Answers, not hedging.
The questions patients ask before booking — dry needling, what to expect, insurance, conditions, specialty programs, and the first visit. If something is not here, call the clinic and ask Dr. Maks directly.
Dry Needling — Common Questions
Is there a downside to dry needling, and who should not do it?
For most patients, the downside is mild post-session soreness for 24–48 hours — similar to the soreness after a hard workout. Hydration and gentle movement resolve it. Patients with active infection or open wound at the treatment site should not be needled. Blood thinners are evaluated case-by-case. Pregnancy is a partial contraindication — pelvic and low-back regions are restricted, other regions are typically fine. Genuine needle phobia we cannot work through is a soft contraindication; cupping, IASTM, or manual work may be a better fit.
Will insurance pay for dry needling or myofascial release?
It depends on your plan. We operate as an out-of-network practice and provide a detailed superbill you submit to your insurer for reimbursement. Some plans cover dry needling as part of PT; some don’t. HSA and FSA funds are accepted. We’ll walk through what to expect on your free consultation.
How long does dry needling take to work, and how many sessions will I need?
Most patients feel measurable relief from a session immediately or within 24 hours. For simple, recent trigger points, 2–4 sessions often does it. Chronic patterns layered over years take longer — 6–10 sessions is a common range. We’ll give you a projected number after your evaluation. No package commitment required.
How much does dry needling typically cost?
Dry needling here is delivered as part of the full one-on-one session, not as a separate add-on. You pay the standard session rate for the full hour of integrated treatment. We’ll give exact pricing on your consultation — no hidden charges.
Does dry needling hurt?
The needle itself is hair-thin and the insertion is typically not felt. What you feel is a brief twitch response in the muscle as the trigger point releases — uncomfortable for a second or two and then a clear easing. We check in throughout the session and stop the moment you want to stop.
Can dry needling help a torn rotator cuff or other complex shoulder pain?
Dry needling does not heal a structural tear, but it can reduce the protective muscle guarding and trigger points that often accompany rotator cuff injuries — and it’s an important part of the manual therapy plan during rehab. For shoulder cases we always combine it with manual joint work and progressive strengthening.
What to Expect at Physica Medica
How is one-on-one PT here different from a traditional PT clinic?
You get the full 45 to 60 minutes with a Doctor of Physical Therapy — the same one every visit. No handoff to an aide for the exercise portion, no double-booked rooms, no group rotations. The DPT is the entire session. That model exists because it’s what gets results for patients who haven’t gotten them at high-volume clinics.
How many sessions will I need? I don’t want an open-ended commitment.
Neither do we. After the first visit you’ll have a projected number of sessions and a rough timeline. We re-evaluate at session 3 or 4 and adjust. Most cases land in the 4–10 session range; complex cases can run longer. You’re never locked into a package.
I’ve tried PT before and it didn’t work. Why would this be different?
Two reasons, usually. First, the math: you actually get an hour with the DPT here, not 15 minutes plus aides. Second, the toolkit: manual therapy, dry needling, IASTM, cupping, and corrective movement are integrated in the same session by the same practitioner, not split across appointments. For patients who’ve cycled through exercise-only PT without results, that combination is usually what was missing.
What happens at my first appointment?
A history conversation, a focused movement and tissue assessment, same-day treatment (manual therapy and dry needling if indicated, plus first corrective work), and a clear plan with projected sessions. You leave the first visit knowing what’s driving the pain, what we’ll do about it, and roughly how long it should take.
What should I wear?
Anything you can move in. Layers help — some of the assessment and treatment happens lying down. Athletic clothing is ideal but not required. For specific regions we’ll have you change into gym shorts or a tank top in private if needed.
Insurance, Cost, and Payment
Do you accept insurance, or is this a cash-pay practice?
We operate as an out-of-network, cash-pay practice. The one-on-one, full-hour model is incompatible with the volume that in-network reimbursement requires. We provide a detailed superbill for out-of-network reimbursement, and many patients use HSA or FSA funds. We’ll walk through specifics on your consultation. See the full insurance & payment page for details.
What does a session cost out of pocket?
We share exact pricing on your consultation so the number is paired with what we’re treating. Sessions are not nickel-and-dimed by modality — the rate covers the full hour of integrated treatment, regardless of which combination of techniques your case requires that day.
Do you offer payment plans?
For longer treatment plans we can talk through structured payment options on the consultation. HSA and FSA funds work without any extra paperwork. We don’t run packages or pre-paid bundles — you pay per visit.
Will my employer’s HSA or FSA cover this?
Almost always, yes. Physical therapy is a qualified medical expense for HSA and FSA accounts. We provide receipts and superbills that meet the documentation requirements of every major plan administrator.
Conditions and Who We Treat
Do you treat low back pain?
Yes — it’s one of the most common reasons patients come here. We treat acute strains, chronic recurrent pain, sciatica, disc-related pain, postural-driven back pain, and post-surgical recovery. Manual therapy, dry needling for trigger-point components, and corrective movement together. See lower back pain treatment for detail.
Can PT help my sciatica?
For most patients, yes. Sciatica is a symptom — pain referred along the sciatic nerve — and the cause is usually treatable. Common drivers include piriformis dysfunction, disc-related nerve irritation, or lumbar joint issues. The first visit determines which, and the plan is built from there.
Is PT effective for chronic pain?
Yes, and it’s specifically what this practice is built for. Chronic pain that hasn’t responded elsewhere usually has a movement, postural, or soft-tissue driver that wasn’t identified or wasn’t treated with the right combination of modalities. The one-on-one, multi-modality model here is designed for exactly these cases.
Do you treat shoulder pain, knee pain, and other joint pain?
Yes. Shoulder impingement, frozen shoulder, rotator cuff issues; knee pain, IT band syndrome, patellofemoral pain; hip pain, labral irritation. Each gets a focused assessment to find the actual driver, not a generic protocol.
Specialty Services — Scoliosis, Prenatal PT, and More
Can physical therapy help scoliosis?
Yes — for many adult and adolescent patients, it’s the most effective non-surgical option. Schroth-informed corrective exercise, manual therapy, and targeted strength work can reduce pain, improve function, and in some cases reduce curve progression. We’re not promising surgery becomes unnecessary in every case; we are saying that PT is rarely the wrong first step. See scoliosis treatment for the full approach.
When should I start prenatal PT?
Whenever symptoms appear, or proactively in the second trimester if you’ve had back, pelvic, or SI joint pain in a previous pregnancy. The earlier we get involved, the more we can prevent rather than treat. We see patients through all three trimesters and into postpartum recovery.
What is Pancafit stretching?
Pancafit is a postural decompensation method developed in Europe. It uses an inclined apparatus to address compensatory shortening throughout the body’s myofascial chains — useful for chronic postural patterns that don’t respond to localized stretching. We use it as one tool inside the broader treatment plan.
What is the Wim Hof Method?
Breathwork and graded cold exposure used together to influence the autonomic nervous system. Patients often report better sleep, reduced stress, and improved recovery as a result of consistent practice. We are not framing it as a treatment for anxiety or depression — those benefits are secondary. Baltimore’s only certified WHM instructor is on staff. See Wim Hof Method for full detail.
Booking and First Appointment
Do I need a referral?
No. Maryland is a direct-access state — you can start PT here without a physician referral. Some insurers may require one for out-of-network reimbursement, which we’ll flag on your consultation.
How quickly can I get an appointment?
Most patients are seen within a week. Free consultations can often happen sooner, including by phone first if that’s easier. Tell us how flexible you are on the intake form and we’ll work around it.
What is the complimentary movement screen?
A free, 30-minute movement assessment. Not a sales call. We listen to what’s going on, do a quick screen, and tell you honestly whether we are the right fit for your case. If we’re not, we’ll tell you who else to try. There is no obligation to book treatment after.
What should I bring to my first appointment?
Comfortable, movement-friendly clothes; any relevant imaging or PT notes from previous providers; a list of medications; and the intake form we’ll send ahead of the visit (or arrive ten minutes early to fill it out).