Functional NOR

WHAT IS FNOR?​

Dr. Giudice is a Functional Neurology-Ortho Rehab (FNOR) practitioner which is an

advanced approach to treating pain and injuries. For more information go to:

FUNCTIONAL NEURO-ORTHOPEDIC REHABILITATION

Functional Neuro-Orthopedic Rehabilitation (FNOR) is a rehabilitation system that incorporates biotechnology, neuroscience, pain science, and musculoskeletal rehabilitation. It has steadily grown in popularity recently as it speaks to challenges and opportunities facing the contemporary healthcare environment. This system answers the need for clinical approaches that are safe, efficient, and effective to patients. FNOR is the answer that both patients and healthcare providers have been seeking as it unites neuroscience with orthopedic rehabilitation for an effective, innovative clinical tool that gets results.

Origins of FNOR

The development of FNOR initially revolved around the response to Failed Back Surgery Syndrome (FBSS), a debilitating condition that affects an estimated 20 to 50 percent of lumbar surgery patients. The patient suffering from FBSS endures tremendous pain, disabling mobility issues, and tremendous financial costs. Patients with FBSS typically do not respond to physical therapy or medication, so finding a treatment that could provide relief and restore at least some quality of life was the primary goal, albeit a challenging one.

As FNOR consistently helped patients with FBSS, it benefits were soon noted for other types of post-surgical pain. 

Man getting FNOR treatment

 From there, healthcare clinicians found practical applications for vestibular rehabilitation, biomechanics, psychology, and neurology. They found that even some of the most stubborn, difficult pain responded very well to FNOR, but many other uses have been realized as well.

The application of FNOR has evolved over time and expanded far beyond an effective treatment for difficult to treat pain of the spine and joints. It incorporates orthopedic physical therapy, neurorehabilitation, pain management, modern psychology, and manual therapy and it can be applied to a wide range of orthopedic conditions. Conditions like various forms of musculoskeletal injury, gait abnormalities, movement dysfunction, and even conditions like stroke, concussion, and traumatic brain injury.

Man getting Musculoskeletal injury treatment

FNOR used for Motor and Pain Abnormalities

Musculoskeletal injury often affects the central nervous system and can be linked to neurophysical changes. Nervous system function and shifts in brain chemistry are related to the pain process. When a patient is experiencing pain, motor abnormalities or limited motor function is also often present. While the patterns may vary, the results are the same. FNOR is very effective.

Traditional approaches to treatment of pain and disruptions in the nervous system involve therapeutic movements that rely on repetition. While having an understanding of the brain and neurological function does enhance the process, it is by no means complete.

 FNOR revealed the limitations of the traditional methods. It provides a systematic, multimodal approach to pain management and the restoration of functionality.

FNOR is a multimodal method that is based on the idea that the best way to stimulate the brain is to provide therapies that are created to meet the specific needs of the patient’s unique nervous system. By directing these therapies to those areas of the nervous system that are affected, the patient can get relief. This non-invasive procedure maintains a focus on the rapid reduction of pain as its primary goal. In the FNOR system this translates to recognizing and treating changed in the peripheral central nervous system (PNS) and central nervous system (CNS) that generate pain.

That is why when FNOR is used in an orthopedic setting, initially the clinician does a complete assessment of the PNS and CNS as well as tissues and joints that are involved in the process, motor function, as well as both behavioral and cognitive components. It is this complex, comprehensive assessment and approach that culminates in a while body, integrative rehabilitation, and sets FNOR apart from other rehabilitation methods that are currently in use.

lady practising orthopedic exercise
Basically Dr G SAVED my life. All his interventions and advice got me walking again, decreased my pain, helped me build my leg muscles and my CORE and now 17 months later I am walking 3 to 6 miles WITHOUT pain. My balance has improved and my posture is much better. I am still working on my health journey and have returned to YOGA and Zumba classes with some modifications. I recommend Dr G to everyone I see! — Vicki Rashbaum Horowitz
I am a very physical person and don’t know what I would do without Dr. John to help me heal from various strains and injuries from martial arts and other training. I am very grateful to be more fit and healthy in my forties than I was in my late 20’s! — Scott Sim

FNOR used for Motor and Pain Abnormalities

FNOR relies heavily on three core components, neuroscience, technology, and interdisciplinary collaboration to feed its growth in the field of non-invasive neuromodulation.

Neuroscience

Understanding the roles of the nervous system and brain when an injury occurs is integral to providing the best, most effective course of treatment. This leads to improved rehabilitation and even very difficult orthopedic cases can be effectively addressed. Since pain is primarily rooted in the nervous system, this approach makes it much easier to understand, predict, and treat.

Technology

Technology opens up a world of opportunity and using it intelligently provides valuable insight, allowing the clinician to more accurately assess and treat conditions. Through technology, clinicians can be exposed to applications that provide assessments related to physiology, endurance, movement, biomechanics, the nervous system, and overall mobility and function on a platform that is easy to understand and easy to apply. Technology makes good practitioners even better.

Interdisciplinary Collaboration

Since FNOR is influenced by a diverse set of clinical approaches such as chiropractic, physical therapy, alternative medicine, nursing, and psychology, then it only stands to reason that when these various disciplines collaborate it only further strengthens the system. This approach also serves to increase understanding and provide a broader knowledge base for more effective and efficient applications.