What in the world is a What in the world is a physiatrist?physiatrist?

Danielle Groves, M.D.Danielle Groves, M.D.Premier Orthopedics and Premier Orthopedics and

Sports MedicineSports Medicine

PhysiatristPhysiatrist A physiatrist (fizz ee at' trist) is a doctor A physiatrist (fizz ee at' trist) is a doctor

that specializes in physical medicine and that specializes in physical medicine and rehabilitation. Physiatrists treat problems rehabilitation. Physiatrists treat problems that range from a sore shoulder to spinal that range from a sore shoulder to spinal cord injury. They see patients in all age cord injury. They see patients in all age groups and treat problems that touch groups and treat problems that touch upon all the major systems in the body. upon all the major systems in the body.

A physiatrist focuses on improving a A physiatrist focuses on improving a patient’s function and quality of life. patient’s function and quality of life.

EducationEducation 4 years of medical school4 years of medical school 1 year internship in medicine or 1 year internship in medicine or

surgerysurgery 3 years of residency in physical 3 years of residency in physical

medicine and rehabilitationmedicine and rehabilitation Some do an added 1-2 year Some do an added 1-2 year

fellowship in a specific area of the fellowship in a specific area of the specialtyspecialty

Specialty AreasSpecialty Areas Traumatic Brain InjuryTraumatic Brain Injury StrokeStroke Spinal Cord InjurySpinal Cord Injury Neuromuscular DisordersNeuromuscular Disorders PediatricsPediatrics Amputee MedicineAmputee Medicine ElectrodiagnosisElectrodiagnosis Sports MedicineSports Medicine Pain ManagementPain Management

ArthritisArthritis Arthritis is a condition of wear and tear Arthritis is a condition of wear and tear

that causes gradual damage to the that causes gradual damage to the cartilage of the joints.cartilage of the joints.

It can be treated by:It can be treated by:• Physical therapy and lifestyle modificationPhysical therapy and lifestyle modification• MedicationMedication• InjectionsInjections• BracingBracing• SurgerySurgery

How can a physiatrist help?How can a physiatrist help? The physiatrist can perform a detailed The physiatrist can perform a detailed

examination and with the occasional examination and with the occasional assistance of x-rays make the appropriate assistance of x-rays make the appropriate diagnosis.diagnosis.

Treatment can then be started by the Treatment can then be started by the physiatrist who will discuss options with physiatrist who will discuss options with the patient and develop a plan of attack.the patient and develop a plan of attack.

Therapy, medication, injections, and Therapy, medication, injections, and bracing are all things a physiatrist may bracing are all things a physiatrist may offer.offer.

TendonitisTendonitis Many patients sustain a one time Many patients sustain a one time

injury to a part of the body, but more injury to a part of the body, but more patients actually injure themselves patients actually injure themselves by a repetitive irritating activity. by a repetitive irritating activity. This type of injury often results in This type of injury often results in tendonitis.tendonitis.

Tendonitis is a condition that can be Tendonitis is a condition that can be managed with conservative managed with conservative measures.measures.

Back PainBack Pain Back pain is the second most Back pain is the second most

common reason a patient goes to the common reason a patient goes to the doctor.doctor.

Many physiatrists specialize in Many physiatrists specialize in treating back pain without surgery.treating back pain without surgery.

This may include physical therapy, This may include physical therapy, specific medications, epidural specific medications, epidural injections, nerve testing-EMG, and injections, nerve testing-EMG, and acupuncture.acupuncture.

Spinal StenosisSpinal Stenosis This is a narrowing of the spinal This is a narrowing of the spinal

canal. canal. The spinal nerves are left with a The spinal nerves are left with a

smaller space due to this narrowing smaller space due to this narrowing and sometimes increased pressure is and sometimes increased pressure is put on the nerves.put on the nerves.

This causes pain down the legs.This causes pain down the legs.

Herniated DiscHerniated Disc The disc is the soft gel structure between The disc is the soft gel structure between

the bones of the spine. the bones of the spine. Sometimes the soft gel pushes out into the Sometimes the soft gel pushes out into the

spinal canal and can put pressure on a spinal canal and can put pressure on a nerve root causing pain.nerve root causing pain.

Sometimes the pain travels down the Sometimes the pain travels down the associated leg.associated leg.

Epidural injections can often reduce pain if Epidural injections can often reduce pain if therapy and medications are not enough.therapy and medications are not enough.

Facet ArthritisFacet Arthritis The facets are the small joints of the The facets are the small joints of the

spine.spine. The provide a lot of support to the back The provide a lot of support to the back

and prevent us from being able to and prevent us from being able to hyperextend our back.hyperextend our back.

These joints can get arthritis and cause a These joints can get arthritis and cause a lot of back and sometimes leg pain.lot of back and sometimes leg pain.

Injections into and around these joints can Injections into and around these joints can often help. often help.

The MusclesThe Muscles The majority of back pain is actually The majority of back pain is actually

caused by the muscles.caused by the muscles. The back has a complex system of The back has a complex system of

muscles that are prone to injury.muscles that are prone to injury. These muscles can cause pain by These muscles can cause pain by

themselves but can also cause pain in themselves but can also cause pain in response to an underlying problem that response to an underlying problem that makes them spasm.makes them spasm.

Muscle pain can be just as severe as any Muscle pain can be just as severe as any other cause of pain.other cause of pain.

EMGsEMGs In many instances a patient is told they In many instances a patient is told they

may have nerve damage.may have nerve damage. The EMG is a test that can identify nerve The EMG is a test that can identify nerve

damage. It can diagnose problems such damage. It can diagnose problems such as carpal tunnel syndrome, neuropathy, as carpal tunnel syndrome, neuropathy, ulnar nerve injuries, and even pinched ulnar nerve injuries, and even pinched nerves from the neck and back.nerves from the neck and back.

A physiatrist is often the one to perform A physiatrist is often the one to perform this test.this test.

BracingBracing When a nerve has been damaged it When a nerve has been damaged it

can lose its ability to control a can lose its ability to control a muscle. When the muscle no longer muscle. When the muscle no longer functions correctly certain joints may functions correctly certain joints may malfunction.malfunction.

A brace is a way to compensate for A brace is a way to compensate for this.this.

A brace can also help provide A brace can also help provide support to a painful joint.support to a painful joint.

SummarySummary A physiatrist treats many common A physiatrist treats many common

and uncommon conditions. and uncommon conditions. They focus on pain reduction and They focus on pain reduction and

increased quality of life.increased quality of life. The physiatrist tries to accomplish The physiatrist tries to accomplish

these goals without surgery but may these goals without surgery but may refer a patient to a surgeon when it refer a patient to a surgeon when it is necessary.is necessary.

SummarySummary In an orthopedic setting, the In an orthopedic setting, the

physiatrist treats arthritis, tendonitis, physiatrist treats arthritis, tendonitis, back pain, neck pain, nerve injuries, back pain, neck pain, nerve injuries, and various sprains and strains.and various sprains and strains.