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A physiatrist practices in the field of physiatry - also called physical medicine and rehabilitation - which is a branch of medicine that specializes in diagnosis, treatment, and management of disease primarily using "physical" means, such as physical therapy and medications.
Essentially, physiatrists specialize in a wide variety of treatments for the musculoskeletal system - the muscles, bones, and associated nerves, ligaments, tendons, and other structures - and the musculoskeletal disorders that cause pain and/or difficulty with functioning. Physiatrists do not perform surgery.
A physiatrist's treatment focuses on helping the patient become as functional and pain-free as possible in order to participate in and enjoy life as fully as possible.
A physiatrist can be either a medical doctor (MD) or a doctor of osteopathic medicine (DO). A physiatrist may be referred to as a:
- Physical medicine and rehabilitation physician
- PM&R physician
Physiatry Training and Specialization
A physiatrist's training includes four years of medical school as well as four years of residency training. The first year of residency training focuses on internal medicine (general practice), and the following three years of residency emphasize specialty training.
After residency, further specialization and training is available through Fellowships in a particular field. A Fellowship is typically one to two years of training in a particular specialty.
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Physiatrists may complete one of the following Fellowships that provide additional focus and training in particular forms of treatment:
- Spine - for treatment of back pain, sciatica, and any form of pain or dysfunction that originates in the spine
- Pain management - for treatment of many types of chronic pain (e.g. chronic lower back pain, osteoarthritis). Physiatrists who specialize in pain medicine have additional specialty training in injections used to treat pain.
- Sports medicine - for sports injuries
- Brain injury (e.g. stroke) - for rehabilitation
- Spinal cord injury - for rehabilitation
- Pediatric medicine - for patients under age 18
Physiatry and the Spine
Physiatrists treat a wide range of problems that affect the musculoskeletal system. The following is a list of back conditions commonly treated by physiatrists:
- Back pain, sciatica
- Muscle and ligament injuries
- Work injuries
- Myofacial pain
- Spinal cord injury
- Ankylosing spondylitis
Because the spine is the locus of most of the body's musculoskeletal system, many physiatrists focus on treating back pain. For those who specialize who treating spinal problems, their focus may be more on rehabilitation or on injections (pain management), depending on their training and personal preference.
Physical Medicine and Rehabilitation Specialty
The specialty of Physical Medicine and Rehabilitation, or physiatry, is approximately 60 years old. Today, there are over 8,000 physicians practicing physical medicine and rehabilitation.1
Many PM&R physicians who treat back pain are part of a Spine Center or Spine Hospital, treating patients within a practice that includes other specialists, such as physical therapists, spine surgeons, rehabilitation specialists, and more.
Whether or not they work in a multispecialty spine practice, many physiatrists also serve to coordinate the patient's care with a multidisciplinary team of other doctors and specialists - for example, physical therapists, spine surgeons, psychologists, chiropractors, and more.