A physiatrist works in rehabilitation, but he differs from physical therapists and chiropractors.
What is a Physiatrist?
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, they can work with pain management, and they provide non-surgical treatments. Philosophically, physiatrists treat the whole person, not just the area causing pain or movement problems.1 Focus, in physiatry, is on muscles, nerves, and bones. Treatment 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, and they have post-doctoral education in “a physical medicine and rehabilitation residency”, with “one year developing fundamental clinical skills and three 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 “quality of life…medically, socially, emotionally, and vocationally”. Physiatrists can also work with injury prevention. This field has been around since the 1930s, when it was developed to help neurological and musculoskeletal problems, and it expanded after World War II.2
Physiatrist vs. Physical Therapist
The difference between a physical therapist and a physiatrist is not only in training. Physiatrists spend three times the amount of time training, and they are able to use neurological and orthopedic knowledgeto diagnose patients. In addition, they can interpret MRIs and perform EMGs. Physical therapists may not prescribe drugs or diagnose.3 Physiatrists, however, are not 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 to be involved, some of whom may be physical therapists. Physical therapists do perform the actual treatment and exercises and use modalities such as heat, cold, and TENS. 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 professionals that may be employed when a physiatrist is putting together a treatment plan. Collaborative care helps. For example, if a physiatrist is treating a patient and they aren’t responding to medication and injections, a chiropractor may be very helpful for providing manual and physical therapies and chiropractic adjustments.5 While not a medical doctor, and although they cannot prescribe medications, a chiropractic doctor is an “expert in the nervous, muscular and skeletal systems”. They will also treat a person holistically by using physical therapies, exercises, orthotics, manipulation, and other methodologies. Chiropractors, like physiatrists, want to relieve symptoms and restore functionality.6