic fields to stimulate cell metabolism, increase oxygen supply, and improve circulation, thereby promoting healing and reducing inflammation.
Integrating PEMF therapy into a chiropractic practice can provide a comprehensive approach to patient care. The chiropractic adjustment realigns the spine, relieving pressure on compressed nerves, while PEMF therapy enhances cellular function and promotes tissue healing. This combination can accelerate recovery from injury or illness, reduce pain, and improve overall wellness.
The non-invasive nature of both treatments makes them a preferred choice for patients seeking safer choices. Chiropractic adjustments are generally safe, with minor side effects such as temporary discomfort in the treated areas. Similarly, PEMF therapy boasts a low-risk profile, with the most common side effects being mild discomfort or nausea, typically subsiding after the body adjusts to the treatment.
PEMF therapy and chiropractic care are two complementary therapies that, when used together, can offer a broad spectrum of health benefits. Their ability to stimulate the body's natural healing processes at different levels—structural and cellular— provides a powerfully effective approach to healthcare.
As research continues to evolve, I predict that you’ll see growing interest in the integration of these therapies as I’ve witnessed first-hand how PEMF therapy has been used to successfully treat chronic pain and inflammation in my patients.

You don’t have to suffer.  Dr. Dukes can help.  Call (813) 752-2525. Schedule your consultation. Learn if PEMF therapy is right for you. We want to help you take back control, free yourself from the pain and get back to living life on your terms.

Sports Injuries and Improved Performance

Any parent of a child who plays baseball, soccer, gymnastics, or any other sport, knows that injuries will happen. So how does a parent help ensure the best course of care for their child?
Parents looking to ensure their athletes health should consider talking to Dr. Dukes and learning about the benefits of chiropractic treatment of acute injuries, preventative care and to improve performance - all naturally without the risk associated with dangerous drugs or invasive surgeries.

Dr. Dukes and her team employ natural, drug-free and non-surgical treatment for many musculoskeletal injuries and preventative care. Athletes benefit greatly from chiropractic care and most professional sports organizations from the NFL to the MLB and the MLS provide regular chiropractic care for their athletes.

Kids looking for competitive advantage have found that chiropractic care improves agility, balance, kinetic perception, power and reaction time. Here is a deeper dive into the benefits for athletes:

1. Improve range of motion and performance.
Athletes often experience bouts of joint stiffness which reduces range of motion. The results is reduced performance efficiency and increased risk of injury. Typically chiropractic manipulation is employed to improve motion within the joint spacel followed by mobility treatment to improve joint health.

2. Improved recovery and injury prevention.
It's critical to address both acute (new) injuries as well as assess the athlete as a whole through musculoskeletal, neurological, and orthopedic examination to prevent chronic issues. By considering the 'whole patient' Dr. Dukes athlete patients often report shorter recovery times and reduced flare-ups of chronic injuries.

3. Healthier gut through reduced use of drug treatment.
The risks of opioid pain killers is obvious but did you know that over-the counter pain-relievers and anti-inflammatories cause a host of issues too? Common pain-relievers and anti-inflammatories kill the flora in our gut which causes a host of issues - particularly for athletes. Chiropractic care can allow your body to naturally relieve pain and inflammation so that athletes can find relief without exposing themselves to drug risks and side-effects.

4. The competitive advantage of champions.
Champions utilize chiropractic to feel and perform thier best. Here's what a few of the greatest athletes of all time have to say:

     “Chiropractic just makes you feel so much better. When I walk out of the clinic, I feel like I’m about three inches taller and everything’s in place. And as long as I see the Chiropractor, I feel like I’m one step ahead of the game.” – Tom Brady

    “Chiropractic gives me the flexibility I need to keep in the game.” – Venus Williams

    “I didn’t know how much I could improve until I started seeing a Chiropractor. Since I’ve been in Chiropractic, I’ve improved by leaps and bounds both mentally and physically.” – Michael Jordan

Chiropractic care helps athletes of all ages. Whether you are a champion athlete or growing to become one, call Dr. Dukes today (814) 752-2524. Schedule your consultation. Learn how Chiropractic can help you improve your performance and feel your best game in and game out.