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Stretches And Exercises For Herniated Disc Pain

Stretches And Exercises For Herniated Disc Pain

Although herniated discs can’t be replaced, they can often be treated without the need for surgery. Here are some exercises and stretches that can help relieve herniated disc symptoms. The cushioning discs between the vertebrae can be compared to your car’s brake pads. However, they have more similarities with shock absorbers. If your brake pads start making a grinding sound, it’s time to replace them or hire a mechanic.

Your back is a different story. Even though disc replacement procedures are less expensive and more sophisticated, you still need to have surgery. If your intervertebral disks are damaged or herniated you will need to change tracks. This means stretching and exercise.

The body’s shock absorbers: Intervertebral Discs

Between each vertebrae, the small bones that make your spine, there are cushioning discs. The discs are small, flexible balloons that are filled with a gel-like substance. These cushions are called intervertebral or discs. The intervertebral disks are held in position by the cartilage at each end of each vertebra.

Intervertebral disks act as shock absorbers for the spine and body (see, what did they tell you? They transfer weight and stress from one vertebra to another. These discs can become damaged or worn down over time. Gel centers that contain the gel can leak out and press against the nerve roots. A herniated disk is this type of injury.

Stretches and exercise can help relieve herniated disc pain

It is important to consult your doctor if you have a herniated disk. Without proper instruction and approval, you could inflict additional injury. Avoid stretching and exercises during the acute phase of a herniated disk.

After the proper medical considerations are made, gentle exercises can be used to ease pain and other symptoms associated with a herniated disk. By strengthening your back and hamstring muscles, you can reduce pressure on the spine column, which helps prevent pain. Exercise can also prevent injury and help promote healing.

  • To heal an injury, there is increased blood flow to the spine
  • Strengthening the support muscles of the spine
  • Reduced stress on the spine which reduces pain
  • Improve abnormal postures in relation to pain

After a disc herniation diagnosis, don’t stop doing exercises. With your doctor’s approval, you should get moving and starting to exercise as soon as possible. Start small with the following exercises and gradually increase your intensity. This will ensure safety. Avoid “BLTs”, which are bending, lifting, and twisting.

Although you don’t necessarily need to have any equipment for these exercises, some items can make them more enjoyable and easier. You may need a yoga mat, especially if you have hard floors. A resistance band (a towel works well), yoga blocks, a stable upright chair (not a recliner), and a timer (your smartphone should have one).

If you feel pain from any of these exercises or stretches, please stop immediately and see your doctor.

Stretches and exercises for the Cervical Spine

Exercise in isometric hold

  1. Relax your shoulders and sit straight.
  2. Place your hand on the forehead.
  3. Place your head in your palm and do not move your head.
  4. For 5 to 15 seconds, hold the position. Repeat the process 15 times.

Neck extension and headlift exercise

  1. Place your stomach flat on a stable surface.
  2. Place your arms at your sides.
  3. Keep your head above the edge.
  4. Slowly raise your head to neutral and keep it there for five to ten seconds.
  5. Repeat the process 15-20 times until you are satisfied.

Neck retraction/chin tuck exercise

  1. Place your back on a flat surface.
  2. Place your arms by your sides.
  3. To feel a tug, tuck your chin down towards your chest.
  4. For 5-10 seconds, hold the button down.
  5. Repeat the process 15-20 times.

Shoulder retraction (scapular retractions)

  1. Place your back against the wall, or sit down.
  2. Allow your arms to naturally hang at your sides.
  3. Your elbows should be bent at 90 degrees at the elbow.
  4. Your shoulders should be lowered and your back should be straight.
  5. While pushing your back against the wall, squeeze your shoulders together.
  6. For 15-30 seconds, hold the button down.

Neck rotation stretch: Turn your head slowly to one side, but not so far that your neck is visible. Hold the position for 30 seconds. Then, slowly turn your head to the opposite side.

Lateral bend stretch: Turn your head so that your justify side touches your shoulder. Now hold the position and then move to the right side.

Scalene stretch: While sitting in a chair, grasp the seat with your justify arm, lift your justify shoulder blade down, and then bend your right ear towards your right shoulder until it feels a tug. Then tile the backwards.

Stretches for the Lumbar Spine

Gentle knee-to-chest stretch

This is a good stretch to begin with, and can be used on days your body cannot tolerate more strenuous stretches. To relieve pain, the knee-to-chest stretch targets muscles on both sides of your back.

  1. Place your hands on the ground, and place your knees on the back.
  2. Gently pull one of your knees towards your chest with your hands.
  3. Tend to the stretch for at least 10 seconds. Then, switch sides and do it again.

Stretch for cat-cow

The cat-cow stretch is a favourite for back pain relief. It opens the spaces between your vertebrae, relieving the pressure on your herniated disc, and increasing mobility in your spine.

  1. Keep your hands and knees lower than the floor, so that your body is on the “tabletop” with a flat back.
  2. Take a deep breath and look up at the ceiling from where you are looking.
  3. Slowly exhale and then round your spine to form an arch. This is like an angry cat. Let your head hang loose and your shoulders relax. Your back should be visible.
  4. Do a set of 10 at least two or three times.

Back flexion stretch

To relieve low back pain (one of the most common medical conditions), this stretch will extend your spine and back muscles.

  1. Lay on your back
  2. Bring your knees towards your chest, and then wrap your arms around your knees.
  3. Keep your head up high so that you feel a tug at the middle and lower back.
  4. Tend for 10 seconds, then repeat the process 5-10 times.

Spinal decompression stretch

Stretching the space between your vertebrae can relieve pressure on your spine and discs.

  1. To hang from, you will need something sturdy (e.g. A bar that can be used for pulling ups on the top of a doorframe or playground monkey bars, or any other bar. ).
  2. Use an overhand grip to grasp the bar. Lift your feet off the ground until they touch the ground.
  3. Hold for 30 seconds, then repeat the process three times.

Piriformis muscle stretch

Low back pain can be relieved by stretching this tiny muscle in your buttocks. If you suffer from sciatica, this stretch can be helpful.

  1. Place your back on the yoga mat or floor.
  2. Place your heels on the ground with your heels planted.
  3. Place one leg on the bent knee of the other. It should look like an upside-down triangle.
  4. Reach one arm out through the triangle, and then use your other hand to grab the bent leg.
  5. Hold the position by pulling the leg towards your chest.
  6. Continue with the opposite leg.

Hamstring stretch while seated

  1. Sit down in a chair, with one leg on the ground and the other bent at 90 degrees. The other leg should be extended straight out with your heel on the floor.
  2. Keep your back straight and extend your legs outward until you feel a stretch in your upper thigh.
  3. This stretch should be held for between 15-30 seconds. Then, switch to the other leg.
  4. Repeat as many times as you can.
  5. Option: You can also deepen the stretch by lying down on your back and raising one leg up in the air. You can wrap a towel or a resistance band around your raised foot, and pull your leg towards your body by holding the towel/band.

Prone extension stretch

This helps to reposition discs back in the correct place. It also aids in healing. This stretch may not be suitable for everyone. This is normal. Begin slowly. Stop immediately if you feel any pain.

  1. Place your face on the yoga mat or floor.
  2. Place your forearms next to your body on the ground. Your elbows should be bent at 45 degrees.
  3. Slowly, prop your elbows up in a “Sphinx” pose. Make sure your hips are connected to the ground.
  4. Continue to press your elbows upward until your elbows bend at a 90 degree angle.
  5. For 10-15 seconds, hold the up position and then return to your original position.
  6. You can repeat the stretch 10 more times until you are able to hold the position up for 30 seconds.

Bracing the abdomen or pelvic tilt

  1. Place your feet flat on the floor and place your knees bent on your back.
  2. Without holding your breath, contract and pull in the lower and deeper ab muscles.
  3. As the motion takes place, the lower back will fall to the ground, putting the spine in neutral.
  4. Tend for 10-15 seconds, then repeat the process multiple times.

Thomas stretch

  1. Place your feet on a flat surface.
  2. One leg should be lifted to the chest.
  3. Hold the other leg above the surface with your abs.
  4. You should feel a stretch in the front of your thighs.
  5. The back should not feel pressure or pain.

Avoid these exercises

If you do strenuous exercise or play sports, it can worsen a herniated disk. A herniated disc can be caused by heavy lifting, sudden pressure on the back, and repetitive strenuous activities. If you’re currently in recovery from a herniated disk, you should refrain from engaging in strenuous repetitive activities until your doctor has cleared you.

Avoid any activity that can cause or intensify your pain while you are recovering.

  • Avoid hamstring exercises if you have sciatica.
  • Avoid high-impact activities like running and other sports, as they can cause damage to the spine.
  • Water exercises and swimming are great options because they have no impact on the body.

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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

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

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) 

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. - Mile High Sports and Rehab

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.

Yasuyuki Nonaka, M.D. - Nonaka Lumbago Clinic

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