Physical Medicine and Rehabilitation

Physical Medicine & Physical Medicine & RehabilitationRehabilitation

“ “Physiatrist”Physiatrist”

What is a Physiatrist?What is a Physiatrist?

Medical Doctors (M.D.)Medical Doctors (M.D.) 4 years Residency Program - training 4 years Residency Program - training

in the medical in the medical specialtyspecialty physical physical medicine and rehabilitation (PM&R) medicine and rehabilitation (PM&R)

Certification: Certification: American Board of American Board of Physical Medicine and Physical Medicine and RehabilitationRehabilitation, sponsored by the , sponsored by the American Board of Medical American Board of Medical SpecialtiesSpecialties

What is a Physiatrist?What is a Physiatrist?

Experts at diagnosing and treating Experts at diagnosing and treating painpain

Restore maximum function lost Restore maximum function lost through injury, illness or disabling through injury, illness or disabling conditionsconditions

Treat the whole person, not just the Treat the whole person, not just the problem areaproblem area

Lead a team of medical professionalsLead a team of medical professionals

What is a Physiatrist?What is a Physiatrist?

Provide non-surgical treatmentsProvide non-surgical treatments Explain your medical problems Explain your medical problems

and treatment planand treatment plan Work not only on treatment but Work not only on treatment but

also preventionalso prevention

Conditions Treated Conditions Treated

Amputations/Prosthetics (“artificial Amputations/Prosthetics (“artificial limbs”)limbs”)

ArthritisArthritis Back and Neck PainBack and Neck Pain ““Pinched Nerves” – radiculopathy Pinched Nerves” – radiculopathy Carpal Tunnel Syndrome, Cubital Tunnel Carpal Tunnel Syndrome, Cubital Tunnel

Syndrome, Tarsal Tunnel SyndromeSyndrome, Tarsal Tunnel Syndrome Peripheral neuropathy (hereditary, Peripheral neuropathy (hereditary,

acquired) acquired)

Conditions TreatedConditions Treated

Pain from different Pain from different sources:sources:

JointsJoints BonesBones MusclesMuscles Ligaments/TendonsLigaments/Tendons BursaBursa NervesNerves

Conditions TreatedConditions Treated

Brain Injuries, StrokeBrain Injuries, Stroke Spinal Cord Injuries Spinal Cord Injuries Post-Polio SyndromePost-Polio Syndrome Work-Related InjuriesWork-Related Injuries Auto-Related InjuriesAuto-Related Injuries Sports InjuriesSports Injuries Lymphedema Lymphedema

How the Physiatrist can How the Physiatrist can help?help?

Rehabilitation physiciansRehabilitation physicians accurately accurately pinpoint the source of an ailment. pinpoint the source of an ailment.

Design a Design a treatment plantreatment plan that can be that can be carried out by the patients themselves or carried out by the patients themselves or with the help of the rehabilitation with the help of the rehabilitation physician’s medical team.physician’s medical team.

This This medical teammedical team might include other might include other physicians and health professionals, such physicians and health professionals, such as neurologists, orthopedic surgeons, as neurologists, orthopedic surgeons, and physical/occupational therapists. and physical/occupational therapists.

How the Physiatrist can How the Physiatrist can help?help?

By providing an appropriate By providing an appropriate treatment plantreatment plan, , rehabilitation rehabilitation physiciansphysicians help patients stay as help patients stay as active as possible at any age. active as possible at any age.

The broad medical expertise The broad medical expertise allows the allows the PhysiatristPhysiatrist to treat to treat disabling conditions throughout disabling conditions throughout a person’s lifetime. a person’s lifetime.

TreatmentsTreatments

Injections:Injections: trigger pointstrigger points joints joints

(Synvisc/Hyalgan)(Synvisc/Hyalgan) bursa (i.e. hip bursa (i.e. hip

bursitis, shoulder bursitis, shoulder bursitis)bursitis)

tendon sheath tendon sheath (i.e. rotator cuff (i.e. rotator cuff tendinopathy)tendinopathy)

TreatmentsTreatments

Prescribe Prescribe Medications: Medications:

AnalgesicsAnalgesics Muscle relaxantsMuscle relaxants Anti-inflammatory agents Anti-inflammatory agents

(NSAID)(NSAID) Medications for conditions Medications for conditions

such as neuropathic pain, such as neuropathic pain, fibromyalgia syndrome…fibromyalgia syndrome…

TreatmentsTreatments

May prescribe a May prescribe a Rehabilitation Rehabilitation ProgramProgram

Physical TherapyPhysical Therapy Occupational TherapyOccupational Therapy Mental Mental

Health/PsychologyHealth/Psychology Vocational Vocational

RehabilitationRehabilitation

Diagnostic StudiesDiagnostic Studies

May request May request radiological radiological studiesstudies such such as X-rays, as X-rays, MRI, CAT MRI, CAT scan, Bone scan, Bone Scan…Scan…

Electrodiagnostic Electrodiagnostic StudiesStudies

ElectrodiagnosElectrodiagnostic Studiestic Studies aid aid in the diagnosis in the diagnosis of conditions of conditions related to related to nervesnerves and and musclesmuscles

Electromyography (EMG)Electromyography (EMG) The needle The needle EMGEMG involves the involves the

insertion of very thin pin electrodes insertion of very thin pin electrodes into the skin to the muscle.  Several into the skin to the muscle.  Several muscles are tested in each extremity.muscles are tested in each extremity.

The The EMGEMG helps to distinguish helps to distinguish between muscle conditions in which between muscle conditions in which the problem begins in the muscle and the problem begins in the muscle and muscle weakness due to nerve muscle weakness due to nerve disorders. disorders.

EMGsEMGs can also be used to isolate the can also be used to isolate the level of nerve irritation or injury.level of nerve irritation or injury.

Electromyography (EMG)Electromyography (EMG) EMGEMG is performed using is performed using

an an instrumentinstrument called an called an electromyographelectromyograph, to , to produce a record called produce a record called an an electromyogramelectromyogram. .

An An electromyographelectromyograph detects the detects the electrical potentialelectrical potential generated by muscle cells generated by muscle cells when these cells are when these cells are mechanically active, and mechanically active, and also when the cells are at also when the cells are at rest.rest.

Nerve Conduction Nerve Conduction Studies (NCS)Studies (NCS)

A A nerve conduction nerve conduction studystudy (NCS) is a test (NCS) is a test commonly used to commonly used to evaluate the function, evaluate the function, especially the ability of especially the ability of electrical conductionelectrical conduction, of , of the the motormotor and and sensory nervessensory nerves of the of the human bodyhuman body..

Nerve conduction velocity Nerve conduction velocity (NCV) is a common (NCV) is a common measurement made measurement made during this test. during this test.