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 doctor. However these are not your only options; there is a relatively new discipline that helps a wide range of patients, including those experiencing injury, disease, or musculoskeletal pain. This kind of doctor is called a physiatrist.
Physiatrists provide secondary prevention of disability, take a non-surgical approach to rehabilitation, and are committed to problems of the musculoskeletal system. Consulting with a physiatrist prior to seeking surgical treatment can be a valuable decision. Physiatrists provide big-picture insight to help individuals understand their full range of treatment options.
Physiatrists operate in various settings such as inpatient rehabilitation, outpatient clinics, and pediatric clinics. At WWMG, we have physiatrists on staff in several divisions.
What is a Physiatrist?
A 'physiatrist' is a physician who 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 medicine. The objective of a physiatrist is to help patients restore their functional wellbeing and to return to a healthy and functional life.
Role of a Physiatrist
Physiatrists examine the big picture. Their training is broad, and allows them to consider the entire body, as opposed to just one organ. By considering other areas of the body, physiatrists can be helpful 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 suffering from injuries, diseases, and disorders.
Physiatrists often act 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 rehabilitation, they will do everything, from creating your step-by-step plan for recovery, to guiding your entire rehabilitation team, enlisting the support of several experts such as physical therapists, occupational therapists, psychologists, care managers, and other physicians 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 concentrates on functional wellness, they tailor your treatment to your needs. If you simply 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 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 treatment, advising patients on proper exercise techniques.
- Create a tailored physical therapy routine.
- Serve as a health and nutrition consultant to help patients establish healthy habits.
- Prescribe and manage medication.
- Administer injections to a patient's pain areas to help relieve pain and repair function.
- Secure psychosocial support, and the support of various other medical professionals.
- Prescribe complementary therapies, such as medical acupuncture.
If an individual does not react positively to nonsurgical treatment, a physiatrist may refer patients to a surgical specialist.
Physiatrists complete training needed to treat a range 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, and four years of residency. After residency, physiatrists may choose to specialize. In this case, physiatrists will complete a fellowship in a particular area. Some options are listed below.
In the following specialties, a physician will learn to:
- Rehabilitate the spine after injury. Because back pain is a common ailment, plenty of physiatrists choose to specialize in treating the spine. They may concentrate 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 assess 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 individuals under the age of 18.
What Procedures Do Physiatrists Perform?
As mentioned 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 establish 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 through an ultrasound to evaluate soft tissue abnormalities, and to guide injections.
- Spasticity management: Using oral anti-spasticity agents to treat spasticity after CNS injury (stroke, cerebral palsy, etc.), and also to help alleviate pain.
Physiatrists might also offer treatments such as image-guided spinal diagnostics and injections, epidural injections, radio frequency ablation, and other procedures such as acupuncture, and stem cell treatments.