Introduction to PNBC

If you can answer "yes" to any one of these questions, you may be a candidate for the PNBC program:

  • Have you had neck or back symptoms for more than 6-8 weeks?
  • Are you having any extremity pain (arms/hands, legs/feet)?
  • Have you had similar symptoms to this in the past?

Here are the basic steps of the PNBC rehabilitation program:

  1. On your first visit, you'll meet with a board-certified PNBC physician, who will conduct a physical exam, review your history, and if necessary, recommend a spinal strength test.
  2. If you’re recommended for our program, we’ll create a unique rehab program just for you – typically twice a week for six to twelve weeks.
  3. You’ll receive direct, hands-on supervision by one of our rehabilitation specialists – who’ll train you, coach you, and monitor your progress.

Call us at (651) 735- BACK (2225)

Are You a Candidate?

Less than 2% of patients with chronic spinal pain have a surgical solution. Therefore, 98% will have to find a non-surgical way to deal with the problem. Assuming you are not an immediate surgical candidate, ask yourself the following questions: Are you experiencing an episode of low back pain or neck pain that is not improving after 2-4 months? This includes people who also have mild to severe leg or arm pain associated with their spinal problems. Do you have recurrent low back or neck problems (more than two significant episodes per year separated by pain free periods) that significantly affect your ability to do your desired activities?

If you answered "yes" to either of these questions then you are a candidate for the Physicians Neck & Back Center (PNBC) program. In addition, PNBC also treats patients with herniated discs and sciatica .

Almost all patients seen at PNBC have tried several other therapies (Reference 5) and have attempted exercise either at home or at another clinic. Even so, these patients almost always exhibit significant de-conditioning and poor flexibility indicating that any previous exercise therapy was either inadequate to affect their strength or did not strengthen the appropriate areas.

PNBC, by utilizing equipment that isolates the most important supporting muscles of the back and neck, is able to strengthen the critical structures. Most exercise equipment at health clubs (Reference 2) do not isolate these important muscles well. Consequently, one can exercise yet still be deconditioned in the most critical areas: the neck and/or low back.

The equipment is computerized so that strength and endurance data can be documented and progress easily monitored. Moreover, because on occasion people experience an increase in symptoms when beginning a meaningful exercise program, supervision by knowledgeable professionals is extremely important. In sum, it takes proper equipment, knowledgeable supervision and accurate data collection to maximize the chances of a successful outcome.

MRI's, X-rays, and CT scans

Patients often ask if certain MRI, CT, or x-ray findings indicate whether or not they are candidates for intensive exercise. We review these studies in detail but only rarely do we discover imaging findings that contraindicate exercise. In fact, imaging tests often do not reveal the cause of symptoms. Instead, they reveal "anatomical changes" only and do not "light up" the source of pain. Many studies show an almost equal incidence of abnormal imaging findings in people with and without symptoms. For example, so many people without back pain are noted to have a "bulging disk" that such a finding is now considered to be a normal variation.

Pinched Nerve? Sciatica?

In addition, patients often question whether or not arm or leg symptoms are a reason to avoid exercise since they may suggest the presence of a "pinched nerve". In fact, most arm and leg symptoms associated with spine pain cannot be related to nerve irritation. It is possible to sustain an injury to the small ligaments of the lumbar or cervical spine and experience symptoms radiating to the foot or hand respectively. These symptoms generally improve as the back and neck pain improve. But even if you do have a "pinched nerve" (see Disc Syndromes and Sciatica) exercise is still often effective. During your initial exam the M.D. can usually determine whether or not the extremity problems are referred or radicular (due to nerve irritation).

If you are unsure whether PNBC is appropriate for you, feel free to contact us to speak directly with our staff.

Long Term Benefits

Chronic spinal pain typically takes two different forms. In the first, patients have pain at all times although the intensity may vary. In the second, patients have frequent exacerbations (which are often severe) but remain relatively free of pain between episodes. Passive treatments (e.g., chiropractic, injections, medication, massage, ultrasound, hot and cold packs, electrical stimulation, traction, various types of muscle release treatments, acupuncture, acupressure) may be beneficial but sometimes the results are only temporary.

Lasting relief comes from improvements in spinal fitness. People with chronic spinal pain become experts at protecting the affected body part. For example, people with chronic low back pain learn to do activities without stressing the back. While this may help to prevent severe exacerbations, a physiologic price must be paid. Whenever any body part is not used in the normal manner, it atrophies and weakens. The joints stiffen up. Movement becomes more difficult and painful. Essentially, the affected body part becomes fragile. The more it is protected, the more fragile it becomes. Passive treatment does not make a fragile back less fragile. This can only be accomplished with the correct kind of progressive exercise.

Fortunately, fragile necks or backs can be corrected. And once a fragile body part has been restored to normal functioning, there are several important benefits: The chances of a flare-up are significantly decreased If there is a flare-up it tends to be much less severe and of much shorter duration Activities that have previously caused problems can usually be accomplished after spinal fitness has been optimized.

Another important long-term benefit is that after finishing the PNBC program, the newly obtained high level of spinal fitness can be maintained at home with a simple program that only takes a few minutes each day. You don't have to join a health club or buy exotic equipment. What you do have to do is take responsibility for your spinal health by being willing to commit to a lifetime home program.

In essence, after completing the PNBC program you become your own spine doctor. Since patients with chronic spine pain tend to re-utilize the healthcare system over and over looking for relief, the PNBC program can result in very significant cost savings, by reducing the need for continued care.

Other important benefits include:

  • Our treatment is supported by peer-reviewed medical research
  • PNBC treatment often eliminates the need for surgery
  • All PNBC patients are evaluated and monitored by physicians and treated by a team consisting of a physician and licensed physical therapy professionals. 
PNBC Certification Procedures

PNBC is committed to a developing a well-trained, up to date, staff. Therefore, all rehabilitation personnel directly involved with treating patients must complete a thorough certification process that includes both written and practical exams. The process begins with several weeks of study along with supervised patient interactions.

Each staff member must then complete detailed written exams which tests the members in the following concentration areas:

  • Anatomy, Physiology and Function
  • Body Stabilization
  • Machine Parts and Operation
  • Clinical Aspects of Testing and Strength Training
  • Computer Applications
  • Strength Curve Interpretation
  • Research

To pass the exam, members must score a 70% or higher on the written exam and 80% or higher on the practical exam to become certified as a PNBC clinician.

We believe that education and certification training insures our staff members to be current on today's changing medical practices and skills in delivering exceptional care.

For more information about our certification process, please feel free to contact us.

FAQ about Insurance

A Note to Our Patients – PNBC’s Commitment to Health Care Value

We recognize that many of our patients pay various "out of pocket" costs for treatment at our clinics. This may involve co-pays, deductibles or withdrawals from medical savings accounts.

We want our patients to know that we deeply respect the financial commitment they make to participate in our treatment program. Further, we realize that our patients have the right, indeed the responsibility, to demand value for the services we provide. As we see it, ‘value’ means providing the most effective and lasting treatment outcome for the least amount of health care dollars spent.

We have demonstrated with insurance companies and through published data that patients who complete our program are 67% less likely to reutilize the medical system for spine care when compared to patients that elect other forms of treatment. In other words, money spent on our treatment yields greater value, because there is significantly less need to spend more money later on the same problem.

Also, we have demonstrated through published research that patients can often avoid the costly option of surgery by completing our program. We continue to document our outcomes on an ongoing basis so that our patients, referring physicians and insurance providers can judge our effectiveness.

Finally, we are very open to discussing flexible payment options with our patients as the need arises. We will never turn patients away for financial reasons.

Our pledge as a health care provider is to help stem the rising tide of health care costs through the most effective, lasting, and, value-based treatment available.

Blue Cross Blue Shield now ranks clinics based on quality. PNBC is proud to have been designated as Tier 1, the highest rating.

Insurance Coverage & FAQs
Physicians Neck & Back Center (PNBC)’s treatment is covered by almost all major health plans within Minnesota and Western Wisconsin. A referral may or may not be needed based on a patient’s specific health plan. However, if a referral is required, more than 1,500 physicians in the Twin Cities metro area have referred patients to PNBC. We also treat workers’ compensation patients and those injured in motor vehicle accidents. Following are some

Frequently Asked Questions regarding insurance coverage at PNBC:

Do you accept my insurance?
We currently accept:  

Blue Cross Blue Shield
Preferred One

United HealthCare
Workers’ Compensation
Motor Vehicle and liability claims
Most of the major Minnesota Medical Assistance and Medicare Replacement Plans

There may be some additional insurance carriers that are not listed here. If you have any inquires please call our New Patient Coordinators at 651-735-2225.

PNBC does not require a referral to attend our clinics. However, there are certain insurance companies that require patients to get a referral as we are considered a specialty clinic. Please refer to your insurance plan to see if you fall in that category.

Do I have to pay a co-pay each time I attend the clinic?

It depends on what level of healthcare benefits you have. In most cases, this information can be found on your insurance card. If not, you can find out by simply calling your insurance carrier. Some co-pays are a flat amount such as $15 at each visit. Other policies have a co-insurance instead of a co-pay. This means that instead of a flat fee, you are responsible for a certain percentage of the bill at each visit. If you have co-insurance, PNBC will bill you for that monthly rather than collecting it at the front desk before each visit.

I have previously gone to physical therapy and not had a co-pay. Why do I have a co-pay here?

There could be several reasons for this. Your insurance benefits may have changed. Some policies have different reimbursement levels depending on the setting. Perhaps your previous therapy was performed in a hospital setting while this therapy is at an outpatient clinic. Perhaps when you were attending physical therapy previously you had fully met your deductible, but this year you have not. Your obligation may change depending on whether or not PNBC is in your approved network of providers. Your obligation may also vary depending on whether or not you have a physician referral. Much of this information may be on your insurance card, but if not, you will have to call your insurance carrier. PNBC is an approved provider for almost all networks in the Twin Cities, but check with your insurance carrier or the PNBC front desk personnel to be sure.

Instead of paying at each visit, can you just bill me when I'm done with the program?

No. We must collect co-pays at each visit.

Will my health insurance cover this treatment?

Almost all insurance carriers cover the Physical Medicine delivered at PNBC, but you need to call your insurance carrier to be sure.

If I call my health insurance carrier to inquire about my benefits, what should I ask them?

Ask them about the following:

  1. What are my physical therapy benefits?
  2. What is my deductible?
  3. What is my physical therapy co-pay?
  4. If I have coinsurance rather than co-pay, what is the percentage of the bill that I am responsible for at each visit?
  5. Is PNBC an approved provider for me?
  6. Do I need a referral to go to PNBC? (With some policies you may not need a referral, but without one you will pay more. You should ask about this.)
What should I do if my insurance plan changes while I am coming to your clinic?

Be sure to inform the front desk personnel or the PNBC billing department. Please bring your new insurance card in for the front desk personnel to photocopy.

I don't have insurance. Can I still come to your clinic?

Yes. We offer a self pay financial agreement for people without insurance. 

I really think my pain is from an old work comp injury or a motor vehicle accident. Can you bill them instead of my private insurance?

Yes, if the claim is still open. If not, it will not be covered. You can determine whether or not your claim is still open by contacting the work comp carrier (you may need to call your employer at the time of the injury to find out the name of the company and how to contact them) or your automobile insurance company.

Does insurance pay for items such as ice wraps, therapeutic pillows, or Roman Chairs?

Most workers compensation insurance will usually cover these types of supplies. Private plans or No Fault auto insurance typically will not pay for these types of medical supplies, but this is not always true. You should contact your insurance company to determine their specific policy.

How will I know if my insurance carrier is paying for my treatment here?

You will receive an “Explanation of Benefits” form in the mail that will show the payment being made or give reasons for any denials.

What is my current balance?

Our billing personnel can help you with this question. To reach our billing office, you can simply call the clinic directly. You will hear a recorded option to select to be connected with the billing office. 

Can you just send all bills to my attorney?

No, but each patient can forward bills to his/her own attorney for payment.

Conditions We Treat
  • Chronic low back pain with or without leg pain
  • Chronic neck pain with or without arm pain
  • Herniated/bulging/ruptured disc - low back
  • Herniated/bulging/ruptured disc -  neck
  • Spondylolisthesis
  • Spinal stenosis
  • Foraminal stenosis
  • Degenerative Disc disease
  • Sacroiliac Pain
  • Post surgery pain
  • Failed low back or neck surgery
  • Facet syndrome
  • Low back or neck arthritis
  • Old spinal fracture