David Ciaccia, D.O., an osteopathic (DO) board-certified physiatrist (physical medicine and rehabilitation) with a clinical focus on spine, has joined OrthoCarolina at its Gastonia, North Carolina location.
David Ciaccia, D.O. Joins OrthoCarolina

After obtaining a B.S. in Biology with a Minor in Public Health at Temple University, Dr. Ciaccia attended the Philadelphia College of Osteopathic Medicine.He then pursued a residency in Physical Medicine & Rehabilitation at the University of South Florida. Dr. Ciaccia then completed a Fellowship in Interventional Spineat the OrthoCarolina Spine Center.
Dr. Ciaccia “… specializes in non-surgical spine and musculoskeletal care. His practice focuses on helping patient’s deal with pain related to the neck, low back, sciatica, pinched nerves, bulging/herniated disks, shoulder, hip, and knee.”
Dr. Ciaccia’s customized treatment plan “… includes exercise medicine, osteopathic manipulation (OMM), physical therapy with modalities, oral medications, and therapeutic steroid injections. Dr. Ciaccia performs a variety of image guided minimally invasive interventions including epidural steroid injections, various joint injections including the facet joints, and trigger point soft tissue injections.”
Dr. Ciaccia told OTW, “My first step is to focus on providing comprehensive interventional musculoskeletal spine care to the patients I serve at a convenient location in Gaston County.”
“As our company continues to expand we strategically look for physicians to fill specific roles and needs in the regions and communities we serve,” said Cathie McDonald, chief operating officer, OrthoCarolina.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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