What is a Physiatrist?
A physiatrist works in rehabilitation, but those who work in the profession provide services that differ from what physical therapists and chiropractors usually give. Physiatrists are also called rehabilitation physicians. They are medical doctors who specialize in the field of PM&R (physical medicine and rehabilitation). They can treat injuries, illnesses, and disabilities by restoring function. In addition, they can work with pain management, and they provide non-surgical treatments. Philosophically, physiatrists treat the whole person, mind and body, not just the area causing pain or movement problems.1 Focus, in physiatry, is on muscles, nerves, and bones. Treatment provided can include conditions from shoulder pain and lower back pain, to brain and spinal cord injury, and to muscle and bone problems.
Physiatrists graduate from medical school. They have a post-doctoral education in physical medicine and residency of rehabilitation, with one year spent in developing their fundamental clinical skills and another three years spent undergoing additional years of training. Rehabilitation physicians can become board certified via the American Board of Physical Medicine and Rehabilitation (ABPMR).
Physiatrists diagnose patients with electromyography (EMG), somatosensory evoked potentials, and nerve conduction studies. In treating a patient, they work with a medical team containing specialists from a variety of medical and health fields, from the physical to the neurological. Rehabilitation is focused on treating the whole person so that patients can have their full life functioning restored after an injury or disease. The patient is treated for the improvement of their quality of life in all of the medical, social, emotional, and vocational aspects. Physiatrists can also work with injury prevention. This field of medical rehabilitation has been around since the 1930s, when it was developed to help neurological and musculoskeletal problems. Its influence and practice expanded greatly after World War II.2
Physiatrist vs. Physical Therapist
The difference between a physical therapist and a physiatrist is not only evident in just the training that practitioners in each field receive. Physiatrists spend three times the amount of time that physical therapists do training. And they are able to use neurological and orthopedic knowledge to diagnose patients. In addition to this, they can interpret MRIs and perform EMGs. Physical therapists are not able to prescribe drugs or diagnose.3
Physiatrists, however, are not the ones who are performing the therapy. They will diagnose a patient, work on pain management, and develop treatments and therapies. But they will ask other health care professionals take part in the process of treating the patient in a more hands-on sense, some of whom may be physical therapists. Physical therapists do perform the actual treatment and exercises. They use modalities such as heat, cold, and TENS to help the patient recuperate and strengthen themselves physically. Physiatrists may also treat other illnesses (co-morbidity) that a patient has at the same time as their rehabilitation.4
Physiatrist vs. Chiropractor
Chiropractors are other types of professionals in the physical and mental healing business that may be employed, much like a physical therapist might be, when a physiatrist is putting together a treatment plan for the patient. Collaborative care helps when a plan is in place. For example, if a physiatrist is treating a patient and they are not responding to the traditional medication and injections, a chiropractor may be very helpful for providing the alternative care of manual and physical therapies and chiropractic adjustments. Another example of a healthcare provider a physiatrist might work with would be a massage therapist. A practitioner of massage therapy could provide additional relief and relaxation to a patient where their field of treatment is safe for an injured or afflicted patient. Outside of the treatment plan of a physiatrist, it is common for massage therapists to work with chiropractors already.5
While not a medical doctor, and although they also cannot prescribe medications, a chiropractic doctor is often seen as an expert in the muscular, nervous, and skeletal systems. Chiropractic care is based around how the body and adjustments made to compromised areas of the body affect the physical and mental states of the patient as a whole. A chiropractor is able to make recommendations to the patient to try over-the-counter supplements. And the patient could take the advice if they wish.
Chiropractors do not perform any invasive procedures. In some cases, they might use no other tools in the office other than their own hands for adjustments. In some cases, a chiropractor might use some sort of approved device within their realm of practice to identify the source of a problem or aid in the adjustment process. They will also treat a person holistically by using physical therapies, exercises, orthotics, manipulation, and other methodologies. Chiropractors, like physiatrists, want to work with the patient and any other necessary healthcare providers in order to relieve symptoms, restore functionality, and improve the quality of life of the patient.6