Dr. Mark LaBeau - Physical Medicine in Carmel Valley
What is a Physiatrist and What Conditions Can They Treat?
When you get injured, your first thought may be to make an appointment directly with an orthopedic surgeon, chiropractor, or sports medicine doctor. However these are not your only choices; there is a pretty new practice that helps a wide range of patients, including those experiencing injury, illness, or musculoskeletal pain. This type of doctor is called a physiatrist.
Physiatrists provide secondary prevention of disability, take a non-surgical approach to rehabilitation, and are dedicated to problems of the musculoskeletal system. Consulting with a physiatrist before seeking surgical treatment can be a valuable decision. Physiatrists provide big-picture insight to help patients understand their full range of treatment options.
Physiatrists work in many different settings such as inpatient rehab, outpatient clinics, and pediatric clinics.
What is a Physiatrist?
A 'physiatrist' is a doctor who specializes in Physical Medicine and Rehabilitation. A physiatrist is a highly trained physician who focuses on whole body treatment for the musculoskeletal system and its pain-causing disorders. A physiatrist diagnoses, manages, and treats pain from injury, illness, or medical conditions, primarily using physical means for recovery such as physical therapy and also medicine. The objective of a physiatrist is to help individuals restore their functional wellbeing and to return to a healthy and functional life.
Role of a Physiatrist
Physiatrists study the big picture. Their training is broad, and lets them consider the entire body, as opposed to just one organ. By considering other areas of the body, physiatrists can be useful for pinpointing difficult-to-diagnose pain by examining the relationships of all the moving parts of the body. A physiatrist's goal is to restore functionality in individuals living with injuries, diseases, and disorders.
Physiatrists often serve as a consultant to physicians, such as primary care physicians and neurologists, or lead a team of medical professionals to optimize a patient's treatment. When a physiatrist takes a main role in your recovery, they will do everything, from creating your step-by-step plan for rehabilitation, to directing your entire rehabilitation team, enlisting the support of numerous experts such as physical therapists, occupational therapists, psychologists, care managers, and other doctors and professionals.
Physiatrists can use nonsurgical procedures to treat injury and illness, and manage pain. This can include prescribing adjuvant and analgesic medications to help with function recovery, strength and flexibility exercises, as well as aids such as braces and wheelchairs. For those needing surgical procedures, consulting with a physiatrist before and after surgery can be very helpful in speeding up recovery and maintaining functionality.
Because a physiatrist focuses on functional wellness, they customize your treatment to your needs. If you just want to go up the stairs or be able to play on the floor with your kids, your treatment program may be different than an injured Olympic athlete hoping to compete professionally again. Whatever your needs, a physiatrist can help get you there. Physiatrists will:
- Clarify the value and role of physical therapy in your therapy, instructing patients on proper exercise techniques.
- Create a tailored physical therapy routine.
- Serve as a health and nutrition consultant to help individuals develop healthy habits.
- Prescribe and manage medication.
- Give injections to a patient's pain areas to help alleviate pain and repair function.
- Enlist psychosocial support, and the assistance of other medical professionals.
- Prescribe complementary therapies, such as medical acupuncture.
If an individual doesn't respond positively to nonsurgical treatment, a physiatrist may refer patients to a surgical specialist.
Physiatrists complete training required to treat a range of medical disorders that affect the musculoskeletal system, including the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons.
Training involves an undergraduate degree, four years of medical school, as well as four years of residency. After residency, physiatrists might elect to specialize. In this case, physiatrists will complete a fellowship in a particular area. Some choices are listed below.
In the following specialties, a doctor will learn to:
- Rehabilitate the spine after injury. Since back pain is a common problem, many physiatrists decide to specialize in treating the spine. They might focus more on rehabilitation of the spine or spinal pain management.
- Treat chronic musculoskeletal pain and learn to prescribe medicines and physical therapy for pain main management.
- Rehabilitate after sports injuries.
- Repair function of the brain after stroke or injury. Physicians will determine and prescribe treatment for individuals, attending to changes such as poor memory, impulsivity, and communication disabilities.
- Rehabilitate the nerves and function of the spine.
- Specialize in treating patients under the age of 18.
What Procedures Do Physiatrists Perform?
As discussed above, Physiatrists conduct non-surgical procedures. These treatments may include:
- Electromyography (EMG)-- Placing fine needle electrodes into muscles to measure the performance of muscles and nerves. This helps physiatrists determine if weakness is due to dysfunction of the muscles or nerves.
- Nerve conduction studies (NCS)-- Using electrodes to determine the location of a nervous system injury.
- Peripheral joint injections-- Injecting bone and soft tissues to help diagnose and treat disorders.
- Trigger point injections-- Using lidocaine or dry needling on trigger points to relieve soft tissue pain.
- Musculoskeletal ultrasound-- Using internal imagery with an ultrasound to evaluate soft tissue irregularities, and to guide injections.
- Spasticity management-- Using oral antispasticity agents to treat spasticity after CNS injury (stroke, cerebral palsy, etc.), and also to help ease pain.
Physiatrists may also provide treatments such as image-guided spinal diagnostics and injections, epidural injections, radiofrequency ablation, and other procedures such as acupuncture, and stem cell treatments.