• Arm or Leg Pain, Numbness or Tingling
• Neck Pain
• Shoulder Pain
• Causes of Low Back Pain
• Degenerative Disc Disease
• Scoliosis
• Spondylolithesis
• Stenosis
• Failed Back Surgical Syndrome
• Herniated Discs
• Headaches
• Whiplash
• Fibromyalgia
• Stress

Emergency Care
In order to provide our patients with the care they deserve, we schedule appointments in advance. However, due to the nature of our services, we always accommodate our patients in need of emergency care.
The concern for the health of our new and established patients in need of our immediate assistance extends beyond our normal office hours. For this reason someone from our clinic is available to discuss your current emergency situation and how we can help by dialing 516-991-4300 or 631-584-7722.

Arm or Leg Pain, Numbness or Tingling (return to top)
Pain and/or numbness and tingling in the arms or legs may directly involve the spine. The nerves that exit the neck and travel down the arms are known as the brachial plexus. The nerves that exit the low back and travel down the legs are known as the lumbosacral plexus. These nerves exit through openings of the spinal column called an IVF (intervertebral foramina) if there is interference with theses nerves it may be the direct cause of the problem. This is usually true when the pain travels down the arm or leg. Any time you have a radiating pain and/or numbness and tingling down the arm or leg, you should be checked by your chiropractor immediately.

Neck Pain (return to top)
Your neck is made up of seven vertebrae. Strong yet flexible your neck supports your head (approximately the weight of a bowling ball) and protects the spinal cord and cervical nerves. It should be well balanced with a slight forward curve (lordosis) which allows for proper range of motion. Your neck moves more than any other area of your spine. In turning side to side (rotation), it moves 80° in each direction. In bending ear to shoulder (lateral flexion), 45° to each side. Forward and backward (flexion/extension) totals about 90°. If you have a neck problem it will adversely affect one or more of these ranges of motion.
Nearly everyone at some time or other has had a pain in the neck. (no pun intended!) Prior untreated injuries such as whiplash, poor posture, poor sleeping habits, stress, abuse and neglect, wear and tear are just a few causes of your pain. Here are some of the more common problems.

Stiffness or hypomobility may result from poor posture habits, untreated neck injury and stress. Headaches may develop from chronic stiffness. Left untreated it develops into degeneration of the joints of your neck (osteoarthritis) and tension headaches.

Instability or hypermobility is most commonly caused by an injury such as whiplash. The band-like tissues that hold your vertebrae together - ligaments - can be stretched or torn causing instability and generating considerable pain. If this is not treated immediately many problems develop, but mainly the formation of scar tissue. Immobilization of the neck with the use of a cervical collar has been routine treatment for this type of injury in the past. We now know that unless there is major disruption involved such as fractures total immobilization is not recommended.

Degenerative Joint Disease or (DJD) is the degeneration of the cushion like structures between the vertebrae often diagnosed as osteoarthritis of the spine. This degeneration is also accompanied by bone spur formation. These changes disrupt the proper motion of the spine and may cause pressure on surrounding nerves and soft tissues. Degenerative Disc Disease may be caused from an old untreated back injury

Nerve Root Problems or neuralgia, neuritis or radiculitis, result from direct irritation of the nerves as they exit from the spinal canal. They can be irritated and inflamed or stretched and pinched triggering shooting pains down your arms and into your hands especially when turning your neck. They may be associated with numbness, pins and needles, tingling, weakness, trigger points and referred pain. The cause may be facet joint problems or disc herniations or severe osteoarthritis. If it is not treated the pain will become excruciating and intolerable and allow further degenerative changes to take place.

Dr. Semente deals with these types of injuries on a regular basis with excellent results. Our approach is to use specific spinal adjustments ( manipulation) to assist the spine in returning to normal function. The application of ice will be used to reduce the effects of inflammation. Soft tissue techniques (trigger points, massage etc...) will be used to control pain and promote healing.

Once the acute phase is over you will be given specific stretches to increase the flexibility and exercises to strengthen your neck. These are extremely valuable and the first line of defense in preventing further problems. You will be urged to pay special attention to your posture whether you’re standing, sitting, lifting, walking or sleeping, your posture is important. After you learn the do’s and don’ts in the care of your spine you will need to practice them.

Another phase of care will be the analysis of your job to discover what you may do to improve your neck hygiene. Little things like moving regularly if using a computer terminal all day, stretching regularly, using a telephone headset and thinking before acting go a long way to making sure you have a healthy spine.

Shoulder Pain (return to top)
Many shoulder problems directly involve the cervical spine. Here the nerves that exit the neck known as the brachial plexus may have interference. These nerves that go to the shoulder may be the cause of the problem. This is usually true when the pain goes beyond the shoulder and down the arm. Any time you have a radiating pain down the arm or leg, it should be checked out immediately.
Common injuries to the neck and shoulder may involve weightlifting, or almost any throwing motion, especially in baseball or football. Many contact sports may result in an injury to this area. We see a lot of injuries due to falls off bikes and skateboards. Auto injuries are often the cause.

Problems of the shoulder may range from a mild ache to very severe injuries such as fractures or dislocation. Any pain or symptom that persists for any length of time should be checked out by a doctor.

In our clinic a thorough case history and exam are done to determine the possible cause of the injury or problem. Then an x-ray of the cervical spine is taken. Once we have all this information, we will recommend a course of treatment. If yours is not a chiropractic case you will be referred to the proper specialist.

In conclusion, we have treated hundreds of shoulder problems with a very high success rate. If you would like us to help you, or someone you may know with this condition, please give us a call. We’re here to help.

Causes of Low Back Pain:

Degenerative Disc Disease (return to top)
Degenerative Disc Disease is the degeneration of the cushion like structures between the vertebrae. This degeneration is also accompanied by bone spur formation. These changes disrupt the proper motion of the spine and may cause pressure on surrounding nerves and soft tissues. Degenerative Disc Disease may be caused from an old untreated back injury.
Facet Syndrome
Facet Syndrome is a problem occurring in the weight bearing structure of the spine. Facet Syndrome usually accompanies Degenerative Disc Disease. The pain associated with Facet Syndrome is usually described on being in the hip joint and down the posterior thigh. The pain may also travel into the groin area. A combination of therapies may be necessary to bring maximum relief.

Scoliosis (return to top)
Scoliosis is a lateral curvature of the spine. There are different types of scoliosis and the cause is still unknown. Scoliosis may produce back pain, however few symptoms may occur at the beginning stages and progressively worsen with advanced curvature.

Scoliosis is more prevalent in girls than boys. All children after the age of ten should be screened for this condition by your chiropractor.

Spondylolithesis (return to top)
Spondylolithesis is a defect in the posterior aspect of the vertebra, causing the vertebra to slip forward on top of another, usually seen in the lowest segments of the spine. This may be caused, from falling backwards onto buttocks, sports injuries or may be present as a defect. Pain from this type of condition may vary with individuals, from severe to nonexistent.

Stenosis (return to top)
Stenosis is a narrowing of the spinal canal. There may be several reasons for this narrowing. There may or may not be any symptoms. If the narrowing becomes severe enough, patients may develop leg and buttock pain, leg pain above the knees, and/or numbness in the above areas. It is common for patients with stenosis to develop pain in the legs and buttocks while walking. Often a patient will feel relief when bending forward.

Failed Back Surgical Syndrome (return to top)
At selected times, back surgery may be unavoidable. However, post -surgical pain may develop. There are several factors involved in post-surgical pain. The most common being the formation of scar tissue as a result of the surgical procedures. Mechanical stress may be transferred above or below the fused levels. Recurrent disc herniation may occur. Muscle weakness of the trunk and lower extremity muscular groups may develop. Flexibility of the spine through manipulation, exercise and therapy are useful in controlling the development of post-surgical back syndrome

Herniated Discs (return to top)
Herniated discs are most common in the lumbar spin, the part of your backbone between the bottom of your ribs and your hips. Discs are soft "cushions" between the bones of the spine. The drawing to the left shows the spine. The spine holds up your body. It also protects your spinal cord and nerves. The discs in the spine let you move your backbone. As you grow older, your discs become flatter and less cushiony. If a disc becomes too weak, the outer part may tear. The inside part of the disc pushes through the tear and presses on the nerves beside it. Herniated discs are most common in people in their 30s and 40s.
When part of a disc presses on a nerve, it can cause pain in both the back and the legs. The location of the pain depends on which disc is weak. How bad the pain is depends on how much of the disc is pressing on the nerve. In most people with a herniated disc, the pain spreads over the buttocks and goes down the back of one thigh and into the calf. Some people have pain in both legs. Some people's legs or feet feel numb or tingly.
The pain from a herniated disc is usually worse when you're active and gets better when you're resting. Coughing, sneezing, sitting, driving and bending forward may make the pain worse. The pain gets worse when you do these things because they all put more pressure on the nerve.

In conclusion, the research shows that chiropractic care is very successful in treating disc problems. I believe that anyone considering back surgery should first consult a chiropractor for a second opinion in regards to other options.

Headaches (return to top)
Many people suffer from headaches on a regular basis, and believe that headaches are just a normal part of life. Headaches or any pain for that matter, is your body's way of telling you something is wrong.
Today's attitude towards health has become so involved with treating symptoms that often the cause of the problem goes untreated or completely ignored. For example, a small cavity may be present in a tooth without having pain. As the cavity worsens, pain will develop. Most people will visit the dentist and have the tooth repaired. Very few people would continue to mask the pain or ignore the cavity, because they understand that the pain will only increase without attention from a professional. The same is true of headaches. People have been conditioned to use drugs to ease headache pain; however, drugs can have adverse effects on your body's functions for years to come if they are taken over a long period of time. Drugs cover up the symptoms but do nothing to correct the cause.

There are two major types of the most painful headaches: the chronic recurrent and the migraine headache. Chronic recurrent headaches may be associated with vascular or psychogenic origins, but pressure on spinal nerves is the underlying cause. The second major type of headache, the migraine is so severe that victims often refer to this type as a "sick" headache. You can look at these sufferers and almost feel their pain. The migraine is one of the more painful types of headaches, often leaving the sufferer in bed and immobilized. Most migraine sufferers notice symptoms that occur before the headache actually hits. These include visual changes, dizziness, muscle contraction, nausea, etc. The headache itself may last from a few minutes to days. Once the full-blown migraine hits, there are few painkillers that will have much effect and it usually must run its course. Chiropractic can usually provide very good results for headaches caused by pressure on spinal nerves and correct the cause of many of these headaches.

An important thing to remember, for certain kinds of headaches, chiropractic is very effective. A chiropractor treats the cause of your headaches, not just the symptoms. Through different tests and techniques, your chiropractor can usually identify and treat these causes. Regardless of the type of headache you are experiencing, chiropractic care can usually help you. It is not unusual for other conditions, such as facial pain, ear disturbances and sinusitis to clear up when you are treated with chiropractic care. Don't wait for a headache to start before you see a chiropractor.

Whiplash (return to top)
Whiplash injuries are most commonly the result of being involved in an auto accident. However this type of injury may also occur in sports or even a slip & fall.
During a whiplash injury the head is violently forced backwards and then rapidly forwards. The small tendons, ligaments and muscles of the spine are stretched beyond their normal limits and may tear. The nerve roots and spinal cord may stretch causing severe irritation. Spinal joints become subluxated and their motion impaired.

Many symptoms may arise following a whiplash injury: headaches, dizziness, blurred vision, pain in the front and back of the neck, shoulder pain, pain in the arms and hands, low back pain, and the inability to turn and bend your spine. These symptoms may be instant or take hours, even days to appear.

Dr. Semente deals with these types of injuries on a regular basis with excellent results. His approach is to use specific spinal adjustments ( manipulation) to assist the spine in returning to normal function. The application of ice will be used to reduce the effects of inflammation. Soft tissue techniques (trigger points, massage etc...) will be used to control pain and promote healing. The effects of whiplash if left untreated may produce permanent dysfunction.

In conclusion, it is very important to be seen by a chiropractor as soon as possible, after any type of car accident. Recent research has shown that proper chiropractic care is the fastest road to recovery from the effects of whiplash. It is also the best way to manage the effects of the car accident on a long-term basis. Regardless of when this type of injury has occurred, seek the care of a chiropractor immediately!

Fibromyalgia (return to top)
Fibromyalgia is a medical condition characterized by chronic pain in muscles and surrounding tissue, which are also tender to finger pressure. In actuality it is more accurately termed a syndrome because unlike a disease it has no known cause and there are no laboratory tests that can confirm the diagnosis. Syndrome also refers to the fact that there is a fairly consistent pattern of symptoms observed in people with this medical disorder as opposed to disease which implies that all people with it have the same problems from the same cause. What are the Symptoms of Fibromyalgia? Pain: Pain in and around the soft tissue and joints is the primary complaint of people with this syndrome. It is often described as deep-aching, gnawing, sharp shooting or burning. Often it is described as "Hurting all over". It can be so severe that it is debilitating and limits daily activity. Other symptoms are as follows:

Sleep Disturbance: Ninety percent of FMS patients report trouble sleeping. It manifests as either difficulty falling asleep, frequent waking during the night, inability to fall back asleep, or unrestful sleep.

Neurological Symptoms: About one-fourth of people with FMS report symptoms of tingling or numbness and tingling in the arms and legs. This makes for a feeling of clumsiness.

Headaches: Over 40 percent of people with FMS regularly experience daily headaches. Tension headaches are common, as are migraines.

Temporomandibular Joint Disorders: About a quarter of FMS patients suffer from TMJ disorder. This manifests as joint pain or muscle pain in the masseters and temporalis muscles, the major jaw closing muscles. This can cause terrible pain in the face and head and often be mistaken for a tension headache or migraine. There is also a tendency for people with Fibromyalgia or grind or clench their teeth, a condition known as bruxism.

In conclusion as there is no known definite cause for fibromyalgia, it is often treated symptomatically. A rheumatologist, neurologist, or internist can treat the various body symptoms, and a qualified dentist with special training in treating temporomandibular disorders and orofacial pain can address the TMJ and facial pain concerns.

Stress (return to top)
Stress is something that we’ve all heard a lot more about in the last few years. Stress comes in many forms, both mental and physical. Some of the worst mental stresses can be a death in the family, divorce, loss of a business, or a notice of an audit from our friends at the IRS. Physical stress may result from a car accident or other trauma. It may be from an illness or surgery. It could be from long hours at the office or even from a long trip.
Whether the stress is mental or physical, most of us experience it in one form or another. When the stress is long-term or chronic, or when we experience a combination of mental and physical stress, the effect on the body will be more severe.

Bernie Siegel, MD, stated: "It’s often said that stress is one of the most destructive elements in people’s daily lives, but that’s only half true. The way we react to stress appears to be more important than the stress itself."

Stress has a number of effects on the body. It has been shown to weaken the immune system, making us more susceptible to disease. It depletes our bodies of vitamins and minerals. It tenses our muscles, which results in muscle spasms and tension headaches. Energy is drained; blood pressure goes up.

So what can we do to combat all this stress? The medical approach has been the use and abuse of tranquilizers and sedatives, Valium being one of the favorites. Nonprescription or illegal drugs including alcohol, marijuana, or others might be used. These actually add to the stress, especially when they become a habit.

There is a better way, but it takes some work and it may not be easy. First of all, it is important that any of the signs of stress be checked out by your chiropractor or a family physician to be sure that it is just stress. Then it is a matter of looking at the five phases of health to see which ones need the most attention. Those five phases are nervous system functions, exercise, nutrition, rest, and mental attitude. To go into detail about all five could fill a book.

As a chiropractor, my first concern is to see that your nervous system works at its optimum. Since the nervous system controls the rest of the body, it is a crucial first step toward fighting the effects of stress. Next, it is equally important to see where you need help in the other four areas. Increasing your exercise level and improving your nutrition, especially with certain vitamins is very effective. Rest and relaxation techniques are also necessary. Massage has also been shown to be helpful, which is one of the reasons I have massage therapists in our clinic. Psychologically, massage relieves fatigue, reduces tension, calms the nervous system, and promotes a sense of relaxation and renewed energy.

In conclusion, nobody is completely immune to stress. However, there are a number of things that you can do to combat it effects. A saying I use is, "If you want to drive a Ferrari, you’ve got to keep it tuned up." In other words, if you demand a lot from your body and are subject to high stress, you must put time into keeping your body tuned up or it will break down.