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 physician. But these are not your only choices; there is a relatively new practice that helps a wide range of patients, including those suffering from injury, illness, or musculoskeletal pain. This type of physician 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 prior to seeking surgical treatment can be a valuable decision. Physiatrists provide big-picture insight to help patients understand their full spectrum 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 numerous departments.
What Is a Physiatrist?
A 'physiatrist' is a doctor who specializes in Physical Medicine and Rehabilitation. A physiatrist is a highly trained medical professional 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 methods for recovery such as physical therapy and medication. The objective of a physiatrist is to help individuals recover 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 lets them consider the entire body, instead of just one organ. By looking at other areas of the body, physiatrists can be helpful for identifying 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 patients suffering from injuries, illness, 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 recovery, they will do everything, from creating your step-by-step plan for recovery, to directing your whole rehabilitation team, enlisting the support of numerous specialists 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 involve 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 quite helpful in speeding up recovery and maintaining functionality.
Since a physiatrist focuses 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 hoping 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, instructing individuals on proper exercise techniques.
- Create a personalized physical therapy routine.
- Serve as a health and nutrition counselor to help individuals develop 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 assistance of various other medical professionals.
- Prescribe complementary therapies, such as medical acupuncture.
- If a patient does not respond positively to nonsurgical treatment, a physiatrist may refer patients to a surgical specialist.
Training
Physiatrists complete training needed to treat a variety of medical conditions that impact 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 choose to specialize. In this case, physiatrists will complete a fellowship in a specific 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 ailment, many physiatrists choose to specialize in treating the spine. They might concentrate 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 patients, addressing 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 mentioned above, Physiatrists perform non-surgical procedures. These procedures might consist of:
- Electromyography (EMG): Placing 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 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 ease soft tissue pain.
- Musculoskeletal ultrasound: Using internal imagery with 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 also to help alleviate pain.
Physiatrists might 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.
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