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Pathology

Robert R. Cawley, D.O.

Dover, NH 03802

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Our Services

Seacoast Physiatry

What conditions do physiatrists treat?

Our mission is to improve or maximize your function, such as the ability to walk, perform activities of daily living, return to work, or participate in recreational and athletic activities. We work together with our patients and many local and regional physical/occupational/speech therapists, orthotists, prosthetists and medical specialists to develop an individualized approach to meet your functional and rehabilitative goals. This is achieved through a non-surgical integrative approach to pain management including innovative treatments.

We believe in treating the whole person, not just the problem area. We focus not only on treatment but also prevention. Please see our complete list of offered services.


Ultrasound Diagnostics

Musculoskeletal Ultrasound is a simple, office-based exam providing many benefits in helping us understand the structure of tendons, ligaments, bones and joints. It uses no radiation (unlike X-ray or CT scans) and allows us to view the muscle or tendon in motion to see how you are functioning. We also use ultrasound for precise needle guidance during injections to help you achieve the best results. 


 

Medical Management

We treat people - not just symptoms; and take time to understand your individual needs. We recommend and prescribe medications, exercises and treatments to manage acute and chronic musculoskeletal conditions, such as muscle, joint and nerve-related pain, spasticity, and other symptoms. We use a variety of lab tests and imaging studies to rule out or confirm many metabolic and autoimmune conditions, as well as to ensure the safety of the treatment regimen. Our focus is on non-narcotic management of pain.

Rehabilitation physicians evaluate the impact of the condition on the whole person - medically, socially, emotionally and vocationally, allowing patients to take control of their health.


Joint, Muscle and Tendon Interventional Treatments

Joint and Muscle Injections

We perform joint injections with Steroid or Hyaluronic Acid (joint healing medicine) to relieve acute or chronic pain in a joint and quickly restore function. This is frequently done with the guidance of ultrasound, which allows for precise localization of the injection and better outcomes.

PRP Treatment

Platelet Rich Plasma (PRP) injections help accelerate healing in tendons. This procedure is done by drawing a small amount of blood from a patient then creating PRP by separating platelets and growth factors from the rest of the blood. The physician then performs an ultrasound guided injection of the concentrated blood plasma into the ligament or tendon, which eventually allows for accelerated natural healing and more complete restoration of its function.

Trigger Point Injections

Trigger point injections help relieve muscle are muscle injections done to relieve pain from either acute or chronic muscle injury resulting in developing muscle “knots” which “trigger” pain. To minimize pain during the procedure a local anesthetic is used.  Frequently, the injection will result in a muscle twitch followed by relief in pain.

Prolotherapy

Prolotherapy is a form of injection treatment recommended to treat instability of ligaments and tendons. A proliferant solution is used for the injection, which stimulates the body’s healing response. The average number of injections is 3 to 6 for an area treated. The usual time between injection treatments is 3-4 weeks.

Please visit our frequently asked questions section or simply call us for further information regarding our services.


Permanent Impairment Rating Evaluations and Independent Medical Evaluations

Once a person reaches Maximal Medical Improvement (MMI), a Permanent Impairment Rating Evaluation (PIR) may be performed. In these cases, a physician thoroughly reviews all related medical records and obtains a detailed history from the patient. A physical examination is performed and the physician calculates a Permanent Rating level, using the American Medical Association (AMA) guidelines for disability rating, which is expressed in percentage of total body function loss.

Our providers have vast expertise and training in performing Permanent Impairment Rating evaluations, as well as Independent Medical Evaluations (IME).

Please call our office for more information or to schedule an evaluation.


Conditions We Treat 

Neck and Back Pain

Our providers work with our patients to design the best and most efficient way to treat and prevent back and neck pain. As the largest outpatient physiatry group in New Hampshire, we coordinate care closely with regional orthopedic, neurosurgical, behavioral health and pain management groups, as well as nearly all physical/occupational/speech therapy providers in the area, allowing us to provide the most comprehensive approach to treatment and prevention of variety of spine related problems.

Conditions related to spine problems include Spinal Stenosis, Lumbar Strain, Whiplash Injury, Concussion, Disc Herniation, Sacroiliitis, Sciatica, Cervical, Thoracic and Lumbar Radiculopathy, Compression Fractures, Scoliosis, Facet Arthritis and more

Sports Injuries

We provide innovative diagnostics and non-surgical care for athletes of all ages and abilities. The treatments are designed with the focus on restoration of function and prevention of future injuries. We address all aspects of care including Nutrition, Orthotics, Exercise Regimen, Ergonomics and Pain Management.

Conditions include Tennis Elbow, Tendonitis, Plantar Fasciitis, Rotator Cuff Tear, Compartment syndrome, Sacroiliac Instability, Arthritis, Hip, Shoulder, Elbow, Wrist/Hand, Knee or Ankle problems, Muscle strain, Back injury, Neck pain, Concussion/Traumatic Brain Injury, Spinal Cord Injury, Nerve entrapments such as Carpal, Cubital and Tarsal Tunnel Syndromes, and many more.

Work Related Injuries 

Whether an acute injury, such as a fall or an attempt to lift heavy weight, or a repetitive injury, our physicians consider diagnosis and prognosis of the condition, the work place environment, ergonomics, physical fitness, and legal circumstances related to injury.

We coordinate care closely with case managers, occupational health physicians, therapists and patient advocates to ensure an expedited diagnosis and treatment of the problem, allowing you to return to work without fear of future injury or recurrence of pain.

Nerve and Muscle Disorders 

We diagnose and treat a variety of neuromuscular problems, including the treatment and rehabilitation of Stroke, Cerebral Palsy, Multiple Sclerosis, Neuropathy, Carpal Tunnel Syndrome, Sciatica, Muscle Spasticity, Cervical Dystonia, Brain Injury, Gait disorders, and many other disabling conditions.

A successful treatment always requires an accurate diagnosis. We take time with our patients to collect a detailed history and to perform a physical examination.  We order and review imaging studies and perform EMG/nerve conduction evaluations, allowing us to establish the correct diagnosis, provide proper treatment to prevent many complications, often avoiding surgery.

Treatment of Disabilities

We understand that once you become disabled, your treatment should not end there. If you need a provider who will attend to your needs, you will likely find a Physiatrist to be the right doctor for you. Our physicians and their team evaluate and recommend adaptive equipment, wheelchair and mobility device assessment, we work closely with your prosthetic specialists and therapists to bring you the best equipment and treatment available. We address your medical needs, making sure your pain is controlled and your skin is intact, so you can continue to enjoy life and never let your disability get in a way.

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