5 Aquatic Exercises for Back Pain Relief

aquatic exercises chronic back pain

Regardless of whether or not you suffer from back pain, working out in a pool will offer you so many benefits. A few of the many benefits of pool exercise include a reduced risk of falling2, less pressure on the joints and spine, and having a wider range of motion.4 A 2014 study even showed that aquatic exercise can help alleviate pain, improve quality of life, and even improve a person’s function in their daily life if they suffer from a musculoskeletal condition, such as osteoarthritis.  It’s also common to believe that aquatic exercise is easier and may not have the same benefits as land exercise, however, this same study found that is not the case. The results of regularly engaging in aquatic exercise are equal to the results of regularly engaging in land exercise.1 If you do suffer from back pain, exercising in the pool is a great option that will allow you to exercise while avoiding discomfort.

Why Aquatic Exercise is Beneficial for Back Pain

It’s common for back pain to be caused by weak back muscles. This is why water workouts are so beneficial for anyone dealing with back pain. It provides a low-impact exercise that strengthens and conditions these muscles, creating better support for your spine. When exercising in a pool, the water provides your body with a sort of cushion that removes stress from your back, helping you move more easily and lowering your risk of injury.4 

Your range of motion is also increased in water, because the water supports up to 90% of your weight, taking pressure off your joints and spine. So if, for example, your back pain doesn’t allow you to perform certain movements such as leg lifts, the water will allow you to perform them much more easily.4

Exercising in water will also allow you to strengthen your muscles with little to no risk of injury. You may not feel your muscles strengthening outside of the water, prompting you to test them by lifting a weight that may be too heavy for you. However, because water adds about 12 times greater resistance than air, simply moving through the water is a challenge. This will help you avoid feeling the need to test your strength in a way that can harm you.4 

Moving in water also increases blood flow. The hydrostatic pressure of water encourages blood flow to muscles. This hydrostatic pressure also betters your heart and lung function by requiring them to work hard against it.4

Finally, You may also be able to work out more often and for longer periods of time because water lowers you’re feeling of pain. It’s also easy to modify aquatic exercise based on your goals and specific conditions, making aquatic exercise a great option for back pain sufferers.4

Preparing for Aquatic Exercise

Aquatic exercise is a very common exercise recommended by physical therapists for patients with chronic low back pain. Further, while aquatic exercise is commonly seen as a less effective form of physical exercise, PTJ published a study that found that this is not the case. As other studies have found, PTJ found that aquatic exercise is particularly beneficial for those whose movement is limited by pain. Pain also tends to be reported twice as frequently among those with chronic low back pain who exercise on land.3

Now that you understand why aquatic exercise is beneficial for those suffering from chronic back pain that would like to remain active, it’s important to know what you’ll need in order to start the aquatic exercise.

  • Water shoes, for traction on the pool floor.
  • A pool with water that is waist or chest high.
  • A flotation device of some sort. This can either be a styrofoam noodle or flotation2 belt/vest. This device will help you stay afloat if you’re exercising in deeper water2 and will help remove pressure from your joints when you’re in shallow water.1
  • Webbed water gloves, styrofoam weights, inflated balls, or kickboards in order to increase resistance for an added workout.
  • Drinking water. You may not notice yourself sweating, but it will still be important to stay hydrated.2

Remember that in the water, slow movements will not provide as much resistance as fast movements, so you’ll want to avoid moving too slowly. Also, as with land exercise, you never want to force your body to continue working through pain. This can cause harm during aquatic exercise just as it would on land. If you feel pain, adjust your exercise or move on to something else.2

Before starting any new exercise programs, it’s important that you consult your doctor in order to make sure that the program is safe and appropriate.

The Best Aquatic Exercises for Back Pain

If you’re exercising to alleviate or prevent back pain, your goal should be to build strength in your back, abdominal, and hip muscles. These muscles are essential in keeping your spine strong and will also help improve your posture and balance.4

Proper technique is also important in order to stay safe when performing aquatic exercise. Because of this, it’s recommended that you work with an instructor that will be able to teach you how to move correctly, at least when beginning. The key is keeping your trunk stabilized and your spine in a neutral position.4

The following exercises are considered the best aquatic exercises for anyone with back pain, or anyone trying to prevent back pain.

Warm Up – Walking and Lunges

You should always warm up before any exercise, and aquatic exercise is no exception. You’ll want to start by walking both forward and backward in waist or chest high water. Start out slowly, increasing your speed as your warm up. You can also jog in place or alternate between jogging and walking for five minutes.1 

After this, you can move into lunges. If you feel that you need support, stand by the side of the pool and hold onto it as you do this. However, doing lunges without support will give your core a greater workout.1

When lunging, step forward, and bend your knee. Avoid taking your knee too far forward when doing this. A good rule of thumb is that you should always be able to see your toes. After taking this step and bending, come back up to your starting position, and repeat with the other side. Three sets of ten lunges are recommended.1

Pool Planks

In order to perform the pool plank, you’ll need a styrofoam noodle. Hold the noodle in front of you, then lean forward into a plank position. At this point, the noodle should be submerged under the water, and your elbows should be straight down toward facing the pool floor. Your feet should still be on the pool floor. Hold this position for as long as is comfortable, or for 15-60 seconds. Repeat 3-5 times.2

Knee-to-Chest

You will not need any additional equipment for this exercise. Start by standing on your right leg, keeping your knee slightly bent and using your right hand to hold on to the side of the pool for support. Then bend your left knee and raise your left leg up until your knee reaches your chest. Lower your leg and complete five reps, then switch sides.4

Superman Stretch

Start by holding onto the side of the pool with both hands. They should be wider than shoulder-width apart and your arms should be straight. Extend your legs out behind you and spread them apart, allowing you to float belly-down in the water. The water will support your weight, allowing your vertebrae and back muscles to be fully extended and stretched. You can also place your face in the water for a few moments in order to rest your neck.4

Water Kicks and Sideways Walking

A Sidestepping activity of some sort is recommended, so to do this, face the pool wall, holding onto it if you need to, with your feet and toes facing straight ahead. Take 15 steps to one side and 15 steps back to the other, then repeat once or twice more.1

After sidestepping, you’ll want to exercise in the form of hip kicks and hip swings. This will develop your strength as well as a range of motion at your hip, which is important for the health of your lower back. Stand near a wall, again, holding onto it if you need to. Bring one leg forward, keeping your knee straight, then back behind you. Do three sets of ten then repeat with your other leg.1 

You can also perform water kicks by moving your leg out to the side, bringing it out and back in, crossing in front of or behind your standing leg.1

Water Work For Your Abs

In deep water with a flotation belt, bring your knees up toward your chest and down again ten times. Repeat this three times. You can also do a more advance version of this exercise by bringing your legs back down, straightening your knees, and extending your body into a line, floating on the surface.1

You can also add twisting into this workout, in order to exercise your obliques. Do this by rotating your knees to either the left or right as you bring them up to your chest for one or more sets of ten.1

Cool Down

Walking is a great warm up and it is a good way to cool down as well. It’s recommended that your cool down lasts about five to ten minutes, and includes hip stretches, done either in the water or on land.1

Aquatic exercise is very good for your joints and muscles, allowing you to get a great exercise without increasing or causing pain. If you’re trying to stay active while living with back pain, this is a great option, especially as we move into the summer months. You’ll even be able to stay cool while you workout!

If you’re someone who’s tried exercises like these, other conservative options, or even surgery for your back pain before and failed to experience relief, it may be time to consider another option. The Discseel® Procedure is a non-surgical and minimally invasive treatment that can allow you to live a life without back pain. This procedure has helped many people suffering from back pain get their lives back! Find out if you’re a candidate by applying today.

  1. Asher, A. (2019, October 3). A Water Exercise Routine for Back Pain. Retrieved June 3, 2020, from https://www.verywellhealth.com/water-exercise-routine-for-your-back-296860 
  2. Mulcahey, J. L. (2020, April 17). 10 Exercises To Do In the Pool. Retrieved June 3, 2020, from https://www.choosept.com/resources/detail/top-10-exercises-to-do-in-pool 
  3. Psycharakis, S. G., Coleman, S. G. S., Linton, L., Kaliarntas, K., & Valentin, S. (2019, January 23). Muscle Activity During Aquatic and Land Exercises in People With and Without Low Back Pain. Retrieved June 3, 2020, from https://academic.oup.com/ptj/article/99/3/297/5299588 
  4. Water Workouts For Back Pain. (2019, July 26). Retrieved June 3, 2020, From Https://Www.Canyonranch.Com/Blog/Fitness/Water-Workouts-For-Back-Pain/

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Kevin Pauza, M.D.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Matthias H. Wiederholz, M.D. - Performance Pain and Sports Medicine

Founding Partner, Triple Board Certified – Physical Medicine & Rehabilitation; Sports Medicine; Anti-Aging, Regenerative & Functional Medicine

Dr. Matthias H. Wiederholz is cofounder of Performance Spine & Sports Medicine, LLC. He is a fellowship-trained interventional pain physician whose clinical interests include: Interventional Pain Management, Sports Medicine, Musculoskeletal Medicine, Minimally-Invasive Spine Surgery, Non-Surgical Orthopedics, and Anti-Aging / Functional Medicine.

He received his specialty training in Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston, Texas where he served as chief resident. He completed fellowship training in Interventional Pain Management in Marietta, Georgia. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He also received advanced fellowship training through the American Academy of Anti-Aging Medicine and is board-certified in Anti-Aging, Regenerative & Functional Medicine.

Dr. Wiederholz performs a myriad of interventional pain procedures including, but not limited to the following: epidural steroid injections, facet joint injections, radiofrequency ablation, sacroiliac joint injections, discography, percutaneous disc decompression, epidural lysis of adhesions spinal cord stimulator implants, and minimally-invasive discectomies. Endoscopic spine surgery is a very unique and valuable tool in his armamentarium and makes Dr. Wiederholz one of the most specialized physicians in the field of Pain Medicine.

Dr. Wiederholz uses musculoskeletal ultrasound in the diagnosis of musculoskeletal injuries. He incorporates ultrasound for precise injection therapy including cortisone injections, prolotherapy, and PRP (platelet rich plasma). This technology is also utilized to perform the Tenex procedure, a percutaneous procedure for treating chronic tendon pain (tennis elbow, rotator cuff, plantar fasciitis, etc).

Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Dr. Wiederholz holds an affiliation with Capital Health System and JFK Johnson Rehabilitation Institute.

Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. He is a leading expert in Bio-Identical Hormone Restoration and helps patients achieve wellness through nutrition, lifestyle, and hormone therapies.

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Yasuyuki Nonaka, M.D. - Nonaka Lumbago Clinic

Kevin Pauza, M.D. - Turtle Creek Surgery Center

Prior to attending Penn State University, Dr. Pauza earned his undergraduate degree from Lehigh University, and furthered his training with a Surgical and Medical Internship at Columbia University College of Physicians and Surgeons. He continued his specialty training at the University of Pennsylvania, followed by an Interventional Spine Fellowship. In addition to his research, philanthropic, and clinical endeavors, Dr. Pauza remains a motivated educator. He established a Spine Fellowship program and continues training physicians from around the world. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians.

After helping hundreds of patients who failed to experience relief after spine surgery, it became evident to Dr. Pauza that current methods needed to change. This motivated him to seek better ways to help patients, by thinking outside the box.

Dr. Pauza is the first physician in history to pursue FDA approval for using biologics to treat the spine. Millions of patients will benefit from his development of minimally invasive treatments for degenerative disc disease and other more common and serious disorders of the spine.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Brandon Tolman, D.O. - Nashville Spine Institute

Boris Terebuh, M.D. - Regenerative Spine & Joint Center

Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. Dr. Terebuh completed his Physical Medicine & Rehabilitation residency training at The Ohio State University in 1997 and has been in solo practice in Ohio since 2001 because he is committed to providing accessible, individualized and attentive care to his patients. His regenerative approach to solving spine problems enhances the body’s natural ability to heal itself. His guiding principle is integrity – doing what is right for patients in a conscientious manner with the motivation of helping them become fully functional, independent and satisfied. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. Boris Terebuh, MD is delighted to be a Discseel® provider because this revolutionary new technology aligns perfectly with his preferred regenerative treatment approach and patient care philosophy. Dr. Terebuh is also grateful to Discseel® developer, Kevin Pauza, MD, for all the years of diligent and meticulous research to create this innovative, paradigm-shifting intervention, which will certainly spare countless individuals the prospect of avoidable spine surgical procedures.

Thierry Bonnabesse, M.D. - Champlain Spine and Pain Management

Gregory Lutz, M.D. - Regenerative Sportscare Institute

Dr. Gregory Lutz is the Founder and Medical Director of the Regenerative SportsCare Institute (RSI). In addition, he currently serves as Physiatrist-In-Chief Emeritus at Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Dr. Lutz is one of the world’s leading experts in the field of regenerative interventional orthopedic medicine, appearing annually on Castle Connolly’s and New York Magazine’s “Top Doctors” lists.

Janet Pearl, M.D. - The Boston Stem Cell Center

Dr. Janet Pearl has been in practice since 1999 and is the Medical Director of The Boston Stem Cell Center. She is also the Medical Director of  Complete Spine and Pain Care  an interventional integrated Pain Management practice, both located in Framingham, Massachusetts. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.

Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Pain Management Fellowship program.

After graduating from Harvard College with an A.B. in Applied Mathematics with Economics, Dr. Pearl received a M.Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She then received her M.D. from the Columbia College of Physicians and Surgeons, where she represented the Medical School as a senator in the Columbia University Senate.

Watch Dr Pearl give an introduction to The Boston Stem Cell Center

Dr. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Women’s Hospital. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)’s Residency Review Committee for Anesthesiology. She is a Joseph Collins Scholar and a Rotary Scholar and was awarded the AMA/Glaxo Welcome and AMA/Burroughs Welcome Resident Leadership Awards.

From 2004 to 2010, Dr. Pearl served on the University of Massachusetts Board of Trustees. While there she chaired the Committee on Science, Technology and Research, was a member of the Committee on Academic and Student Affairs and the Governance Committee and also served as Vice Chair of the Advancement Committee, and as a member of the Committee on Athletics.

Dr. Pearl is Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology with the American Board of Regenerative Medicine and the American Board of Anesthesiologists.

Memberships:

  • The American Pain Society;
  • The Massachusetts Medical Society;
  • The Massachusetts Society of Anesthesiologists;
  • The Massachusetts Society of Interventional Pain Physicians;
  • The American Society of Anesthesiologists;
  • The American Society of International Pain Physicians;
  • The American Institute of Ultrasound in Medicine; and,
  • The American Board of Regenerative Medicine.

PUBLIC SERVICE:

  • Member, Massachusetts Department of Industrial Accidents, Health Care Services Board 
  • Member of the Association of Harvard College Class Secretaries and Treasurers
  • Past Member of the Board of Directors of the Harvard Alumni Association
  • Former Member of the Board of Trustees University of Massachusetts. (10/2010 – 10/2014) 

Travis Foxx, M.D. - Premier Anesthesiology & Pain

Mark Reecer, M.D. - Fort Wayne Physical Medicine

Dr. Mark Reecer is board certified in Physical Medicine & Rehabilitation and Pain Management. He has over 20 years of work comp experience, and he routinely provides Independent Medical Examinations (IMEs) for the Indiana Workers’ Compensation Board. Dr. Reecer has lectured extensively and has authored multiple publications that promote his specialty and the use of treatment modalities to eliminate pain, improve function and avoid surgery.

Dmitry Buyanov, M.D. - IV Infusion Treatment Center

Dr. Buyanov is originally from Kiev, Ukraine. He received his training in Anesthesiology and his Interventional Pain Management Post-Doctoral at Penn State Medical Center, PA. Dr. Buyanov moved to San Antonio in 2003 at which time he was part of a multi-specialty group before he founded Premier Pain Consultants in 2004. His practice has over 5000 active patients in his practice. Dr. Buyanov treats his patients in a cost-effective manner although giving them the best care with interventional pain treatments/procedure to help each patient improve their quality of life. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: “pain is inevitable but suffering is optional”. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. Dr. Buyanov enjoys spending his spare time with his children.

Desmond Hussey, M.D. - NASA Neuroscience and Spine Associates. P.L

Dr. Hussey earned his undergraduate degree from Dartmouth College, and proceeded to earn his Medical Degree from The University of Miami School of Medicine. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. Dr. Hussey continued his specialty training at John Hopkins University pain clinic. A member of The Spinal Injection Society and The American Academy of Neurology and Psychiatry.

Haley Burke, M.D. - Colorado Rehabilitation and Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Maxim Moradian, M.D. - Interventional Spine Care & Orthopedic Regenerative Experts

Dr. Moradian is triple-board certified in Physical Medicine and Rehabilitation (PM&R), Sports Medicine and Pain Management. Dr. Moradian’s clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. He is proficient in performing advanced, minimally-invasive procedures under fluoroscopic and/or ultrasound guidance in the entire spine. Dr. Moradian performs electrodiagnostic testing (EMG/NCS) for the accurate diagnosis of muscle and/or nerve disorders. He has a special interest in regenerative medicine, sports concussions, neuromuscular ultrasound, medical education, and clinical research. His true passion is to treat his patients like his family and friends.

Wendi Lundquist, D.O. - Active Life Physical Medicine & Pain Center

Dr. Lundquist is the Medical Director and founder of Active Life Physical Medicine & Pain Center, Innovative Surgery Center, and Regena Spa. She is dual board certified in Physical Medicine and Rehabilitation along with Pain Management and a diplomat with the American Board of Pain Medicine. She completed her training at Loyola University in Chicago, Illinois in July of 2005. During her time there, she served as Chief Resident and was involved in several research projects. Prior to, she completed medical school at Midwestern University at the Arizona College of Osteopathic Medicine campus in Glendale, Arizona and internship at Doctors Hospital in Massillon, Ohio. She also has a Bachelor of Science in Biology and minor in Chemistry from the University of New Mexico in Albuquerque. She has a special interest in sports medicine, pain and spine. With 17 years experience, she has great enthusiasm towards regenerative medicine.

Michael Wolff, M.D. - Southwest Spine & Sports