Physical Medicine & Rehabilitation Doctor: Your Expert in Preventing & Minimizing Disability
What is a physical medicine and rehabilitation doctor (physiatrist)?
A physical medicine and rehabilitation doctor specializes in diagnosing and treating people of all ages with muscle, bone, and nervous system conditions that affect physical and mental abilities. Physical medicine and rehabilitation doctors are experts in preventing and minimizing disability. They provide long-term or lifelong care for such conditions as stroke, sports injuries, and spinal cord injuries.
A physical medicine and rehabilitation doctor typically:
Evaluates a patient’s medical history and educates the patient about disability prevention and how to maximize cognitive and physical function
Performs a physical exam that includes evaluation of blood pressure, vital signs, general health, and functional ability
Orders and interprets laboratory and imaging tests and prescribes medications
Diagnoses and treats acute and chronic diseases and conditions that affect mobility and cognitive functioning
Provides direct care for problems of mobility and cognitive function in the office, hospital, and rehabilitation facility
Diagnoses, treats and monitors conditions that increase the risk of disability, such as neuromuscular disorders and chronic pain
Works closely with your primary care doctor, other specialists, and members of your healthcare team to provide optimal care
Physical medicine and rehabilitation doctors may also be known by the following names: physiatrist, physical rehabilitation doctor, rehab doctor, physical medicine doctor, and rehabilitation doctor.
Who should see a physical medicine and rehabilitation doctor?
Many people see a physical medicine and rehabilitation doctor after their primary care doctor or another specialist diagnoses or suspects an illness or injury that affects mental or physical function. This includes a variety of conditions, including chronic pain, neuromuscular disorders, injuries, stroke, and surgery. Your doctor may refer you to a physical medicine and rehabilitation doctor for any illness or condition that can affect your ability to function in daily life and activities.
Seeing an experienced physical medicine and rehabilitation doctor for early evaluation and treatment is the best way to reduce the risk of permanent or worsening disability and other complications.
When should you see a physical medicine and rehabilitation doctor?
Consider seeking care from a physical medicine and rehabilitation doctor if you have any of the following symptoms or conditions:
Pain or painful syndromes
Problems with movement including muscle spasticity or stiffness that makes daily activities difficult
You should also seek care from a physical medicine and rehabilitation doctor under the following situations:
You are obese or an older adult and have trouble moving or being active.
You had an accident or injury that has caused chronic pain or limited function.
You had surgery, especially a major surgery with a difficult recovery.
You have nervous system damage from diabetic neuropathy, stroke, or other neurological conditions.
You have a condition that affects your ability to function and take care of yourself, or causes ongoing pain.
Your child has a disabling condition including cerebral palsy, scoliosis, or congenital birth defects.
What conditions and diseases does a physical medicine and rehabilitation doctor treat?
A physical medicine and rehabilitation doctor leads a multidisciplinary rehabilitation team caring for people with a wide variety of conditions including:
Neuromuscular and nervous system conditions including stroke, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), neuropathy, pinched nerves, muscular dystrophy, myopathy, cerebral palsy, multiple sclerosis, Guillain-Barré syndrome, post-polio syndrome, and myasthenia gravis
Post-surgical recovery including joint repair and replacement surgery, amputation, back surgery, brain or spinal cord surgery, organ transplantation, and heart surgery
Trauma including work- and sports-related injuries, falls, crush injuries, severe burns, motor vehicle accidents, and penetrating trauma, such as gunshot and stab wounds
What tests does a physical medicine and rehabilitation doctor perform or order?
A physical medicine and rehabilitation doctor can order, perform and interpret a wide variety of tests including:
General health and screening tests including complete blood count (CBC), urinalysis, chest X-ray, blood glucose (sugar) test, electrolyte tests, liver and kidney function tests, blood pressure screening, and pulse oximetry (blood oxygen levels)
Imaging tests including X-rays, ultrasounds, computed tomography (CT) scans, nuclear scans, and magnetic resonance imaging (MRI)
What procedures and treatments does a physical medicine and rehabilitation doctor perform or order?
Physical medicine and rehabilitation doctors design rehabilitation plans consisting of treatments that patients can perform alone or with the help of their medical rehabilitation team. The treatment plan will vary depending on the diagnosis. A rehabilitation team may consist of a variety of medical specialists, physical therapists, occupational therapists, speech-language pathologists, vocational counselors, psychologists, and social workers.
Physical medicine and rehabilitation doctors do not perform surgery. Common procedures and treatments physical medicine and rehabilitation doctors perform or order include:
Adaptive equipment and assistive devices including orthotics (shoe inserts), orthoses (braces), prostheses, wheelchairs, and communication devices
Hand therapy including splinting, range of motion, strengthening, and sensory discrimination
Medications including injections for pain and muscle spasticity
Occupational therapy including relearning daily activities, regaining control of arms and hands, wheelchair evaluations, and using equipment to function independently
Physical therapy and therapeutic exercise including water therapy; soft-tissue massage; therapeutic ultrasound; chest physiotherapy; and other exercises and movements to improve strength, mobility and fitness
Social and psychological services including biofeedback; peer counseling, work or school re-entry; and individual, family or group therapy
Speech-language therapy including swallowing therapy and cognitive-communication therapy to improve speaking, communication, thinking, memory, understanding, reading, writing and swallowing
Vocational rehabilitation including psychological assessments, career counseling, and requesting and obtaining accommodations and accessibility in the workplace
Physical medicine and rehabilitation doctor training and certification
A doctor may practice physical medicine and rehabilitation without becoming board certified in the specialty. However, education, training, experience and certification are key elements in establishing a doctor’s level of competence. Board certification verifies that a doctor has completed residency training in physical medicine and rehabilitation and has passed competency examinations.
A board-certified physical medicine and rehabilitation doctor has earned certification in physical medicine and rehabilitation by the American Board Physical Medicine and Rehabilitation or the American Osteopathic Board of Physical Medicine and Rehabilitation.
A board-certified physical medicine and rehabilitation doctor has:
Graduated from medical school or a college of osteopathic medicine, earning an MD or DO degree
Completed specialized residency training in physical medicine and rehabilitation
Passed a certification exam that validates the doctor’s specialized knowledge and skills in physical medicine and rehabilitation
To maintain board certification in physical medicine and rehabilitation, a doctor must participate in an ongoing certification program.
Doctors who earn board certification in physical medicine and rehabilitation can pursue certification in a subspecialty. Subspecialty board certification requires additional training and testing beyond that of the physical medicine and rehabilitation program. The subspecialties of physical medicine and rehabilitation are:
Brain injury medicine focuses on the rehabilitation of people with brain injuries.
Hospice and palliative medicine focuses on relieving physical or emotional pain and suffering of people with serious and terminal illnesses.
Neuromuscular medicine focuses on diagnosing and treating disorders of nerves and muscles.
Pain medicine focuses on diagnosing, treating and managing pain and a range of painful disorders.
Pediatric rehabilitation medicine focuses on the diagnosis and treatment of disabilities and functional problems that begin in childhood.
Spinal cord injury medicine focuses on the rehabilitation of people with spinal cord damage to due to injury or disease.
Sports medicine focuses preventing, diagnosing and treating injuries related to sports and exercise.