+ What is Osteopathy?

Osteopathy is a medical philosophy that acknowledges that every individual has their own unique combination of body, mind, and spirit. Physical changes in a person’s framework such as poor posture, injuries, or insufficient exercise often result in pain and dysfunction down the line, which can then affect those other aspects of the person’s overall health. Osteopathy seeks the root causes of that pain and dysfunction, and gradually retrains the brain to let go of past defenses to bring about long-term stress reduction and healing.

Osteopathic manipulative therapy (OMT) is one part of osteopathy that aims to correct those physical changes using 12+ types of hands-on techniques that stimulate and relax any type of stressed tissue (muscles, ligaments, cartilage, joints, etc.). Some of these techniques are like those in other schools of bodywork such as physical therapy, massage, and chiropractic, but most of them are unique to osteopathy alone.

+ What is Facial Distortion Model?

The Fascial Distortion Model is a patient-centered, symptom-based modality, useful to diagnose and treat painful musculoskeletal and other medical conditions. In this model, the patient becomes the “expert”, skilfully guiding the trained physician to the FDM diagnosis and treatment.

In the FDM approach, treatment is directed to the specific anatomical distortions of the capsule, ligaments, and surrounding fascia, physically reversing them. When the fascial distortions are corrected, the anatomical injury no longer exists, the patient can resume normal function and is pain-free.

+ What does it mean to be a DO?

In America, there are two routes to becoming a medical doctor. Doctors of osteopathic medicine (DOs) must complete 4 years of medical school just like their MD colleagues, and they also complete 200+ hours of training in osteopathy. Then, both DOs and MDs complete a residency for 3 to 7 years, often shoulder-to-shoulder, before sitting for board certification in a specialty such as family medicine, general surgery, or neurology. The culmination of training for a few DOs is a one-year fellowship in osteopathy which better prepares them to help harmonize the many spheres of their patients’ lives. DOs diagnose medical conditions, order blood work and imaging studies, perform injections, prescribe medications, and counsel their patients compassionately.

+ Can Osteopathy help me?

Patients with the following conditions have found benefit in an osteopathic approach:

acute muscle strains

motor vehicle collisions

neck/back pain

pregnancy-related pain

headaches and migraines

sports injuries

carpal tunnel syndrome

infant head shape

post-surgical pain

fibromyalgia

TMJ pain

arthritis/DJD

+ When is a good time to try Osteopathy?

You might want to consider osteopathy if:

You have already tried numerous pain remedies available to you

You are interested in reversing the source of an injury

You want to take your own body’s healing to the next level

You are contemplating surgery to repair or replace a body part

+ What can I expect at my first visit?

Our number one priority at New River Osteopathy is developing a healthy, positive relationship with you. We take our time to get to know you as a unique human being. Next, we perform a thorough exam to narrow down your specific diagnosis. You will then experience OMT first-hand. Lastly, we will go over one or two 2-minute exercises that best address your unique conditions. You will leave with Dr. Razvi’s cell phone number so that you can always ­­­­­­­­­­reach out with any questions about your treatment plan or if your pain flares for any reason.

+ Do I really get my Doctor’s cell phone number?

Yes! We believe that restoring the doctor-patient relationship will lead to better outcomes and much higher satisfaction for both parties. Dr. Razvi responds personally within one business day. Feel free to ask about a nagging pain, or a video call to see how well you’re performing your exercises!

+ Do you work with Insurance Companies?

Yes, as an out-of-network provider. We will help you submit your claims to your insurance company, and you will be their main point of contact as their member. Be sure to call the phone number on the back of your insurance card, or log in to their portal, to see if you have a separate out-of-network deductible, specialist co-pay, and co-insurance. See next FAQ below regarding what to tell them. We do take Medicare patients, but unfortunately those patients will be unable to submit for any reimbursement because federal law prohibits any out-of-network claims.

+ Should I tell my Insurance Company?

At New River Osteopathy, you will have an office visit as well as one or more procedures at every session. The E&M (evaluation and management) code for initial visits is usually 99204 or 99205, and follow up visits are either 99214 or 99215. The CPT (Current Procedural Terminology, copyright American Medical Association) codes for procedures that are commonly used at New River Osteopathy are:

98925-98929 osteopathic manipulative treatment

20552-20553 trigger point injections

20604/20606/20611 ultrasound-guided joint injection

76881-76882 diagnostic ultrasound of an extremity

76942 ultrasound guidance for needle placement

Please be aware that most insurance companies will not reimburse for prolotherapy despite Level 1 Evidence supporting its use in knee arthritis.

+ What is your pricing?

New River Osteopathy's rates are $320 for a 60 minute session, $180 for a 30 minute session, and $120 for a 20 minute session. For new patients, we offer a free phone consultation for up to 15 minutes. We provide sliding scale discounts as well as pro bono care to 10% of our patients. All supplies (including trigger point therapy balls, exercise bands, k-tape, cold spray, etc.) are typically provided free of charge. Injections are also included as part of the pricing structure, except for the cost of certain kits. Because our overhead is so low, we only charge about 50% of other insurance-based doctors’ fees. The clinic does provide discounts based on income and household size, as well as completely free (pro bono) care to those who need it. Remember to call your insurance company to see how much they might reimburse you as well.

+ How Many Visits Will I need?

Treatment is usually divided into 3 phases: trial, treatment, and training. We recommend that patients mentally commit to 3 once-weekly sessions for the trial period. About half of our patients get enough benefit by then that they can skip directly to the training phase where they can maintain their relief largely on their own. About a quarter of our patients need 2-4 additional sessions over 2-3 months before feeling comfortable enough to move on to the training phase, and the last quarter have had chronic pain which requires several treatment sessions over 4-6 months. Ultimately, the goals are to provide you the tools to both keep yourself active and to minimize the risk of future pain.

+ Isn’t it Cheaper through my Insurance?

Not necessarily. Again, our overhead is incredibly low, allowing us to charge about half of the typical doctor’s fees. Here are several questions to answer before you can make that calculation accurately:

How much is left in my deductible?

Do I have a separate out-of-network deductible?

Can out-of-network costs be applied towards my in-network deductible (combined deductible)?

When does my insurance year end?

What is my copay and coinsurance for PT and doctors visits?

Can other clinics tell me the average number of visits, chance of significant symptom improvement, and costs to expect?

How much have I spent up to this point to solve this problem, and how much do I expect to spend?

+ But I have Insurance, why wouldn’t I use it?

95% of our patients have health insurance, and they choose to seek care with us because their first priority is getting back to the activities they enjoy without pain. At New River Osteopathy, you can be seen sooner, more often, and for longer visits, resulting in more efficient progress towards measurable outcomes that take less time and are often cheaper than in-network care. Don’t forget that you can still submit your claims as well.

+ How do I submit my claims?

The simplest way is to use our partner Reimbursify. Just enter a few pieces of information, upload the invoice and receipt that we send after each visit, and submit — all within 2 minutes for just $3! To avoid that fee, you can log in to your insurance portal and look for a medical claim form to submit electronically or by mail.

+ Does OMT Hurt?

Dr. Razvi’s philosophy is to first use the least painful techniques within Osteopathic Manipulative Treatment that are likely to produce noticeable results. He may then use more forceful techniques on more stubborn areas. Remember, even light touch may be incredibly painful to patients who have had severe, chronic pain. If ever any technique is too much for you, simply say the word “less” and Dr. Razvi will modify his approach to suit your tolerance level. Some level of post-treatment soreness is possible for 1-2 days after a treatment.

+ Do the injections Hurt?

Dr. Razvi uses cold spray before injecting skin-numbing medicine using the thinnest needles possible. Some people feel nothing but the cold, while others feel a sting and a burn for a few moments, similar to getting a flu shot. Sometimes Dr. Razvi must pass through tendons which unfortunately do not numb well, and he will let you know if that might happen beforehand. Some people feel sore for several hours to 2 days after the numbing medicine wears off, depending on which kinds of injections were provided.

+ How are you different than a Chiropractor?

Dr. Razvi is a fully-licensed, board-certified medical doctor who can manipulate not only every joint in the entire body, but also every muscle, tendon, ligament, nerve, artery, vein, and connective tissue. Further, Dr. Razvi is fellowship-trained in musculoskeletal diagnosis, so he will help you understand all the possible anatomic reasons for your pain. He also performs ultrasound-guided diagnostics and injections depending on your specific history and exam. In short, Dr. Razvi provides the most comprehensive, integrative treatment he possibly can.

+ Do you perform osteopathic cranial manipulative medicine (OCMM) or craniosacral therapy (CST)?

Yes, Dr. Razvi has received hundreds of hours of training specifically in cranial manipulation (although this modality is actually used on every part of the body). OCMM is gentle enough to perform on babies as young as a few hours old! For more information, please visit the Osteopathic Cranial Academy website at https://cranialacademy.org/

+ What research has been done?

OMM

Meta-analysis of OMM for low back pain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159549/

Hundreds of smaller-scale articles available upon request

Prolotherapy

Meta-analysis for osteoarthritis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5079700/

Meta-analysis for rotator cuff tendinopathy: https://www.ncbi.nlm.nih.gov/pubmed/30076801

+ How should I prepare?

Wearing loose-fitting clothing or sportswear will make it easy for Dr. Razvi to perform the exam and manipulations (shorts and sleeveless shirts will be available in the clinic in case you forget).

Regarding mental preparation, understand that improving your health is a team effort, and that you may only see low-grade results in the first few visits, especially if your body has been dealing with pain for many years. Dr. Razvi will stay with you as long as you’re seeing at least a little more overall progress at each visit.

Please complete the forms available on our website before your first visit in order to maximize your time with the doctor.

Dr. Razvi is committed to tailoring your treatment as much as possible, so be prepared to discuss what you did or did not like about any previous treatment sessions.