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What is a Physiatrist? Physical Medicine and Rehabilitation Explained

Various body pain highlighted on figure of man

Rehabilitation physicians treat disabilities resulting from a variety of diseases or injuries. The focus is not on one part of the body, but rather on the development of a comprehensive treatment plan for putting the pieces of a patient’s life back together – medically, socially, emotionally, and vocationally – after injury or disease (American Academy of Physical Medicine and Rehabilitation, AAPMR).

Physical medicine and rehabilitation (PM & R) involves the management of disorders that alter the movement and performance abilities of the patient. The focus is on maximizing function through a variety of treatment modalities. Along with musculoskeletal and neurological assessment, PM&R utilizes specialty diagnostic and treatment tools.

One example is needle electromyography (EMG). EMG requires needle electrode insertion into the muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials such as fibrillation potential or positive sharp wave detected by EMG needle signify abnormal nerve supply to the muscles being tested (AAPMR). EMG is a useful diagnostic tool for determining if nerve damage is contributing to patient symptoms. (KCBJ has the only accredited EMG lab in the greater KC area as well as the entire state of Kansas).  Additional tools used by physical medicine doctors and nurse practitioners include ultrasound and radiology tests.

Once a diagnosis is made, treatment plans are individualized, taking in to consideration patient needs and desires. After a thorough history and assessment of the problem, the provider (Dr. Atul Patel and/or Laurel Short, APRN) present patients with treatment options. They then develop a treatment plan together based on these options. Patients are encouraged to consider which modalities will be the best fit for them when there are multiple appropriate choices. Clearly defined treatment plans are outlined, along with specific short and long-term goals. Both Dr. Patel and Laurel Short, ARNP ensure patients are part of decision-making and that they understand what their role is in the treatment plan.

Treatment options may be a combination of the following: medications, physical modalities, physical therapy or therapeutic exercise, movement & activities modification, adaptive equipment and assistive device, orthotics (braces), prosthesis, and complementary therapies. Additional tools include heat and cold therapy, manual medicine, biofeedback, and injection techniques. A patient’s treatment plan will depend on factors such as age, functional level prior to the illness or injury, and patient goals. For example, the treatment plan for a twenty-five year old competitive athlete with vertebral disc herniation will differ from the same diagnosis in a sixty year old whose functional goal is to complete activities of daily living and walk pain-free.

PM&R providers, sometimes referred to as Functionologists, are nerve, muscle, and bone specialists who treat injuries or illnesses that affect movement. Goals of treatment include restoring function and improving performance. PM&R uses a multidisciplinary approach to create personalized treatment plans for patients.

Author:  Laurel Short, ARNP

Kansas City Bone & Joint Clinic