Conditions · Baltimore, MD
Generic PT. Chiropractic adjustments. Massages. Medication. If those worked, you wouldn't be reading this. I'm Maksim Birikov, DPT, and back pain treatment at my Fells Point studio starts from a different premise: back pain is a symptom, not a diagnosis. Until someone identifies the specific driver of yours, no protocol will fix it.
The Premise
Here's what usually happens at a chain clinic: fifteen minutes with a therapist, a printout of generic exercises, and an aide watching you do them next to other patients. The protocol is the same whether your pain comes from a disc, a joint, or a muscle, because nobody spent the time to find out which one it is.
At Physica Medica, the entire hour is mine and yours. I do the assessment, I do the hands-on treatment, and I coach the corrective work in the same session, every session. When one practitioner handles all of it, the treatment actually matches the diagnosis. That's the whole difference, and it's why people who've failed everywhere else get results here.
The Diagnosis
"Back pain" is five different problems wearing the same disguise. Effective treatment starts with knowing which one you have.
A bulging or herniated disc irritates nearby nerves. Pain often radiates into the hip or leg, worsens with sitting, and eases when you walk. This needs decompression and nerve mobilization, not deep pressure. See herniated disc treatment.
The small joints between vertebrae get stiff and irritated, producing sharp, localized pain with extension or rotation. Manual therapy restores the joint mechanics; strengthening keeps them restored.
Deep stabilizers like the quadratus lumborum and multifidus develop trigger points that ache constantly and refer pain across the low back. Too deep for massage. This is dry needling territory.
The thoracolumbar fascia is the broad connective sheet across your low back. It loses its glide from years of sitting, old injuries, or scar tissue, making the whole area feel tight, weak, and guarded.
Sometimes the nerve itself is the restricted structure. Numbness, tingling, or pain that follows a line down the leg points here, and stretching it harder makes it worse. See neural tension release.
The System
No single technique fixes back pain. The fix is the right techniques, in the right order, under one set of hands. Every 60-minute session integrates three layers:
For the deep muscular drivers like QL, multifidus, and glute medius, dry needling releases the trigger points that hands can't reach. A thin filament needle triggers the twitch response that resets the contracted fibers and restores blood flow. Yes, it works for lower back pain specifically: those deep stabilizers are exactly where needling outperforms everything else. Expect mild soreness for a day, then a range of motion you haven't had in months.
Joint mobilization for stiff facets, IASTM and myofascial cupping for the thoracolumbar fascia, targeted deep tissue work for the surrounding musculature. This restores the mechanics of how your spine actually moves, so the pain-generating tissue stops being overloaded.
The layer everyone skips, and the reason results elsewhere didn't last. In the same session, I retrain the hip hinge, the breathing pattern, and the core strategy that caused the overload, then build capacity with rehabilitation-grade strength training. Release without retraining is a two-day fix. This is what makes it permanent.
No Surprises
I watch how you move, test what provokes and relieves the pain, and palpate the tissue. By the end, I'll tell you in plain language which driver (disc, joint, muscle, fascia, or nerve) is running your pain.
Assessment and treatment aren't separate appointments here. Hands-on work begins in your first session, calibrated to your tolerance. If you've had painful treatments before, tell me, and we work within what your body accepts.
You leave with a clear explanation of findings, a realistic session estimate, and a home program measured in minutes, not hours. My goal is to fix the problem and discharge you. Not to book you forever.
In Their Words
[Real patient testimonial will be placed here — a review from a back pain patient naming Maksim and describing lasting results.]
[Real patient testimonial will be placed here — a review from a back pain patient naming Maksim and describing lasting results.]
Fair Questions
Physica Medica is cash-pay, and I'll quote you a real number when you call. No surprise bills. What you're buying is 60 full minutes with a DPT every session, versus 15 minutes with a tech at a chain. Because every minute is treatment, most patients need fewer total sessions, which is where the math evens out. HSA/FSA typically eligible. See Insurance & Pricing.
Honest answer: it depends on the driver, the severity, and how long you've had it. Recent muscular pain often shifts in 3 to 5 sessions; chronic, multi-layered problems take longer. What I won't do is put you on an open-ended plan. After your first assessment I give you a realistic estimate and an endpoint, and we track against it.
Yes. It's one of the strongest applications. The muscles that drive chronic low back pain (quadratus lumborum, multifidus, glute medius) sit too deep for hands to treat effectively. Dry needling reaches them directly and releases the trigger point at its source. I combine it with fascial release and movement retraining in the same session so the release holds.
Get Started
One hour in Fells Point and you'll know what's actually driving your pain. And exactly what it will take to fix it. Minutes from Canton, Federal Hill, and Harbor East.
Your first visit is a full 60-minute, one-on-one assessment with Maksim Birikov, DPT.
Physica Medica · 800 S Bond St, Baltimore, MD 21231