Knee pain and kids

Joint pain is kind of my business.  As your chiropractor in the Woodbridge, Dale City VA area a popular joint complaint I see is knee pain.  Lots of parents mention their child has knee pain that isn’t related to any type of injury.  Often called growing pain but the real term is Osgood Schlatters disease.  It is a pretty fancy name for it that you can use to impress others.

Symptoms

Symptoms of Osgood Schlatters disease typically consist of pain at the tibial tuberosity or bony bit at the top of the shin. The tibial tuberosity may become swollen or inflamed and may even become more prominent than normal. Tenderness and pain is worse during and after exercise but usually improves with rest. The athlete is likely to experience pain when contracting the quadriceps muscles or performing squat type exercises.

Causes

Osgood Schlatter syndrome is primarily an over use injury although certain factors can increase the likelihood of sustaining this condition.

Age – It is more likely to affect boys aged around 13 to 15 years old than girls, although girls certainly can be affected and if they are it is more likely to occur earlier at about aged 10 to 12 years old. it is often put down to growing pains in knees. Obviously this is a general guide and ages can vary. It occurs due to a period of rapid growth, combined with a high level of sporting activity. Osgood Schlatter in adults can occur, especially if it has not been looked after during teenage years but is more unusual.

Activity – As the young athletes bones grow quickly, it can take some time for the muscles and tendons to catch up. These changes result in a pulling force from the patella tendon, on to the tibial tuberosity at the top of the shin. This area then becomes inflamed, painful and swollen. This is frequent in younger people because their bones are still soft and are not yet fully grown. It is seen more often in children involved with running and jumping activities which put a much greater strain on the patella tendon.

Osgood Schlatter Treatment

Treatment for Osgood Schlatters disease consists of reducing pain and inflammation by applying the PRICE principles of protection, rest, ice, compression and elevation along with longer term managing the condition through training modification and educating the athlete or parent until the young athlete grows out of it.

Apply a cold therapy and compression wrap to the knee regularly throughout the day to reduce pain and inflammation and particularly following activity or sport. Ice should be applied at least three times a day for 10 to 15 minutes. If it is particularly painful then ice can be applied for 10 minutes every hour. Ice massage with an ice cube is also a convenient way to apply cold therapy to a specific area such as the patella tendon. Keep the ice moving as applying directly to the skin can cause ice burns.

Rest is the most important element of treatment. Only do as much exercise as it will allow without causing pain. Weight bearing exercise will make Osgood Schlatters disease worse. Keep your sessions few and high quality rather than training every day.

Use a patella knee strap or patella tendon taping technique to help reduce the tension on and support the knee. A patella strap or taping can absorb some of the shock or impact and change the angle the forces are transmitted through the tendon.

A Doctor may prescribe NSAID’s or anti inflammatory medication such as Ibuprofen to help reduce pain and inflammation, although this is not good to rely on long term, or mask how bad the condition actually is. Athletes with asthma should not take Ibuprofen.

Once normal daily activities are pain free then gentle stretching exercises may be beneficial along with massage for the quadriceps muscles and myofascial release techniques to help stretch the muscles can help ensure they are strong enough to cope with the loads placed on them as well as not being too tight.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Packing on a few!

Once we make it to middle age putting on weight becomes easier and easier.  At the same time low back pain becomes more common.  Sometimes the low back pain was coming no matter what and sometimes it is a factor of the weight gain.  So, it is a factor but just how much.  Your Woodbridge, Dale City VA chiropractor has some information that sheds some light on it.

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese.  The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.

Some of the most common obesity-related problems include musculoskeletal and joint related pain.  For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the back.  In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.

In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain.

Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back.

In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area.

Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis.

The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese. For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the Need for Weight Loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.  Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight.

It is also important to evaluate where excess fat is carried on the patient’s body. Patients who carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Shoulder Pain

As your Chiropractor in the Woodbridge, Dale City VA area I see lots of shoulder pain.  One common one isn’t pain while moving it but it is pain when not moving it.   This goes against some joint pain logic.  Most injuries if you keep them from moving, they don’t hurt but with frozen shoulder it hurts when not moving it AND when you move it.  So, this one is really awesome for the patient.

Frozen shoulder, also known as adhesive capsulitis, is a common condition in which the articular shoulder capsule (a sac of ligaments surrounding the joint) swells and stiffens, restricting its mobility. It typically affects only one shoulder, but one in five cases affect both.

The term “frozen shoulder” is often used incorrectly for arthritis, even though the two conditions are unrelated. Frozen shoulder refers specifically to the shoulder joint, while arthritis may refer to other/multiple joints.

The shoulder has a spheroidal joint (ball – and – socket joint), in which the round part of one bone fits into the concavity of another. The proximal humerus (round head of the upper arm bone) fits into socket of the scapula (shoulder blade). Frozen shoulder is thought to cause the formation of scar tissue in the shoulder, which makes the shoulder joint’s capsule (not to be confused with the rotator cuff) thicken and tighten, leaving less room for movement. Therefore, movement may be stiff and even painful.

The modern English words “adhesive capsulitis” are derived from the Latin words adhaerens meaning “sticking to” and capsula meaning “little container” and the Greek word itis meaning “inflammation”.

Frozen shoulder is a condition that commonly occurs in people between 40 and 60 years of age. Women tend to suffer with frozen shoulder more than men.

 

Causes of frozen shoulder

The cause of frozen shoulder is not fully understood and in some cases is unidentifiable. However, most people with frozen shoulder have suffered from immobility as a result of a recent injury or fracture. The condition is common in people with diabetes.

 

Risk factors for frozen shoulder

A risk factor is something that elevates the risk of developing a disease or condition. For example, smoking is a risk factor for cancer – it elevates the risk of developing lung cancer.

 

Common risk factors for frozen shoulder are:

You’re more likely to suffer from frozen shoulder if you’re female and over 40 years of age.

Age – being over 40 years of age.

Gender – 70% of people with frozen shoulder are women.

Recent surgery or arm fracture – immobility of recovery may cause the shoulder capsule to stiffen.

Diabetes – two to four times more likely to develop frozen shoulder for unknown reasons; symptoms may be more severe.

Having suffered a stroke.

Hyperthyroidism (overactive thyroid).

Hypothyroidism (underactive thyroid).

Cardiovascular disease (heart disease).

Parkinson’s disease.

 

Symptoms of frozen shoulder

A symptom is something the patient feels and/or reports, while a sign is something others, including the doctor observe. For example, pain is usually a symptom, while a rash could be a sign.

The most pervasive sign or symptom of frozen shoulder is a persistently painful and stiff shoulder joint. Signs and symptoms of frozen shoulder develop gradually; usually in three stages in which signs and symptoms worsen gradually and resolve within a two – year period.

 

There are three stages of frozen shoulder:

Painful stage – the shoulder becomes stiff and then very painful with movement. Movement becomes limited. Pain typically worsens at night.

Frozen/adhesive stage – the shoulder becomes increasingly stiff, severely limiting range of motion. Pain may not diminish, but it does not usually worsen.

Thawing stage – movement in the shoulder begins to improve. Pain may fade, but occasionally recur.

 

You should visit your local chiropractor to have this problem evaluated and treated.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Low Back Pain is pretty common!

As your chiropractor in the Woodbridge, Dale City area I see lots of patients with low back pain.  I started looking at the numbers and 31 million Americans experience low-back pain at any given time.1   Even though it is so common there is a lot people don’t know about it.  I must confess when my back has a problem and I call a chiropractic friend of mine I seem to forget the causes of back pain too.  Naturally my back complaint is different than the rest of the worlds.    Here are some pretty interesting facts about back pain and if you ever get back pain be sure to call.

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

One-half of all working Americans admit to having back pain symptoms each year.2

Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.

Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7

More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8

A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

 

  1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

 

  1. Ibid.
  2. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  3. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

 

  1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  2. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  3. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  4. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Back pain facts

I guess this is the reason I see so many back complaints as your Woodbridge, Dale City VA Chiropractor. 31 million Americans experience low-back pain at any given time.1   Even though it is so common there is a lot people don’t know about it.  I must confess when my back has a problem and I call a chiropractic friend of mine I seem to forget the causes of back pain too.  Naturally my back complaint is different than the rest of the worlds.    Here are some pretty interesting facts about back pain and if you ever get back pain be sure to call.

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

One-half of all working Americans admit to having back pain symptoms each year.2

Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.

Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7

More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8

A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

 

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

 

  1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

 

  1. Ibid.
  2. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  3. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

 

  1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  2. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  3. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  4. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Fibromyalgia

I have patients that come into my Woodbridge, Dale City VA Chiropractic office with diffuse complaints of pain.  Most aren’t sure why all of a sudden something starts hurting or why they have no energy.  When you start asking more questions you discover there are lots of other problems.  Sometimes it is unrelated but sometimes it is something bigger causing all of them.  Here is some information on fibromyalgia which is a big cause of a lot of different symptoms.

Fibromyalgia is typically diagnosed in patients with:

Widespread pain in all 4 quadrants of the body for a minimum of 3 months; and

Tenderness or pain in at least 11 tender points when pressure is applied. These tender points cluster around the neck, shoulder, chest, hip, knee, and elbow regions.

Some fibromyalgia experts say, however, that many people may still have fibromyalgia with fewer than 11 tender points if they have widespread pain and several other common symptoms, including:

Fatigue

Sleep disorders

Chronic headaches

Dizziness or lightheadedness

Cognitive or memory impairment

Malaise and muscle pain after exertion

Jaw pain

Morning stiffness

Menstrual cramping

Irritable bowels

Numbness and tingling sensations

Skin and chemical sensitivities

Correct Diagnosis Is Key

Correct diagnosis of fibromyalgia is very elusive, so if you are diagnosed with the disorder—or suspect that you have it—seek the opinion of more than 1 health care provider. Other conditions may create fibromyalgia—like pain, fatigue, and other symptoms. Ruling other conditions out first is very important.

 

In addition to clinical evaluation that will assess possible causes of your pain, your doctor may need to order blood work to determine if you have:

Anemia

Hypothyroidism

Lyme disease

Other rheumatic diseases

Hormonal imbalances

Allergies and nutritional deficiencies

Disorders that cause pain, fatigue, and other fibromyalgia-like symptoms.

If the tests show that you have 1 of these conditions, treatment will focus on addressing that problem first. If your pain is caused by a muscle or joint condition, chiropractic care may help relieve it more effectively than other therapies.

Treatment Alternatives

If no underlying cause for your symptoms can be identified, you may have classic fibromyalgia. The traditional allopathic approach includes a prescription of prednisone, anti-inflammatory agents, antidepressants, sleep medications, and muscle relaxants. These temporarily relieve the symptoms, but they do produce side effects. If you prefer a natural approach, the following suggestions may be helpful:

Studies have shown that a combination of 300 to 600 mg of magnesium per day, along with malic acid, may significantly reduce may significantly reduce the number of tender points and the pain felt at those that remain. B vitamins may also be helpful.

Eating more omega-3 fatty acids and fewer saturated fats has shown promise in fibromyalgia patients. Limit red meat and saturated fats and increase the amounts of omega-3 fatty acids by including fish, flax, and walnut oils in your diet. Fatty acid deficiencies can interfere with the nervous system and brain function, resulting in depression and poor memory and concentration.

Improving the quality of sleep can help reduce fatigue. Watch your caffeine intake, especially before going to bed. Reduce TV and computer time. If you watch TV in the evening, choose relaxing, funny programs instead of programs with violent or disturbing content. Ask your doctor of chiropractic for other natural ways to help you sleep better.

Stress-managing strategies can also help address anxiety or depression issues. Cognitive therapy has been shown helpful in relieving fibromyalgia patients’ negative emotions and depression by changing their perception of themselves and attitudes toward others.

A traditional gym-based or aerobic exercise program may exacerbate fibromyalgia symptoms and is not recommended. Instead, yoga, Pilates, or tai chi—which offer mild stretching, relaxation, and breathing techniques—may work better than vigorous exercise.

Studies have shown that acupuncture is another effective, conservative approach to treating fibromyalgia symptoms and many doctors of chiropractic offer this service right in their offices.

Chiropractic care has consistently ranked as one of the therapeutic approaches that offer the most relief for the fibromyalgia patient. Your doctor of chiropractic can also include massage therapy, ultrasound and electrical stimulation in the treatment program, which may help relieve stress, pain, and other symptoms.

Your doctor of chiropractic has the knowledge, training, and expertise to help you understand your problem and, in many cases, to manage it successfully. Remember, however, that the treatment program can be successful only with your active participation. If your doctor of chiropractic feels that he or she cannot help you, you will be directed to another health care provider.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link