All About A Physiatrist
What Is a Physiatrist?
How did the specialty develop?
What types of conditions does a physiatrist
What is the physiatrist's role in
How do physiatrists diagnose?
What kinds of treatments do physiatrists
Where do physiatrist practice?
What kinds of differences do physiatrists
A physiatrist, pronounced fizz ee at' trist, is a physician
specializing in physical medicine and rehabilitation. As the population of
America ages, as people survive conditions that once would have been fata, and
as quality of life is an increasing concern, the field of physiatry is moving to
the forefront of medicine.
The specialty serves all age groups and treats problems that touch upon all
the major systems in the body.
How did the specialty develop?
The field of physical medicine and rehabilitation (PM&R) began in the 1930s
to address musculoskeletal and neurological problems, but broadened its scope
considerably after World War II.
As thousands of veterans came back to the United States with serious
disabilities, the task of helping to restore them to productive lives became a
new direction for the field. The Advisory Board of Medical Specialties
granted PM&R its approval as a specialty of medicine in 1947.
What types of conditions does a
Physiatrists are physicians who treat a wide range of problems from sore
shoulders to spinal cord injuries. The focus of the specialty is on
restoring function to people.
Physiatrists treat acute and chronic pain and musculoskeletal disorders.
They may see a person who lifts a heavy object at work and experiences back
pain, a basketball player who sprains an ankle and needs rehabilitation to play
again, or a knitter who has carpal tunnel syndrome. Physiatrists' patients
also include people with arthritis, tendonitis, any kind of back pain, and work-
and sports- related injuries.
Physiatrist treat very serious disorders of the musculoskeletal system that
result in severe functional limitations as well. They would treat a baby
with a birth defect, someone in a bad car accident, or an elderly person with a
broken hip. Physiatrists also treat people with spinal cord injuries,
brain injuries, strokes, amputations, cancer, and multiple sclerosis.
All require a long-term rehabilitation process.
A physiatrist may treat patients directly, lead an interdisciplinary team, or
act as a consultant. Here are some scenarios that illustrate the varied
roles of a physiatrist:
A carpenter is lifting some heavy wood when he feels pain in his lower
back and down his legs. He sees a physiatrist who does a thorough history
and physical examination and performs all the testing needed to make the
diagnosis: a herniated disc. The physiatrist develops an appropriate
treatment program, monitoring and adjusting it as needed. With this
treatment and rehabilitation program, the patient does not need surgery.
A woman in a diving accident has a spinal cord injury and is paralyzed
below the waist. The physiatrist assesses her injury and with the patient
and a team of health care professionals determines the course of her
rehabilitation. The physiatrist treats the array of medical issues that
occur as the result of a spinal cord injury. and also leads the
interdisciplinary team to enable the woman to reach the highest level of
functioning possible. The team varies in composition depending on the
needs of the patient. In addition to other physicians, the team may
include health care professionals such as nurses, physical therapist,
occupational therapists, social workers, neuropsychologists, and vocational
A baby is born with cerebral palsy. The physiatrist is called in
as the expert who advises on the correct treatment and rehabilitation that can
affect the rest of the child's life.
do physiatrists diagnose?
Physiatrists' diagnostic tools are the same as those used by other
physicians, with the addition of special techniques in electrodiagnostic
medicine like electromyography (EGM), nerve conduction studies, and
somatosensory evoked potentials. These techniques help the physiatrist to
diagnose conditions that cause pain, weakness, and numbness.
kinds of treatments do physiatrists offer?
Physiatrists offer a broad spectrum of medical services. They do not
perform surgery. Physiatrists may prescribe drugs or assistive devices,
such as a brace or artificial limb. They also use diverse therapies such
as heat and cold, electrotherapies, massage, biofeedback, traction, and
Where do physiatrists practice?
Physiatrists practice in rehabilitation centers, hospitals, and in private
offices. They often have broad practices but some concentrate on one area
such as pediatrics, sports medicine, geriatric medicine, brain injury, and many
other special interests.
What kinds of differences do physiatrists make?
Since it is the concern of physiatrists to restore patients to maximum
function, the difference they make can be dramatic. In the case of the
herniated disc, the physiatrist not only takes care of the acute problem, but
also treats the patient until he returns to optimal functioning, usually without
surgery. Thy physiatrist also teaches the patient how to prevent the
injury in the future.
Another example is that of a broken hip in the elderly. Physiatrists
can provide aggressive rehabilitation so patients can walk and even exercise
And because the physiatrist is concerned with all areas of rehabilitation -
social, vocational, and medical - the quality of life is significantly increased