Physical Medicine &
Rehabilitation

What does a physical medicine and
rehabilitation doctor (physiatrist) do?

Physical medicine and rehabilitation doctors may also be known by the following names: physiatrist, physical rehabilitation doctor, rehab doctor, physical medicine doctor, and rehabilitation doctor.

• Evaluates a patient’s medical history and educates the patient about disability prevention and how to maximize cognitive and physical function

• Performs a physical exam that includes evaluation of vital signs, general health, and functional ability

• Orders and interprets laboratory and imaging tests and prescribes medications

• Diagnoses and treats acute and chronic diseases and conditions that affect mobility and cognitive functioning

• Provides direct care for problems of mobility and cognitive function in the office, hospital, and rehabilitation facility

• Diagnoses, treats and monitors conditions that increase the risk of disability, such as neuromuscular disorders and chronic pain

• Works closely with your primary care doctor, other specialists, and members of your healthcare team to provide optimal care

Who should see a physical medicine
and rehabilitation doctor?

• Many people see a physical medicine and rehabilitation doctor after their primary care doctor or another specialist diagnoses or suspects an illness or injury that affects mental or physical function.

• This includes a variety of conditions, including chronic pain, neuromuscular disorders, injuries, stroke, and surgery. Your doctor may refer you to a physical medicine and rehabilitation doctor for any illness or condition that can affect your ability to function in daily life and activities.

• Seeing an experienced physical medicine and rehabilitation doctor for early evaluation and treatment is the best way to reduce the risk of permanent or worsening disability and other complications.

When should you see a physical medicine and rehabilitation doctor (physiatrist)?

Consider seeking care from a physical medicine and rehabilitation doctor if you have any of the following symptoms or conditions:

• Pain or painful syndromes

• Problems with movement including muscle spasticity or stiffness that makes daily activities difficult

• Weakness

  
  

You should also seek care from a physical medicine and rehabilitation doctor under the following situations:

• You are obese or an older adult and have trouble moving or being active.

• You had an accident or injury that has caused chronic pain or limited function.

• You had surgery, especially a major surgery with a difficult recovery.

• You have nervous system damage from diabetic neuropathy, stroke, or other neurological conditions.

• You have a condition that affects your ability to function and take care of yourself, or causes ongoing pain.

• Your child has a disabling condition including cerebral palsy, scoliosis, or congenital birth defects.

In which conditions I can benefit from rehabilitation?

• A physical medicine and rehabilitation doctor leads a multidisciplinary rehabilitation team caring for people with a wide variety of conditions including:

  • Bone and joint conditions including ligament injuries, bone fractures, arthritis, osteoporosis, carpal tunnel syndrome, scoliosis, back pain, herniated disc, and neck pain

  • Chronic diseases and conditions that limit function or cause pain including birth defects, cancer, diabetes, lung disease, and heart disease

  • Neuromuscular and nervous system conditions including stroke, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), neuropathy, pinched nerves, muscular dystrophy, myopathy, cerebral palsy, multiple sclerosis, Guillain-Barré syndrome, post-polio syndrome, and myasthenia gravis

  • Painful conditions including headache, cancer pain, fibromyalgia, painful joints, postherpetic (shingles) pain, and any type of chronic pain

  • Post-surgical recovery including joint repair and replacement surgery, amputation, back surgery, brain or spinal cord surgery and heart surgery

  • Spinal cord and brain injuries including concussion, brain hemorrhage, skull fracture, spinal cord compression, and back and neck fracture

  • Trauma including work- and sports-related injuries, falls, crush injuries, severe burns and motor vehicle accidents.

What type of tests does a physical medicine and rehabilitation doctor (physiatrist) order?

A physical medicine and rehabilitation doctor can order, perform, and interpret a wide variety of tests including:

• Electrodiagnostic tests including electromyography (EMG), nerve conduction studies, and somatosensory evoked potentials to analyze nerve function and the electrical functioning of the nervous system

• General health and screening tests including complete blood count (CBC), urinalysis, chest X-ray, blood glucose (sugar) test, electrolyte tests, liver and kidney function tests, blood pressure screening, and pulse oximetry (blood oxygen levels)

• Imaging tests including X-rays, ultrasounds, computed tomography (CT) scans, nuclear scans, and magnetic resonance imaging (MRI)

What are the procedures and treatments physical medicine and rehabilitation doctors perform or order?

Physical medicine and rehabilitation doctors create rehabilitation plans tailored to each patient's diagnosis. These plans include treatments that patients can do independently or with the support of their medical rehabilitation team. This team may include various medical specialists, physical therapists, occupational therapists, speech-language pathologists, vocational counselors, psychologists, and social workers.

Physical medicine and rehabilitation doctors do not perform surgery. Common treatments include:

• Adaptive equipment and assistive devices: orthotics (shoe inserts), orthoses (braces), prostheses, wheelchairs, and communication devices.

• Hand therapy: splinting, range of motion exercises, strengthening, and sensory discrimination.

• Lymphedema and cancer therapies: techniques to manage cancer treatment side effects and reduce lymphatic fluid accumulation.

• Medications: injections for pain and muscle spasticity.

• Occupational therapy: relearning daily activities, regaining control of arms and hands, wheelchair evaluations, and using equipment to function independently.

• Physical therapy and therapeutic exercise: water therapy, soft-tissue massage, therapeutic ultrasound, chest physiotherapy, and other exercises to improve strength, mobility, and fitness.

• Speech-language therapy: swallowing therapy and cognitive-communication therapy to enhance speaking, communication, thinking, memory, understanding, reading, writing, and swallowing.