Why Should You See a Physiatrist?
Don’t be embarrassed if you don’t know what a physiatrist does. In the context of the medical world, physiatry is a relatively new discipline.
Recognition of the practice was heightened during World War II, when physiatrists were asked to supervise the rehabilitation of U.S. soldiers returning home with severe musculoskeletal disabilities. Soon afterward, in 1947, physiatry was formally approved as a medical specialty by the American Board of Medical Specialties.
Physiatrists (also known as physical medicine and rehabilitation physicians) specialize in non-surgical care for conditions – particularly neuromuscular (nerve, muscle, and bone) disorders – that cause pain and impair normal, everyday functions. Along with their standard medical training, many physiatrists also pursue additional training in one or more of the following subspecialties: musculoskeletal rehabilitation, pediatrics, spinal cord injury, sports medicine, traumatic brain injury, and pain medicine. Brigham and Women’s Hospital physiatrists focus on caring for pain related to spine and sports conditions.
Why Should I See a Physiatrist?
Having a physiatrist guide your musculoskeletal (spine and sports) pain care is akin to having a primary care physician who also specializes in diagnosing and treating musculoskeletal conditions. Physiatrists not only have a keen understanding of how the body works and the medical issues at play, but also understand how these medical issues can affect a patient’s mobility, mood, and quality of life. Through their breadth of training, physiatrists aim to rehabilitate the whole person, addressing their physical, emotional, medical, and vocational needs.
Zacharia Isaac, MD, Medical Director of the Comprehensive Spine Center at BWH.
How Do Physiatrists Diagnose Patients with a Musculoskeletal Condition?
Along with performing a comprehensive examination of the musculoskeletal system, developing a detailed medical history, and performing standard diagnostic procedures, physiatrists have particular expertise in using specialized diagnostic tools for detecting bone, muscle, and nerve damage. To develop a complete diagnosis, the physiatrist also will evaluate whether a patient has other musculoskeletal and neurological conditions and how that may be contributing to the patient’s primary condition.
How Do Physiatrists Treat Patients with a Musculoskeletal Disorder?
A physiatrist’s treatment focuses on thoroughly educating patients about their diagnosis and coordinating a multidisciplinary approach to non-operative (conservative) musculoskeletal care. Treatment – focused on restoring function, reducing pain, and improving quality of life – may include one or more of the following:
- Explain benefits and role of exercise therapy, and instruct patients about proper exercise techniques and regimen guidelines.
- Establish a physical therapy regimen.
- Counsel patients about ways to improve their overall health, such as smoking cessation and weight management.
- Prescribe and manage a medication regimen, with a focus on non-opiate therapies.
- Administer minimally invasive injections to the joints, nerves, or other painful structures – using ultrasound or x-ray guidance – to treat pain and restore function. (These injections also can be used as a diagnostic tool, helping to pinpoint pain sources.)
- Refer to psychosocial support.
- Refer to alternative therapies, such as medical acupuncture.
When these non-operative measures fail to effectively treat pain and restore function, physiatrists can refer patients to a surgical specialist for further evaluation.