If you're reading this page, you've probably already tried physical therapy, maybe more than once. You may have been given a sheet of exercises, seen a different therapist every visit, or been discharged before you felt better. That experience is common. It's not what happens here.
Chronic pain is a different clinical problem than acute pain. By the time pain has persisted for three to six months, the pain system itself has changed. Not just the tissue.
The nervous system becomes sensitized. Pain signals amplify. Protective patterns set in: you guard the area, then surrounding muscles compensate, then those compensations create their own problems. The tissue that hurts may no longer be the tissue that's actually driving the pain.
Standard PT protocols address tissue. They focus on the painful area, prescribe range-of-motion and strengthening exercises, and discharge when pain reduces by a certain percentage. For chronic pain, that's incomplete by design. A 15-minute session with a rotating provider cannot address sensitized neural pathways, layered compensation patterns, and the behavioral guarding that's developed over months or years.
Chronic pain requires three things most clinics can't deliver: time to actually work through the layers, continuity so the clinician understands the full pattern, and modality breadth to address tissue, movement, and nervous system together. That's the model Physica Medica was built on.
Three coordinated tracks, not three separate appointments. Each session weights them differently based on what the assessment shows that day.
After leaving Dr. Maks table I felt so inspired by his knowledge. I had chronic pain in my right glute and leg muscles and did not know how to escape it. I was in pain most days, but especially sitting in class all day or driving long distances.
I have had a low back/piriformis/hip flexor problem for years. As a yoga, Pilates, and barre instructor, managing that has been tough. When the pain became unignorable, I turned to dry needling. It has been the only method that truly helped me.
DR. MAKS BIRIKOV helped me walk again! If it weren't for his expertise, I would still be struggling with my pain and having my mobility severely limited. I can not recommend more highly!!
Each modality has a specific role. Most chronic pain patients see two or three deployed within a single session. That's the point of a 60-minute one-on-one model.
Resets neuromuscular trigger points that refer pain across regions. Particularly effective for chronic neck, low back, and headache presentations.
→Decompresses adhered fascial planes, which is common in chronic pain patients who've spent months guarding.
→Instrument-assisted soft tissue mobilization for scar tissue, adhesions, and chronic tendinopathies that have stopped responding to hands-on work alone.
→Retrains the patterns that drive your day: sitting, lifting, walking, sleeping position. So the manual gains don't get re-created the moment you walk out.
→For patients whose chronic pain is amplified by stress and nervous-system sensitization. Clinical breathwork instruction with proper contraindication screening. Not a class drop-in.
→No quick history-and-handoff. The first session is built to give you a clear picture of what's wrong and what we'd do about it.
Onset, evolution, prior treatments, what worked, what didn't. We read your imaging and surgical reports if you have them.
Watching how you move through the day, sitting, standing, walking, reaching, to identify the compensations layered onto the original problem.
Hands-on assessment of tissue mobility, trigger points, joint restriction. This is where we identify what's actually drivable.
You leave the first visit having received treatment, not just an assessment. Dry needling, manual therapy, and movement re-education. Whatever fits.
Honest projection: how many sessions you'll likely need, what insurance is likely to cover, what you'll do between visits. No mystery, no upsell.
One-on-one with a doctoral-level PT for a full hour, every visit, justifies the premium model on its own. But only if you actually need it. Chronic pain cases are exactly where it earns its keep: a 15-minute session in a shared room cannot work through the layers a chronic case requires.
We're out-of-network. Most patients pay $145–$220 per session, with partial reimbursement common via plans with out-of-network PT benefits. We verify your specific benefits in advance and tell you what to expect to pay before your first visit. HSA and FSA accepted.
If finances are a deciding factor, request a free 30-minute movement screen first. A therapist will tell you whether your case is likely to need 6 sessions or 16, which changes the financial math substantially.
After leaving Dr. Maks table I felt so inspired by his knowledge. I had chronic pain in my right glute and leg muscles and did not know how to escape it. I was in pain most days, but especially sitting in class all day or driving long distances.Mackenzie F.
It depends on the case, and we'll tell you honestly which we think yours is. Many chronic pain cases respond meaningfully to the right combination of manual therapy, movement re-education, and nervous system regulation. Some achieve full resolution. Others reach a sustained, manageable baseline that no longer dominates daily life. We're transparent about expected outcomes after the first session. We're also clear about the cases where PT is a piece of the puzzle but not the whole answer. Chronic widespread pain often benefits from coordination with primary care, pain management, or behavioral health alongside what we do.
Most chronic pain patients notice meaningful change by session 3–4 and reach a durable result between sessions 8–14. Some respond faster, especially when the primary driver is identifiable trigger-point referral or a single joint restriction. Complex multi-region chronic pain typically needs longer. We re-evaluate at the four-week mark with you. If we're not seeing the expected change, we either revise the plan or tell you we don't think we're the right fit.
Most plans cover physical therapy for chronic pain, though specific modalities like dry needling vary. We're out-of-network, which means we don't bill your plan directly. We do provide the documentation you need to submit for reimbursement. Many patients with PPO plans see partial reimbursement. We verify your specific benefits before your first visit and tell you exactly what to expect. HSA and FSA are accepted. See our insurance & payment page for details.
Honest framing: research supports both for specific indications, not as universal panaceas. The clinical question isn't "do these work" — it's whether your specific case has the pattern these are designed for. Dry needling earns its place when there are identifiable trigger points referring pain. Cupping earns its place when fascial restriction is part of the picture. We use these tools when the diagnosis calls for them and explain why each session, not as a default.
