What Is a Physiatrist and What Conditions Can They Treat?
When you get hurt, your first thought may be to make an appointment directly with an orthopedic surgeon, chiropractor, or sports medicine physician. But these are not your only choices; there is a fairly new discipline that helps a wide range of individuals, including those experiencing injury, illness, or musculoskeletal pain. This kind of physician is called a physiatrist.
Physiatrists offer secondary prevention of disability, take a non-surgical approach to rehabilitation, and are committed 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 spectrum of treatment options.
Physiatrists work in various settings such as inpatient rehabilitation, outpatient clinics, and pediatric clinics. At WWMG, we have physiatrists on staff in numerous departments.
What Is a Physiatrist?
A 'physiatrist' is a doctor that specializes in Physical Medicine and Rehabilitation. A physiatrist is a highly trained medical professional that 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, predominantly using physical means for recovery such as physical therapy and also medicine. The goal of a physiatrist is to help patients restore their functional wellbeing and to resume a healthy and functional life.
Role of a Physiatrist
Physiatrists examine the big picture. Their training is broad, and lets them consider the entire body, rather than just one organ. By looking at 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 objective is to restore functionality in individuals living with injuries, illness, and disorders.
Physiatrists frequently serve as a consultant to physicians, such as primary care doctors and neurologists, or lead a team of medical professionals to optimize a patient's treatment. When a physiatrist takes a main role in your rehabilitation, they will do everything, from creating your step-by-step plan for rehabilitation, to directing your whole rehabilitation team, enlisting the support of several 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 medicines to help with function recovery, strength and flexibility exercises, and aids such as braces and wheelchairs. For those needing surgical procedures, consulting a physiatrist before and after surgery can be very helpful in speeding up recovery and preserving functionality.
Because a physiatrist focuses on functional wellness, they customize your treatment to your needs. If you just want to climb the stairs or be able to play on the floor with your children, your treatment program might be different from an injured Olympic athlete wanting to compete professionally again. Whatever your needs, a physiatrist can help get you there. Physiatrists will:
- Define the value and role of physical therapy in your therapy, advising patients on proper exercise techniques.
- Layout a tailored physical therapy routine.
- Act as a health and nutrition counselor to help patients develop healthy habits.
- Prescribe and manage medication.
- Give injections to a patient's pain areas to help relieve pain and repair function.
- Enlist psychosocial support, and the support of other medical professionals.
- Prescribe complementary therapies, such as medical acupuncture.
If a patient doesn't react positively to nonsurgical treatment, a physiatrist may refer patients to a surgical specialist.
Physiatrists complete training needed to treat a variety of medical conditions that affect the musculoskeletal system, including the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons.
Training includes an undergraduate degree, four years of medical school, as well as four years of residency. After residency, physiatrists may choose 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. Because back pain is a common problem, many physiatrists choose to specialize in treating the spine. They may focus more on rehabilitation of the spine or spinal pain management.
- Treat chronic musculoskeletal pain and learn to prescribe medications and physical therapy for pain main management.
- Rehabilitate after sports injuries.
- Restore function of the brain after stroke or injury. Physicians will determine and prescribe treatment for individuals, addressing changes such as poor memory, impulsivity, and communication disabilities.
- Rehabilitate the nerves and function of the spinal cord.
- Specialize in treating patients under the age of 18.
What Procedures do Physiatrists Perform?
As mentioned above, Physiatrists perform non-surgical procedures. These treatments may include:
- Electromyography (EMG): Inserting fine needle electrodes into muscles to measure the performance of muscles and nerves. This helps physiatrists discern if weakness is because of 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 ease soft tissue pain.
- Musculoskeletal ultrasound: Using internal imagery through an ultrasound to evaluate soft tissue abnormalities, and to guide injections.
- Spasticity management: Using oral antispasticity agents to treat spasticity after CNS injury (stroke, cerebral palsy, etc.), and to help relieve 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.