Conditions & approach
Pelvic Obliquity & Iliosacral Dysfunction
Pelvic obliquity is a tilt or asymmetry in pelvic position, most often driven by imbalanced muscle tone — tight hip flexors or rotators on one side creating a functional leg-length discrepancy. Left untreated, it produces compensatory loading through the lumbar spine, hip, and knee. Dr. Knopp evaluates pelvic alignment as a root-cause finding in many patients presenting with back pain or hip pain. Treatment is hands-on OMT: muscle energy techniques and soft tissue work to restore normal pelvic mechanics.
Lumbar & Cervical Radiculopathy
Radiculopathy — what most patients call a "pinched nerve" — occurs when a spinal nerve root is compressed or irritated, producing pain, numbness, or weakness that radiates into an arm or leg. Causes include herniated disc, foraminal stenosis, and degenerative bone spurs. Dr. Knopp approaches radiculopathy with an initial trial of OMT to address the structural contributors; when conservative care is insufficient, he moves to epidural steroid injections or targeted nerve blocks performed at Hartford HealthCare.
Facet Joint Pain
Facet joints connect the vertebrae of the spine and are a common — and commonly under-diagnosed — source of axial neck and back pain. Facet-mediated pain is typically worse with extension and rotation, and often produces a predictable referral pattern that doesn't follow a dermatomal distribution. Dr. Knopp confirms the diagnosis with medial branch blocks; definitive long-term treatment is radiofrequency ablation (RFA) of the medial branch nerves, performed at Hartford HealthCare. RFA typically provides 6–12 months of relief before the nerves regenerate.
Sacroiliac Joint Dysfunction
The sacroiliac joint sits at the junction of the sacrum and ilium and transmits load between the spine and legs. SIJ dysfunction produces pain at the posterior superior iliac spine that can radiate into the buttock or posterior thigh — often mistaken for lumbar disc pain or hip pathology. Dr. Knopp uses provocative physical examination and diagnostic blocks to confirm SIJ as the pain generator. Treatment ranges from OMT addressing iliosacral mechanics, to steroid injections, to RFA of the lateral branch nerves for longer-lasting relief.
Myofascial Pain Syndrome
Myofascial pain is characterized by trigger points — hyperirritable nodules within muscle that produce local tenderness and referred pain in predictable patterns. Unlike fibromyalgia, myofascial pain is regional and mechanically driven, often arising from postural overload, repetitive strain, or biomechanical dysfunction elsewhere in the chain. Dr. Knopp treats myofascial pain with direct trigger point work through OMT — including myofascial release, strain-counterstrain, and soft tissue techniques — targeting the source rather than applying general manual therapy.
Post-Concussion Somatic Sequelae
Persistent post-concussion symptoms — headache, neck pain, dizziness, visual discomfort — often have a significant cervicogenic (neck-originating) component that is separate from the neurological injury itself. Whiplash-pattern muscle and fascial strain, upper cervical joint dysfunction, and suboccipital muscle tension can perpetuate symptoms long after the neurological recovery is complete. Dr. Knopp addresses the somatic component through upper cervical OMT and myofascial work, in coordination with the patient's neurologist when appropriate.
Sports & Overuse Injuries
Tendinopathies (patellar, Achilles, rotator cuff, lateral epicondyle), stress reactions, and repetitive strain injuries require treatment that addresses the biomechanical cause — not just inflammation management. Dr. Knopp evaluates the full kinetic chain to identify the loading patterns that produced the injury. Treatment combines OMT for structural correction with PRP therapy for chronic tendinopathy that hasn't responded to conservative care. Return to sport planning is part of the clinical discussion.
Cervicogenic Headache & Occipital Neuralgia
Cervicogenic headache originates from the cervical spine — upper cervical joint dysfunction, suboccipital muscle tension, and referred pain from C2–C3 facet joints can all produce headache that is indistinguishable from migraine without careful examination. Occipital neuralgia is irritation of the greater or lesser occipital nerve producing sharp, shooting pain at the back and top of the head. Dr. Knopp treats the cervical structural component through OMT and can perform occipital nerve blocks at Hartford HealthCare when indicated.
Spinal Stenosis
Spinal stenosis is narrowing of the spinal canal or neural foramina — most often from degenerative changes — that compresses the spinal cord or nerve roots. Symptoms include neurogenic claudication (leg pain and heaviness with walking that improves with sitting or flexion), and in cervical stenosis, upper extremity weakness or myelopathic symptoms. Dr. Knopp manages stenosis through a combination of OMT to reduce compressive loading patterns, epidural steroid injections to address inflammatory flares, and surgical referral when indicated by progressive neurological deficit.
Failed Back Surgery Syndrome
Failed back surgery syndrome (FBSS) describes persistent or recurrent pain following spinal surgery — a common and underserved population. Pain sources include adjacent segment disease, epidural fibrosis, residual structural dysfunction, and central sensitization. Dr. Knopp evaluates these patients with attention to what the surgery did and didn't address. OMT can treat the compensatory patterns above and below a fusion; interventional options include spinal cord stimulation and peripheral nerve stimulation (Sprint PNS) for patients who have exhausted conventional approaches.