Physiatry is an integrative, nonsurgical medical specialty focused on prevention, diagnosis, rehabilitation, and therapy for patients who have functional limitations resulting from injury, disease, or malformation. Our physicians are muscle, nerve and bone experts who focus treatment efforts on restoring physical function. A physiatrist leads a multidisciplinary team of medical professionals to treat the whole person not just the affected area of the body. Our doctors also have different subspecialties in Sports Medicine, Traumatic Brain Injury, Neuromuscular Medicine, Pediatric Rehabilitation Medicine and Pain Medicine to address unique needs of their patients.
Our faculty are trained to understand the kinetic chain, motion along the musculoskeletal system and factors that affect that motion. As such, we are involved in the care of children and adults along the spectrum of physical needs, ranging from athletes with sports injuries to individuals with long-term management needs after amputation, traumatic injury, chronic back pain, stroke, spinal cord injury or traumatic brain injury. Depending on the condition or level of disability, a variety of services and procedures are used to enhance physical ability:
Physiatrists consider exercise, and therapies if appropriate, (physical, occupational, speech) vital parts of the treatment plan for any diagnosis in both inpatient and outpatient settings. Exercise is the primary conservative treatment that is complemented by a variety of options including bracing, injections, and medications.
In some cases, patients may need support or assistive devices to enhance movement and preserve as much physical independence as possible. If applicable, prosthetics for upper and lower limbs, various braces and orthotics may be prescribed. Wheelchair fittings are performed to optimize function and reduce injury risk.
A variety of imaging methods are used in the diagnosis of conditions and injuries in the physiatry clinic. Common imaging modes include radiography (X-ray), magnetic resonance imaging (MRI), computed tomography (CT scan) and ultrasound. Our faculty perform a high volume of musculoskeletal ultrasound during clinical visits to improve diagnostic ability.
Injections of anesthetics and Botox are used to treat spine and musculoskeletal pain after injury or spasticity in chronic conditions, like stroke or cerebral palsy. Our Physiatrists have expertise with viscosupplements (hylauruonic acid) that reduce osteoarthritis pain and improve joint function. Peripheral injections help diagnose and treat bone and soft tissue disorders rotator cuff tendinopathy, shoulder or knee osteoarthritis and epicondylitis.
Spasticity is a condition that can occur after any type of injury to the brain or spinal cord. The most common causes of spasticity include stroke, traumatic brain injury, spinal cord injury and multiple sclerosis. Spasticity causes muscles to become tight which restricts movement. This can lead to pain, difficulty with daily self care such as dressing and bathing, difficulty transferring and walking, problems with fitting of splints and bracing, difficulty with positioning and sleep limitations. We use a comprehensive approach to spasticity which includes oral medications and injections into spastic muscles in combination with rehabilitation therapies, splinting, bracing and other treatments to maximize function and quality of life.
We use 3D-motion motion capture and high-speed video analysis to complement diagnosis determination to to enhance clinical care. We find underlying weak links in the kinetic chain, identify rehabilitation targets, follow disease or injury recovery, and to track changes in sport motion and functional tasks with clinical interventions. Fitness tests, body composition testing, metabolic rate can supplement clinical plan development.
Our Physiatrists have specialization in a variety of interventional procedures like image-guided spinal diagnostics and injections and radiofrequency ablations. These techniques are being used as a nonsurgical pain-relieving intervention for back and neck pain and radiculopathy.
We also provide platelet-rich plasma injections (PRP) for chronic pain or enhanced healing from injury. Complementary and alternative methods are used in appropriate cases to support medical treatment. We have specialists in acupuncture, lifestyle medicine and exercise prescription.
Diagnosis of some medical conditions is determined by the use of EMG. This process determines the health and function of the muscles and nerves that stimulate them. The results identify nerve dysfunction, muscle dysfunction or problems related to the transmission of nerve signals. Physiatrists use EMG results to find muscle dystrophies, radiculopathies, degenerative nerve disorders and more.
Medications are prescribed for the purpose of allowing patients to fully engage in therapy and perform normal activities or sport with less discomfort. As ‘ability doctors’, Physiatrists do not focus on the use of medication as the sole treatment for pain. Medications are used in conjunction with active participation from the patient to achieve the greatest gains in physical function.