A physiatrist is a doctor who specializes in physical rehabilitation medicine. As a specialist in this field, I am an expert in the musculoskeletal system, and I deal with problems of the muscles, joints, bones, nerves, and connective tissues. Physiatry encompasses a whole range of different fields, and can often overlap other specialties. Besides dealing with the most common complaints of back pain and other musculoskeletal complaints, physiatry also includes the diagnosis, medical management, and rehabilitation of: stroke, spinal cord injury, traumatic brain injury, neuromuscular diseases, amputations, and all orthopedic or deconditioned post-surgical patients. Physiatrists traditionally tend to use a conservative, non-surgical approach towards managing pain, which may include a large array of treatments, from manual (osteopathic) medicine, to pharmaceuticals, to muscle, botox, and interventional spine injections. Invariably, the physiatrist will often use physical therapy and home exercises as part of the treatment plan.
For physiatrists who work in the inpatient hospital setting, the idea is not only to help hospitalized patients become well enough not to require acute medical care, but also to successfully transition back home or to a long-term care solution. The goal of rehab is to have a patient attain the highest level of independence and quality of life, whatever the impairments or problems they face. If we can help our patients help themselves to the point of no longer needing our care, our work is done. Physiatrists are also trained under the “team approach” philosophy, and have experience coordinating the work of physical therapists, occupational therapists, speech therapists, psychologists, social workers, and other important members of the rehabilitation team. We usually work closely with other physicians as well, including orthopedists, neurosurgeons, neurologists, rheumatologists, anesthesiologists and other pain specialists, and of course, primary care physicians.