Physical Medicine and Rehabilitation
PM&R, also known as physiatry, is a branch of medicine devoted to the prevention, diagnosis and treatment of neurologic, musculoskeletal, cardiovascular, pulmonary and other disorders that may produce temporary or permanent impairment and associated functional disability. PM&R provides care for a broad spectrum of disorders including multiple trauma, brain injury, spinal cord disorders and injuries and stroke. PM&R also focuses on restoring function to people with problems ranging from physical mobility limitations to those with complex cognitive impairments. PM&R physicians may have specialty or fellowship training to treat children, as well as adults.
What is a physiatrist?
A physiatrist is a physician who specializes in physical medicine and rehabilitation and treats patients of all ages, primarily in three areas of medical care:
- Musculoskeletal injuries and acute and chronic pain syndromes, which include the diagnosis and treatment of sports and work injuries, back and neck pain disorders and degenerative conditions such as arthritis.
- Electrodiagnostic medicine, which involves special training in electromyography (EMG) and nerve conduction studies and is used for evaluating various neurological disorders.
- Rehabilitation for severe impairments and functional limitations, which includes developmental disorders, multiple trauma, spinal cord injuries, traumatic and acquired brain injuries, cancer, stroke, amputations, multiple sclerosis and other neurological disorders.
What type of education is needed to become a physiatrist?
A physiatrist completes four years of graduate medical education, a one-year internship and a minimum of three additional years of postdoctoral residency training. Many physiatrists complete fellowship training in a specific area of the specialty, such as pediatric rehabilitation, geriatrics, musculoskeletal rehabilitation, traumatic brain injury, spinal cord injury, sports medicine or pain management.
To become board certified in PM&R, physiatrists take both a written and oral examination administered by the American Board of Physical Medicine and Rehabilitation (ABPM&R). The ABPM&R has agreements with the boards of pediatric rehabilitation, internal medicine and neurology for special training programs leading to certification in those specialties.
Where do physiatrists practice?
Physiatrists practice in rehabilitation centers, hospitals and in private offices. Some physiatrists concentrate their practice on a specialty area such as pediatric rehabilitation, geriatrics, sports medicine or brain injury.
What type of treatments do physiatrists offer?
Physiatrists offer a broad array of treatments, but they do not perform surgery except for minor wound debridement. They prescribe medications, prosthetic devices, orthoses and assistive devices. They also prescribe physical therapy for heat and cold therapies, electrotherapies, massage, biofeedback, traction and therapeutic exercise as well as occupational and speech language therapies. Some physiatrists receive additional training in spinal intervention techniques to treat pain and some perform nerve blocks, Botox injections and intrathecal medication administration to treat spasticity.