What do physiatrists do? What kind of training and certification do they have?
A physiatrist—or physical medicine and rehabilitation specialist—is a physician (M.D. or D.O.) who treats physical impairments or disabilities that affect the bones, joints, ligaments, muscles, tendons, brain, spinal cord, and nerves. Conditions that a physiatrist might treat include arthritis, carpal tunnel syndrome, back injury, osteoporosis, tendon pain, stress fractures, a recent stroke, Parkinson’s disease, and multiple sclerosis.
Physiatrists work in various settings, including hospitals, private practice, and rehab facilities, often on teams with other health care professionals such as neurologists, orthopedic surgeons, occupational therapists, and physical therapists (with whom physiatrists are sometimes confused due to their similar-sounding names).
Physiatrists focus primarily on restoring or enhancing physical function and quality of life while reducing pain and preventing complications that could arise from a person’s injury or disability. They may prescribe or provide a wide range of treatments including medication, exercise, injections (trigger point or epidural steroid injections, for example), assistive devices (such as knee braces or orthotics), and osteopathic manipulations. For someone who recently had a stroke, for instance, a physiatrist might prescribe an exercise program (to be done with a physical therapist) to improve range of motion and boost strength; a knee brace and orthotics to help with mobility; and medication to reduce painful muscle spasticity. Physiatrists do not perform surgery.
In addition to addressing physical needs, physiatrists are supposed to be trained to take into account a patient’s psychological and social functioning, according to the American Academy of Physical Medicine and Rehabilitation (AAPM&R). That often includes assessing the home and work environments and suggesting modifications where needed. In some cases, the physiatrist might refer the patient to an occupational therapist.
The American Board of Physical Medicine and Rehabilitation certifies physiatrists in the U.S. Many have a subspecialty, such as sports medicine, pain medicine, or spinal cord injury. Your primary care doctor can refer you to a physiatrist or, if you have been hospitalized, you can get a referral to a physiatrist on staff. AAPM&R provides a searchable directory of board-certified physiatrists.
