When Should You See a Physiatrist?

Usually, when you suffer from an injury involving the bones, muscles, or other soft tissues, you may think one of two things. Either, “I need to see an orthopedic surgeon,” or “I need to see a sports medicine doctor.” And in truth, that’s not really such a bad idea.

But the treatment of musculoskeletal injuries isn’t limited to these two stripes of doctors. In fact, physiatrists often address the same problems in which sports medicine doctors and orthopedic surgeons specialize. However, unlike an orthopedic surgeon, a physiatrist does not perform spine or joint surgery. This often becomes a key consideration in deciding which doctor to choose.

Physiatry: A Brief History

Years ago during WWII, a doctor by the name of Howard Rusk was caring for injured soldiers—as doctors of his day often did. The interesting thing about Dr. Rusk’s take on medicine was his particular concern with the dignity of the soldiers he treated. He would go on to create a groundbreaking treatment methodology that would later develop into what we now call physiatry.

Physiatrists take a holistic approach when it comes to addressing their patients’ medical condition. Basically, this means that they consider many, many different aspects when it comes to treating their patients. Whereas a “normal” practicing physician might adopt a heavier focus on treating physical injuries, physiatrists don’t exactly operate that way. Instead, they also consider every aspect of their patient’s life, such as their role at work, everyday activities, psychological and emotional aspects, and more. Medical experts often aptly describe physiatry as a rehabilitation medicine—otherwise, a branch of medicine that focuses on the diagnosis, treatment, and prevention of injuries involving the nerves, bones, muscles, and brain.

The goal of physiatry is to improve the patient’s function to its maximum potential. This approach strives to reduce pain while simultaneously improving the overall quality of life and well-being of those who suffer from a debilitating medical condition, like back pain.

Physiatrist Diagnostics & Treatment

Physiatrists usually begin the diagnostic process with a detailed examination of the patient’s musculoskeletal system. Naturally, they achieve this with special diagnostic equipment that allows them to properly examine bone, muscle, and nerve tissues throughout the body. For a complete diagnosis, physiatrists will typically determine whether their patient has any pre-existing medical conditions (usually musculoskeletal and neurological) that contribute to the patient’s current state.

A focal point with physiatry is to educate patients about their diagnosis and condition. Physiatrists highly value their “multi-faceted” outlook on medicine. Their goal is to look at the patient’s condition from multiple angles while treating problems in a conservative manner.

Some examples of physiatry treatment include:

  • Establishing the benefits of exercise therapy, as well as setting the patient up with a physical therapy regimen.
  • Offering medical counsel to patients, including ways to improve their overall health. This in part focuses on lifestyle choices such as smoking and obesity.
  • Prescribing non-opioid pain medications and establishing a solid rapport between the patient and doctor on this matter.
  • Administering minimally invasive injections to affected structures within the body. Usually, these are administered to the patient via ultrasound or x-ray imaging guidance. These treatments help with pain and will ideally restore function to affected areas.
  • Recommending alternative therapies (such as acupuncture or tai chi) but with added psychosocial support.

You can probably spot a trend here. It’s all about being minimally invasive as well as emotionally and mentally accommodating. In the event that your physiatrist believes that surgery is truly necessary, he or she will recommend you to a specialist for a second opinion.

When To See a Physiatrist

The reasons for seeing any kind of medical doctor are many. For this subject matter, you should seek out aid if:

  • You have some kind of chronic problem. Maybe it’s an illness, disability, or failed prior treatment. Perhaps you just have chronic pain (ex. sciatica or fibromyalgia) or repetitive stress injuries. This is where these kinds of doctors truly shine.
  • You are recovering from major surgery. Just because your pain doesn’t have a name in a medical textbook doesn’t mean that it isn’t very real. A doctor is a doctor is a doctor. The specialist in our subject matter focuses on patient care before all else.
  • You have a condition that limits functioning. Maybe you’ve had a stroke, or perhaps you were born with something that handicaps your ability to live the life you want to lead. Traumatic brain & spinal cord injury fall into this category.
  • You are considering surgery. Physiatrists are all about staying away from surgical treatments. Would you rather have a more conservative treatment to address your problem? Perhaps a physiatrist is for you.

Of course, these are only some very general examples. It is important to note that physiatrists treat all patients regardless of their age. So, if you have a child who needs medical care, consider physiatry.

Most Common Medical Conditions That Physiatrists Treat

If you have gotten this far, then you’ve obviously read the section above. It kind of gives you a broad overview of what these kinds of doctors do. Of course, that doesn’t mean that the above list is exhaustive. Here are some other medical conditions that physiatrists address:

  • Neck & Back Pain
  • Strokes
  • Traumatic Brain & Spinal Cord Injuries
  • Sports Injuries
  • Arthritis
  • Herniated & Pinched Discs
  • Fibromyalgia
  • Sciatica
  • Phantom Limb Pain (Amputees)
  • Parkinson’s Disease
  • Multiple Sclerosis
  • Cancer Recovery
  • and more…

As you can see, the scope of physiatry extends far and wide. If you do not need surgery, then a physiatrist is not a bad choice.

Limitations of Physiatry

Ok, so maybe you really do need surgery. Unfortunately, all a physiatrist can do is tell you to see someone else. After all, conservative treatments can’t fix everything. Orthopedic surgeon: Enter stage left.

Of course, this is not to say that orthopedic surgeons are slice and dice happy—quite the opposite, actually. Your doctor—no matter his or her specialization—will always consider conservative methods first (physiatrist or not). But when you really need surgery for your condition, then an orthopedic surgeon should be your first choice. Here are just a few examples of things that an orthopedic surgeon can do:

  • Spinal Fusion: Think, welding. Your surgeon will fix bones in the affected area with screws and rods to ensure that they will meld together throughout the healing process.
  • Arthroscopy: Surgeons usually employ this method for procedures involving the joints. Your surgeon will use a tiny, specialized camera and instruments to repair and remove debris from an affected joint.
  • Joint Replacement: There are different stages of joint replacement (partial, total, and revision). Your orthopedic surgeon will use the best method for your specific needs. Usually, your surgeon will reserve this for cases of severe arthritis.
  • Osteotomy: Using wedge-shaped cuts, your surgeon will fix bone deformities by removing the affected area and repositioning the bones together.
  • Soft Tissue Repair: Exactly what it says on the tin. These procedures involve the mending of damaged soft tissues, such as torn tendons or ligaments.

However, this list only covers a fraction of what a talented orthopedic surgeon can do. For more information, please contact The Advanced Spine Center at (973) 538-0900. Our doctors are leading experts in both minimally invasive surgery and conservative care. We will work tirelessly to make sure that you receive the best course of treatment for you.