Physiatry – also called physical medicine and rehabilitation – is a branch of medicine that specializes in diagnosis, treatment and management of disease primarily using “physical” means (such as physical therapy and medications). Physiatrists specialize in a wide variety of conservative treatments for the musculoskeletal system (the muscles and bones) and do not perform surgery.
The specialty of physiatry is approximately 60 years old. Today, there are over 8,000 physicians practicing physical medicine and rehabilitation. Because the back is the locus of most of our musculoskeletal system, many physiatrists specialize in treating back pain.
To become a physiatrist, one must complete four years of medical school and four years of residency training. The first year of residency training focuses on internal medicine (general practice). The following three years of residency emphasize specialty training.
Goals of physiatry treatment
Physiatrists strive to treat the whole patient – not just the specific injury or condition -which improves overall recovery and prevents recurrence. The goal of treatment is to restore normal function and improve quality of life for patients from a physical, emotional, psychosocial and vocational perspective.
Back problems treated by physiatrists
Physiatrists treat a wide range of problems that affect the musculoskeletal system (the muscles and the bones). The following is a list of some of the back conditions related to back pain commonly treated by physiatrists:
- Low back pain
- Neck pain
- Acute muscle and ligament injuries
- Acute and chronic pain
- Work injuries
- Myofascial pain
- Spinal cord injury
- Rheumatoid arthritis
Physiatrists diagnose back injury and back problems
Physiatrists diagnose injuries and problems of the musculoskeletal system by taking a thorough medical history of the patient and performing a complete physical exam. Further diagnostic testing may include laboratory testing, x-rays and MRI scans. Electromyography and nerve conduction studies and procedures may also be performed to diagnose injuries or diseases of nerves and muscles.
Treatments offered by a physiatrist
The treatment offered for pain and injury is an aggressive approach that may include:
- Active physical therapy (exercise), occupational therapy, recreational therapy
- Passive physical therapy (modalities)
- Health psychology
- Massage therapy
- Assistive devices
- Back braces
Injections performed by a physiatrist
Some physiatrists also perform injections of ligaments, muscles, bursae, joints, and specialized injections such as epidural injections or facet joint block injection. Injections may include image guidance with fluoroscopy or ultrasound.