Physical medicine and rehabilitation (PM&R) doctors, also known as physiatrists, are medical specialists who focus on improving the quality of life and functional abilities of patients with various physical impairments or disabilities. They diagnose, treat and manage a wide range of conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. Crucially, they provide comprehensive patient care, developing holistic treatment plans that address patients’ physical, social, emotional and vocational needs. They take a whole-person approach, considering all aspects of a patient's life that may be affected by their condition.
Conditions treated. Physiatrists treat a wide range of conditions, including:
- Musculoskeletal disorders and injuries
- Neurological conditions (e.g., stroke, traumatic brain injury, spinal cord injury)
- Multiple sclerosis
- Chronic pain
- Amputation
- Sports injuries
- Parkinson’s disease
- Arthritis
- Post-surgery rehab
Diagnosis. They use various diagnostic tools, including:
- Physical examination
- Neurological examination
- Blood tests
- X-rays, MRI, or CT scans
- Electromyography (EMG)
- Nerve conduction studies
- Psychological testing
Treatment Modalities. PM&R doctors provide nonsurgical treatments that target symptoms and/or promote healing. Some conditions (e.g., Parkinson’s disease) are incurable, in which case the goal is to help the patient function as independently as possible. Treatments include:
- Medication
- Injections (e.g., trigger point injections, epidural steroid injections, botulinum toxin injections)
- Physical therapy
- Occupational therapy
- Complementary therapies (e.g., acupuncture, yoga, massage)
- Assistive devices (e.g., prosthetics, orthotics, wheelchairs, walkers)
Practice Settings. PM&R physicians work in outpatient clinics, inpatient rehabilitation units, acute care hospitals, and long term care facilities.
Collaboration and Coordination. Physiatrists often lead interdisciplinary teams, working closely with:
- Neurologists
- Orthopedists
- Neurosurgeons
- Physical therapists
- Occupational therapists
- Speech therapists
- Psychologists
- Social workers
This collaborative approach ensures comprehensive care tailored to each patient's unique needs.
Specialization. The American Board of Physical Medicine and Rehabilitation certifies physiatrists in seven subspecialties:
- Brain injury medicine
- Hospice and palliative medicine
- Neuromuscular medicine
- Pain medicine
- Pediatric rehabilitation medicine
- Spinal cord injury medicine
- Sports medicine
In summary, physical medicine and rehabilitation doctors play a vital role in helping patients with physical impairments or disabilities maximize their functional abilities, reduce pain, and improve their overall quality of life through a combination of medical expertise, therapeutic interventions and coordinated care.
