FAQs

We are located at

700 Garden View Ct Suite 102,
Encinitas, CA 92024

No. We no longer accept insurance

Please contact our billing office at 949-716-8629, 800-608-5435 or JOHNHOWMD.MOOLAHPAY.CC

yes, we accept payment plans

Patient records can be viewed through OnPatient. You can reach out to our front desk for a registration link.

We ask that you give a 24 hour notice for any cancellations or rescheduling. Any appointment changes within 24 hours is subject to a $75 fee.

Our appointments range from 15 minutes up to 90 minutes depending on the type of evaluation.

Joint pain is a general term that includes any discomfort you experience in one or more of your joints. Your joints are the points in your body where two or more bones meet and rely on ligaments, tendons, muscles, cartilage, bones, and nerves to function properly.

Any injury or disease that affects the many components that make up your joints may result in pain. The How Clinic works closely with patients who live high-stress lives, including emergency room doctors, nurses, first responders, members of the military, and athletes. Due to their occupation and lifestyle, this group of people is especially at risk of joint pain, which can affect many aspects of their life.

The How Clinic specializes in helping you get the treatment you need to alleviate your pain and restore joint function so you can get back to work and your active lifestyle.

You can develop joint pain from many causes. Some of the most common include:

These causes may develop after an acute injury or from overuse. Most commonly, a person’s pain is caused by a combination of several of these. In any case, your joint pain affects not only your physical health but may also affect your emotional and financial health.

Dr. John How at The How Clinic in Encinitas, CA dedicates himself to offering innovative treatments for alleviating joint pain. It all starts with listening to your story and examining you. Dr. John How and his team will also often use modern ultrasound imaging to safely view the structures in and around your joint and how they move. Based on where your pain is and what is found while examining you from your musculoskeletal ultrasound, they conduct guided interventions to alleviate the underlying cause of your pain, which may include:

To get the relief you need from joint pain, contact The How Clinic today by calling the office or clicking the online booking button.

SGB is a sympathetic nervous system “Re-Boot” used to improve the functional health of patients suffering from a variety of conditions. SGB has been used to treat military personnel for Post-Traumatic Stress Disorder (PTSD), behavioral illnesses and other disorders following their return to civilian society, as well as shown efficacy in improving symptoms of depression, anxiety, long-term pain syndromes, stress disorders, and sexual dysfunction in the general population. Additionally, athletes have begun to use SGB to synchronize their brain and body to maximize optimal competitive performance.

The sympathetic part of the autonomic nervous system (ANS) is responsible for the body’s emergency “fight or flight” response. It controls our heart rate, blood pressure, skin temperature, and the response of our eyes to light, which are the body’s responses to stress, perception of pain, the ability to relax or focus our thoughts, and to function sexually. When the sympathetic nervous system (SNS) is overwhelmed, generally from extreme stress, it becomes programmed to an inappropriately high set point. This causes the body to remain in a state of extreme, survival-level response. This is a stress injury, in which the brain is inappropriately stuck in a “fight or flight” response and a great solution is to reset that part of the nervous system.  In the same way as rebooting a computer can free the system from an inappropriate or dysfunctional program, SGB works to reset the nervous system and restore it to its normal settings.

 An evaluation for the use of SGB therapy is right for anyone suffering from PTSD, depression, stress, anxiety, chronic pain and many other behavioral challenges which prevent them from being physically and emotionally present in their everyday life. SGB may also be a helpful therapy if you routinely struggle with insomnia, fogginess, irritability or decline in sexual function, or if you are an athlete looking to sharpen your mental acuity, heighten your reflexes and improve your competitive edge.

The procedure is done with the patient laying fully clothed on a comfortable table.  An ultrasound is used to visualize the target nerve bundle in the neck and to guide a needle into the correct position.  Once the correct needle position is confirmed, a small amount of local anesthetic is injected into the area and the needle is withdrawn.  After an injection is completed, the patient is observed for a time to ensure safe recovery.  The procedure takes approximately one hour and for many patients the relief is immediate.

 There are several other nerve bundles in the same area as the one we are targeting with the procedure, and interruption of these often result in a droopy eyelid, blood shot eye, changes in the size of the pupil on one side, hoarseness of the voice, and mild difficulty swallowing.  The symptoms listed above are expected and are actually used to gauge the likely success of the procedure.  Uncommonly, some patients report some difficulty breathing.  All of these conditions are temporary and resolve within a few hours of the procedure. In a vanishingly small number of patients, the anesthetic can be placed in an unintended place such as a blood vessel. If this happens, the function of the brain or heart can be affected which may result in seizure, pathological heartbeat or cardiac arrest. As an extra precaution we use a medication that is more specific to the sensory nerve fibers over motor or the nerves affecting the heart. While theoretical, we hope that this will further improve the safety profile of this procedure. Bleeding deep in the neck that can form a swelling and close off your windpipe and result in death. If the lung is hit with the needle, a life-threatening condition called a tension pneumothorax can develop.

Musculoskeletal ultrasound refers to using ultrasound to diagnose problems with your muscles, ligaments, tendons, joints, nerves, and bones.

During an ultrasound, a device called a transducer sends sound waves into your body. The waves bounce off tissues and return to the transducer, much like an echo. The transducer sends the information to a computer, which turns them into detailed, real-time images.

The high-resolution images from an ultrasound allow The How Clinic practitioners to quickly diagnose nearly any musculoskeletal condition or injury, including sprains, strains, and tendon and ligament tears.

Diagnostic ultrasound is great for athletes who need a prompt treatment that targets the problem, promotes optimal healing, and gets them back into the game as quickly as possible.

Musculoskeletal ultrasound allows your provider to identify the earliest signs of arthritis and to diagnose other causes of joint pain and inflammation. The How Clinic also uses ultrasound to diagnose nerve entrapment or pinched nerves.

These causes may develop after an acute injury or from overuse. Most commonly, a person’s pain is caused by a combination of several of these. In any case, your joint pain affects not only your physical health but may also affect your emotional and financial health.

Most musculoskeletal injuries cause symptoms such as:

An entrapped nerve causes pain, tingling, numbness, or muscle weakness, and eventually restricts movement.

Ultrasound’s ability to produce real-time imaging makes it an essential tool for musculoskeletal injections. Using ultrasound guidance, your provider can see the needle as it’s inserted and ensure your treatment is injected at the specific site of injured tissues.

At The How Clinic, you may receive ultrasound-guided injections of orthobiologics such as platelet-rich plasma (PRP). The practitioners also use ultrasound to administer prolotherapy injections, a treatment that triggers healing, and to treat pinched nerves with nerve hydrodissection.

Acupuncture is a way of balancing the body. It uses thin needles placed at specific points in the body. [dm-name] is trained to know where to locate these points for the related condition or symptom. When these specific points are stimulated, your body’s function improves and begins a self-healing process. An acupuncture session will typically last an hour. [dm-name] will develop a treatment plan based on your specific needs. The number of treatments will vary among each individual or condition. The best acupuncture is painless despite popular belief. Many patients even report being more relaxed after receiving treatment. Acupuncture is a safe, alternative treatment for pain. It has fewer side effects than medications you may be taking to relieve your pain.

A typical session begins after your initial visit to assess your health condition and goals. Before you start any treatment plan, it is important to know the benefits and risks to make sure it is the right choice for you. [dm-name] will place the sterile needles in specific points of the body. The needles will be left for a short period of time. This allows the body a chance to balance and start healing itself. The needles will then be removed. You are free to return to normal daily activities following your acupuncture treatment session. It is recommended to drink plenty of water to help in the detoxifying process.

Acupuncture has been gaining popularity in the U.S. even though it has been around for thousands of years. Acupuncture should be considered as a potential alternative to pain medications or steroid treatments. It is also a “complementary” medicine meaning it can be used along with other treatments like spinal adjustments. What conditions can Acupuncture help treat? Even though acupuncture has been around for thousands of years, it has started gaining popularity recently. More and more people are turning to alternative care as the success of this industry grows. The best acupuncture relieves many symptoms and problems. It has long been known to alleviate chronic pain. It is especially beneficial for back and neck pain, osteoarthritis, chronic headaches and shoulder pain. Acupuncture has also been known to relieve other symptoms including, but not limited to:

The World Health Organization also recognizes the following conditions as having benefited from acupuncture treatments:

Acupuncture has also been effective in reducing symptoms of nausea and vomiting due to cancer treatments. Many patients get acupuncture concurrently with their cancer treatments. With the growing opioid epidemic, more physicians are turning to a more natural approach for pain relief. Some physicians prefer acupuncture over prescription medicine due to the low risk of complications and adverse side effects.

Although acupuncture is generally safe and serious problems are rare, there are some risks and concerns associated with the procedure. Acupuncture may not be right for you if you have a blood disorder or take blood thinners. It is crucial to visit a licensed physician when receiving acupuncture. Any non-licensed individual could be using needles that are not sterile or could puncture too far into your skin. That is why it is important to come to [dm-name] where our provider is skilled and trained to give you the best acupuncture treatment with all the benefits you are seeking. Our provider will develop a treatment plan specific to your needs. Some people find complete relief in just one visit while other individuals may need to be seen once or twice a week for several months. Treatment varies based on your condition, pain level, and how long you have been experiencing symptoms. Every patient has a unique experience with acupuncture due to duration, frequency and condition being treated. When we are balanced, health and well-being exists. When we are out of balance, illness and disease manifest. Let [dm-name] get you back on track to a healthier you.

For more information on acupuncture or to schedule an appointment, please don’t hesitate to contact us today at [dm-phone]!

People with chronic pain, numbness, and symptoms of peripheral neuropathy

Electric Cell Signaling Treatment (ECST)

Using varied electrical impulses, it reduces pain and inflammation, stimulates blood circulation, and promotes nerve fiber regrowth and long-term healing.

It is non-invasive and comfortable.

Treatments are between 15-30 minutes. Treatment plans are best when done in a series 2-3 times per week.

Yes. Patients may not have pacemakers, current DVT/PE, seizures, medical devices: pain pumps,  or stimulators: bladder, spinal.

Yes. We are contracted with Medicare and PPO insurance plans. We are not contracted with HMO plans.

Given the limited number of treatment options available to people with neuropathy, at The How Clinic, we proudly offer a number of different treatments for the management of peripheral neuropathy symptoms. Dr. John How is an expert at using an ultrasound to find and then treat nerves being pinched causing pain, numbness, or weakness in many areas of the body. **Consider: Dr. John How, in his many years of experience, uses an ultrasound to target and then treat the nerve(s) causing you pain, numbness, or weakness in many different areas of the body.

In addition, The How Clinic offers electrical cell signaling therapy (ECST) for those who suffer from diffuse peripheral neuropathy. The treatment modality uses pain-free targeted electrical impulses in a short treatment session spread over several weeks. Some patients with specific conditions find further benefits when injections are added to the treatment protocol.

Lastly, if the cause of a person’s peripheral neuropathy is heavy metal toxicity, we offer chelation therapy which is an effective way of clearing toxic metals from the body.

It is not uncommon for an individual to benefit from a combination of the above-mentioned treatments. There are very few, if any, clinics in the country offering the combined approach we employ at The How Clinic for the treatment of peripheral neuropathy symptoms.

When peripheral neuropathy involves one nerve it is due to something physically affecting the nerve (i.e. trauma to the nerve, surgery near the nerve, or a pinching or squeezing of the nerve). Sciatica or carpal tunnel syndrome are common examples of peripheral neuropathy resulting from a squeezing of a single nerve. Another name for neuropathy of a single nerve is mononeuropathy.

Conditions such as diabetes, vitamin B12 deficiency, overuse of alcohol, lead poisoning, or treatment with chemotherapy are some common reasons why a person may develop neuropathy involving a large number of nerves at the same time. This type of neuropathy is often referred to as diffuse, peripheral neuropathy, or polyneuropathy.

Approximately 10% of the patients we treat at The How Clinic for peripheral neuropathy symptoms are a result of chemotherapy exposure. In our clinical experience, the response rate is similar across all the different causes of neuropathy. Having said that, some of our greatest success stories are from patients who come to us with neuropathy due to chemotherapy.

Approximately 80% of the patients we treat at The How Clinic for peripheral neuropathy symptoms are due to diabetes. In our clinical experience, the response rate is similar across all the different causes of neuropathy. The majority of successful treatment outcomes are in patients whose neuropathy is due to diabetes.

If a person has neuropathy due to heavy metals toxicity including lead, it is important to not only treat the symptoms of the condition but also decrease the amount of the toxic substance in the body. A combined approach using Electronic Cell Signaling Therapy (ECST) and chelation (a process whereby lead is cleared from the body tissues) has the best chance of improving a person’s symptoms.

It is difficult to predict who will benefit from the treatments we offer without actually trying the treatments. It can take between 8-12 treatments with ECST to determine if any given person is going to see benefit. We first set a baseline level of nerve function prior to treatment. Our standard protocol is to complete eight sessions of ECST before retesting and re-evaluation by a provider. This provides the time needed to evaluate whether you will benefit from ECST.

Call us for any other questions or to make an appointment.

Each hydrodissection procedure takes about an hour to complete. More complex cases may be more than an hour or will require multiple treatment sessions.

Each Electronic Cell Signaling Therapy (ECST) sessions takes approximately 40 minutes from check-in to check-out.

A standard naturopathic clinical encounter begins with a comprehensive, systems-based assessment that is highly individualized to each patient and that addresses underlying mechanisms driving the disease process. Physicians address individual signs and symptoms, as well as the many determinants that influence health and illness.

Your ND will look to gain an understanding of multiple physiological systems and evaluate circumstances and conditions that create clinical dysfunction, including:

NDs may use a range of naturopathic, conventional, functional, and specialized diagnostic tests to perform this comprehensive evaluation, including but not limited to:

Guided by the naturopathic medical school curriculum and scope of practice and informed by the Therapeutic Order (TM) clinical methodology addresses treatment at several levels, based on the  individual’s needs:

Bioidentical hormone replacement therapy is a treatment to restore normal hormone levels. As their name suggests, bioidentical hormones are identical to, or have the same molecular structure, as your body’s natural hormones. As a result, they safely replace hormones when your levels decline. By comparison, synthetic hormones may be more likely to cause side effects.

Women and men develop hormone deficiencies for many reasons. Hormone levels may drop if you:

However, age-related hormone loss is the primary reason most women and men need bioidentical hormone replacement therapy.

Most women experience hot flashes, night sweats, and mood swings before, during, and after menopause. While those problems eventually go away, the loss of estrogen leads to long-lasting problems such as:

Bioidentical hormone replacement therapy may alleviate your menopause symptoms, treats problems like painful intercourse, and helps prevent conditions such as osteoporosis.

Even healthy men experience the natural loss of testosterone as they get older. After the age of 30, testosterone levels drop by as much as 2% every year. As a result, men develop symptoms such as:

Optimizing your testosterone levels bioidentical hormone replacement therapy helps relieve many of these symptoms.

At The How Clinic, patients with low hormone levels receive BioTE bioidentical hormones. BioTE comes in the form of pellets that are custom made to contain the precise dose you need to restore normal hormone levels.

Pellets are made by pressing your hormone dose into a cylinder that’s about as large as a grain of rice. Your provider implants the pellet under your skin, usually on your hip, where the pellet continuously releases small doses of the hormone. Each pellet keeps your hormones at optimal levels for three to six months.

If you need help with a hormone imbalance, call The How Clinic or book an appointment online to explore bioidentical hormone therapy.

Anyone with:

High quality ingredients tailored to your needs including:

The cash price for IV fluid ranges from $125 to $1000 depending on your desired ingredients. IV treatments can be billed to accepted insurances if you have an order from our physicians.

Botox for aesthetics is a cosmetic treatment that uses a botulinum toxin to reduce the appearance of wrinkles and fine lines on the face

Botox works by blocking signals from nerves to muscles, preventing the muscles from contracting. When the muscles can’t contract, wrinkles and fine lines smooth out, resulting in a more youthful appearance.

Botox is generally considered safe when administered by a trained medical professional. However, like any medical treatment, it does come with some risks and potential side effects.

Common side effects of Botox include temporary bruising, swelling, and redness at the injection site, as well as temporary weakness or drooping of nearby muscles.

The effects of Botox typically last 3-4 months, after which time the treatment will need to be repeated to maintain the desired results.

Yes, there are several alternative cosmetic treatments available for reducing wrinkles and fine lines, including dermal fillers, laser resurfacing, chemical peels, and microdermabrasion. It is best to consult with a qualified medical professional to determine the best treatment for your individual needs.

Botox is generally recommended for adults who are in good health and have realistic expectations for the results of the treatment. It may not be appropriate for individuals with certain medical conditions or who are pregnant or breastfeeding.

The O-Shot, also known as the Orgasm Shot, is a non-surgical treatment that uses blood-derived growth factors to rejuvenate the vaginal tissue and improve sexual function. The procedure is performed by injecting the growth factors into specific areas of the vaginal wall and clitoris.

Some potential benefits of the O-Shot include:

Risks and side effects:

As with any medical procedure, there are some potential risks and side effects associated with the O-Shot.

These may include:

Results and duration:

The results of the O-Shot may vary from person to person. Some patients may notice improvements in sexual function and urinary incontinence within a few days, while others may take longer to see results. The effects of the O-Shot typically last for several months, and booster shots may be necessary to maintain results.

The O-Shot is typically recommended for women who are experiencing sexual dysfunction or urinary incontinence. It may be appropriate for women who have not responded to other treatments or who are unable to take certain medications.

How the O-Shot is performed:

The O-Shot procedure typically takes about 30 minutes to complete.

The P-Shot, also known as the Priapus Shot, is a non-surgical treatment that uses blood-derived growth factors to improve sexual function in men. The procedure is performed by injecting the growth factors into specific areas of the penis.

Some potential benefits of the P-Shot include:

The P-Shot is typically recommended for men who are experiencing sexual dysfunction or have other concerns about their sexual health. It may be appropriate for men who have not responded to other treatments or who are unable to take certain medications.

How the P-Shot is performed:

The P-Shot procedure typically takes about 30 minutes to complete.

The following steps are involved:

Risks and side effects:

As with any medical procedure, there are some potential risks and side effects associated with the P-Shot.

These may include: