Real questions patients ask in consults, answered in plain language. No reassurance-speak, no defensive hedging. If your question is not here, call 443-228-8029 — we will answer it.
The most cross-referenced questions from our intake forms and from organic search. Answers lean on clinical mechanism, not marketing language.
Yes, modest ones. Most patients experience mild soreness for 24–48 hours after a session, similar to a hard workout. Minor bruising is possible at deeper insertion sites. Rarely, patients with vasovagal sensitivity feel briefly lightheaded (we screen for this). Serious adverse events like pneumothorax or infection are uncommon, and the risk is reduced significantly by trained, anatomically precise insertion. Dry needling is not risk-free, but the risk profile is well-characterized. See the dry needling page.
Clear contraindications: active infection at the proposed insertion site, an active bleeding disorder, severe needle phobia. Relative contraindications that require discussion include anticoagulant therapy, pregnancy in specific regions, lymphedema in the treated limb, and certain immunocompromised states. We screen every patient before the first session and will tell you honestly if dry needling is not appropriate. There are usually other manual therapy options that fit. Read full screening details.
Coverage varies by plan. Some cover it as part of standard PT codes; others explicitly exclude it. We are an out-of-network provider, so we do not bill your plan directly. We verify your specific benefits in advance and tell you exactly what to expect to pay before your first session. Most patients pay $145–$220 per session out of pocket, and partial reimbursement is common on plans with out-of-network PT benefits. HSA and FSA accepted. Call 443-228-8029 to check your plan.
A thin, sterile, single-use filament is inserted into a hyperactive trigger point, which is a knot in muscle tissue that fires aberrantly. The muscle responds with a local twitch that effectively resets the dysfunctional contraction pattern. Pain decreases, range of motion improves, and the tissue becomes responsive to the manual therapy and movement work that follow. The mechanism is neuromuscular, not energetic. Research supports it for myofascial pain, chronic neck and low back pain, plantar fasciitis, and lateral epicondylitis.
Same needle, different framework. Dry needling is a Western neuromuscular technique targeting trigger points identified by clinical examination, with the goal of resetting muscle dysfunction. Acupuncture is a Traditional Chinese Medicine practice targeting meridian points within an energetic framework. Both can be valuable, as they address overlapping problems with different reasoning. Dry needling at Physica Medica is performed by physical therapists, integrated into a PT plan, and measured against functional outcomes.
Most patients see meaningful change within 3–6 sessions. Acute trigger-point cases sometimes resolve in 1–2 sessions. Complex chronic cases with multiple regions and movement compensations typically require 8–12 visits to durably consolidate. We tell you our honest estimate after the initial assessment and re-evaluate at the four-week mark with you.
The insertion itself is barely felt. The needle is much thinner than the hypodermic needles used for injections. The clinically meaningful moment is the brief twitch response, which feels like a deep muscle cramp that releases within a second. Most patients are surprised at how little it sustains. Mild post-session soreness for 24–48 hours is normal, like the day after a hard workout.
Cupping is one of the more skepticism-prone modalities we offer. Honest answers below.
Yes, that is its primary indication. Most manual therapy compresses tissue (pressure inward); cupping decompresses it (pressure outward via suction). For adhered fascial planes, common in chronic pain, post-surgical scar tissue, and patients who have spent months guarding, decompression accesses restrictions that compression alone cannot reach. Performed within a clinical PT plan, not as a standalone spa service.
Modest ones. The visible marks last 3 to 7 days and look more dramatic than they feel. They are not bruises from trauma. Mild post-session soreness is normal. Cupping is not appropriate over open wounds, certain skin conditions, or on patients with severe lymphatic compromise without specific protocols. We screen before the first session.
The marks result from extravasation, small amounts of fluid drawn to the skin surface by suction. Darker marks generally indicate areas of greater fascial restriction or congestion. They are not bruises from impact; they do not hurt the way a contusion does. Marks fade in 3 to 7 days. We can adjust suction intensity if marks are an issue for you (work, photography, swimming).
Massage applies pressure inward to mobilize tissue. Cupping applies suction outward to decompress it. These address different mechanical problems. Many patients benefit from both within the same session: massage to mobilize the surface layers, cupping to decompress the deeper fascial planes. Within a clinical PT plan, the therapist picks the tool the diagnosis calls for. Learn more about our manual therapy.
What PT can and cannot do for scoliosis. We err on the side of being honest, not optimistic.
Honest answer: structural adult scoliosis cannot be reversed by physical therapy. The bony curvature is fixed. What PT can do, meaningfully, is reduce pain, improve postural awareness, strengthen the muscles that support the curve, and slow progression. For adolescents, specific exercise protocols may slow curve progression during growth. We are transparent about what PT can and cannot do for scoliosis. That honesty is the trust-building move.
In severe cases (typically curves greater than 70 degrees), the lungs and heart can be compressed by the chest wall deformation, leading to restricted breathing and cardiovascular strain. For moderate scoliosis, the most common impact is musculoskeletal: chronic back pain, postural compensation, and reduced trunk range of motion. We treat the musculoskeletal layer; severe cardiopulmonary involvement requires medical management.
PT cannot reverse structural scoliosis, but it can substantially improve function and reduce pain in adults managing scoliosis long-term. Specific exercise protocols (Schroth-based work) target the asymmetric muscle imbalances that scoliosis creates. We work alongside orthopaedists and spine specialists when bracing or surgical consultation is appropriate. See our scoliosis treatment page.
Logistics. Mostly the things that determine whether you book this week or postpone.
A full 60 minutes with a doctoral-level DPT. The session covers full history, movement assessment, manual examination, hands-on treatment, and a plan. You leave having received care, not just been evaluated. Bring your insurance card, any imaging or surgical reports, and clothing you can move in. Full first-visit details on the contact page.
No. Maryland is a direct-access state, which means you can see a physical therapist without a doctor referral. If your insurance plan requires a referral for reimbursement, we will tell you upfront when we verify your benefits. Bring any imaging or surgical notes if you have them.
First visit: 60 minutes (history, assessment, treatment, plan). Follow-up visits: 45 to 60 minutes depending on case. We do not run shorter sessions. The 60-minute model is structural, not optional. It is what makes the clinical work possible.
Every clinician on staff is a Doctor of Physical Therapy (DPT). Dr. Maks holds the FAAOMPT manual therapy fellowship (under 1% of practicing PTs nationally) plus OCS board certification. Dr. Chen is SCS. Dr. Rodriguez is OCS and CLT. Read full team bios.
The questions that come up when a skeptical patient is doing their pre-booking research.
Each has indications where research supports it and indications where it does not. The clinical question is not 'do these work' but rather 'does my specific case have the pattern these are designed for?' Fellowship-trained clinical reasoning is what tells those apart. We deploy each modality when the diagnosis calls for it, explain why, and measure outcomes against function, not against the technique marketing. That is the honest framing.
Every modality at Physica Medica is performed by a Doctor of Physical Therapy with specific training in the technique. Dry needling, cupping, IASTM, manual therapy: none of it is delegated to aides or technicians. Our lead clinician holds the FAAOMPT manual therapy fellowship, held by under 1% of practicing PTs. This is a clinical practice, not a spa.
Coordination, specialty fit, and when we are the right answer.
Our team specialties cover the broad range of musculoskeletal cases: complex chronic pain, post-surgical rehab (ACL, rotator cuff, joint replacements), sports injuries, prenatal and postpartum PT, scoliosis, lymphedema, and balance/falls populations. If we do not think we are the right fit for your specific case, we will tell you and point you to someone who is. See full team specialties.
Yes, we routinely coordinate care directly with surgeons and orthopaedists, especially for post-surgical rehab where following the operative protocol is essential. Bring your surgical notes and any post-op protocol from your surgeon. We will communicate progress and any concerns back to them throughout your course of care.
