Bernard E. Filner, M.D., Pain Medicine, Rockville, MD
Treatment Approach

Exercise, Physical Therapy and Related Approaches

Dr. Filner uses an integrative approach in treating chronic pain. At the appropriate time during the course of treatment, some patients may benefit from exercise, physical therapy, massage therapy, or acupuncture. For those who are interested in these additional approaches, referrals can be made after discussion with the patient.

Physical Therapy

There is no greater truth at times than the statement, “It hurts too much to move.” So, it is sometimes surprising and maybe even a little hurtful to hear a pain-free life is within our reach. Reach? Who can move, let alone reach!

Yet, physical therapy can play a crucial role in restoring normal muscle length (by frequent, gentle stretching), which is required for controlling, and eventually resolving, myofascial pain symptoms.

As pain comes under control, the treatment may call for reconditioning both the cardiovascular system and the specific involved muscles. If physical therapy is needed, rest assured, we will start at the appropriate time, since pain can increase if reconditioning is started too soon. Dr. Filner is aware of many capable physical therapists and appropriate referrals can be arranged.

Physical therapy may benefit your condition as follows:

  • If you have osteoarthritis, maintaining the flexibility of muscles and ligaments is critical. Flexibility will help to decrease pain and will slow progression of the underlying arthritis. This can be achieved with a stretching program geared toward your specific problems.
  • Improved flexibility will help to reduce pain symptoms. Reconditioning muscles for flexibility, rather than bulk, is achieved by increasing the number of repetitions for improving endurance and not by increasing the total amount of weight.
  • If you have fibromyalgia, a stretching and reconditioning program will significantly reduce pain symptoms, as well as decreasing stress.


As your pain improves and you begin or return to active exercising, learning correct methods for exercising may help to minimize the risk of future injury. 4-EverFit, Inc., founded eight years ago by Mr. Paul Fezza, is an independent provider now serving clients in our office. Mr. Fezza is a Nationally Certified Athletic trainer and Muscle Activation Specialist. Muscle Activation Technique (M.A.T.) addresses imbalances in muscles that are associated with pain and dysfunction. Although M.A.T. does not specifically treat pain, addressing imbalances may be useful in some cases as an exercise program begins. Mr. Fezza and the staff at 4-Everfit are personal trainers and are experienced in working with clients who have had injuries, ailments and recurring physical problems.

Massage Therapy and Acupuncture

Some patients benefit from massage therapy or acupuncture. If you are interested in massage therapy or acupuncture, Ms. Christina Sarlo, a licensed massage therapist and acupuncturist (, is an independent practitioner who serves clients in our office. Ms. Sarlo has advanced training in Connective Tissue Massage, Craniosacral Therapy, and certification in Neuromuscular Therapy (Trigger Point Therapy). She has a Masterís degree in Acupuncture from Tai Sophia Institute and she supervises at the Tai Sophia Student Clinic.

Two approaches to massage may be useful for some patients:

  • Deep Tissue Massage is directed to deeper layers of muscle than Swedish massage. This mode of therapy can be directed to specific muscles, perhaps to speed recovery of a pulled muscle.
  • Trigger Point Massage is often used to reduce pain and release tight knots of tension.

In 2002, the World Health Organization (WHO) reviewed and analyzed scientific reports on acupuncture. Although a rigorous definition of acupuncture was not established in this review, the review, nevertheless, suggested that acupuncture is effective for 28 different conditions, and the effects of acupuncture seem to depend on the proficiency of the practitioner. These conditions include: facial pain, headache, knee pain, low back pain, neck pain, dental and temporomandibular pain, rheumatoid arthritis, sciatica, sprain, and tennis elbow. The WHO report indicated that acupuncture is safe and non-addictive when performed by qualified practitioners, especially in regard to pain control. Dr. Filner does not practice acupuncture or supervise the acupuncture therapy provided by Ms. Sarlo. However, acupuncture may be a component of the integrative approach to our treatment of chronic pain for some patients.

So, if accomplishing gentle exercise on your own is difficult to impossible, your treatment plan may include physical therapy, exercise or massage therapy. Anyone interested in Ms. Sarlo’s acupuncture or massage therapy services may schedule an appointment directly with Ms. Sarlo.