For chronic low back pain, multiple large randomised controlled trials have found that structured physical therapy, active rehabilitation, and chiropractic care produce outcomes equivalent to — and in many cases better than — surgery over the long term, with significantly lower risk. For knee osteoarthritis, PRP combined with progressive physical therapy has been shown to reduce pain and improve function, sometimes allowing patients to delay or avoid joint replacement by years.

Try everything evidence-based before surgery or long-term opioids. If conservative care works — and in most cases it does — you’ve avoided a procedure with its own risks, recovery time, and costs. If it doesn’t, you go to surgery better informed, with stronger muscles and better overall function. Clinical guidelines from organisations like the American College of Physicians and the CDC now recommend conservative care as the appropriate first line of treatment for most chronic musculoskeletal pain.

Chronic low back pain affects roughly one in five adults and is the leading cause of disability worldwide. Surgery is appropriate for only a small minority of cases. For most people, a coordinated combination of active physical therapy, chiropractic care, and regenerative medicine produces outcomes that match or exceed surgery over the long term — with significantly lower risk. We treat low back pain as a mechanical problem that responds to the right movement.

A herniated disc is one of the most frequently cited reasons for spine surgery — and one of the conditions most amenable to conservative care. Studies consistently show the majority of disc herniations improve with appropriate rehabilitation within 8–12 weeks. We use directional exercise therapy, chiropractic flexion-distraction, and regenerative injections to support disc healing and centralise symptoms, avoiding surgery for the vast majority of our patients.

Many cases of shoulder pain — including partial rotator cuff tears — improve significantly with 8–12 weeks of structured physical therapy, massage, and targeted injections. For chronic tendinopathy that hasn’t responded to PT alone, PRP has a strong and growing evidence base. We assess each case individually and will tell you honestly if we believe surgery is the appropriate path for yours.

Chronic neck pain is a leading driver of cervicogenic headaches that are often misdiagnosed and undertreated. Chiropractic manipulation combined with targeted physical therapy and massage is evidence-supported for both mechanical neck pain and headaches originating in the cervical spine. Most patients see significant improvement within 6–8 weeks of consistent treatment.

In many cases, yes. The majority of lumbar disc herniations improve with conservative care when the treatment is appropriately matched to the patient and applied consistently over 8–12 weeks. We use directional exercise therapy, chiropractic flexion-distraction, and regenerative injections to support disc healing. We assess each patient individually and will tell you honestly if your case requires a surgical consultation.

The evidence most consistently supports: (1) active physical therapy and exercise; (2) manual therapy including chiropractic and massage; (3) regenerative medicine — PRP and prolotherapy — for tendon, ligament, and cartilage conditions; and (4) addressing co-existing factors like sleep disruption, psychological distress, and inflammation. At EHG we use combinations of these, personalised to the patient, rather than a one-size approach.

This is one of the most consistent findings in pain management research. Patients who engage in structured, progressive physical therapy typically reduce their reliance on both opioid and non-opioid pain medication over time — because PT addresses the underlying mechanical causes of pain, not just the symptoms. Reducing pain at the source means less need to manage it pharmacologically.

At EHG we use: directional exercise therapy; chiropractic flexion-distraction; ozone or PRP injections to reduce disc inflammation and support healing; perineural injections for associated nerve pain; and structured rehabilitation to address the movement patterns that contributed to the disc injury. The specific combination depends on the location and severity of the herniation and the patient’s symptoms.

Coverage varies significantly by insurer and plan. PRP for musculoskeletal conditions is covered by some plans and not others; prolotherapy and ozone are typically not covered. We recommend calling your insurer directly before your appointment. The cost of a regenerative treatment that delays or avoids surgery is almost always significantly less than the cost of the surgical alternative — a factor worth considering even when out-of-pocket.

Yes — and it’s a population we’re particularly experienced with. We are a VA-preferred provider for mental health services, and treat many active and retired military personnel, law enforcement officers, and first responders. Chronic pain in this population often has both physical and psychological dimensions. Our integrated model means we can address both in one place, with one coordinated team.