Who are physiatrists, and what do they do?
Physiatrists are experts at investigating, diagnosing, and treating pain that develops in any part of the human body and at any age. They are also known as physical medicine and rehabilitation physicians or PM&R physicians. Physiatrists deeply understand various pain-causing ailments, injuries, and conditions in the bones, joints, muscles, nerves, brain, and spinal cord.
Physiatrists use several diagnostic tests to identify the cause of pain and develop treatment plans to restore mobility and functions in the entire body, not just the problem area. Physiatrists usually include a team of experts: primary care physicians, physical and occupational therapists, orthopedic surgeons, and neurologists.
Common spinal and back conditions that physiatrists treat include chronic back pain (sciatica), injury to the spinal cord leading to disc herniation, muscle and ligament injuries due to work or sports, osteoarthritis, osteoporosis, ankylosing spondylitis, and fibromyalgia.
Physiatrists develop a treatment plan to rehabilitate the nervous system in patients who have had a severe injury affecting the brain and spinal cord or recently suffered a stroke. They also manage chronic musculoskeletal pain, which could result from osteoarthritis or rheumatoid arthritis. Physiatrists also play a critical role in rehabilitating athletes who have injuries from playing. They are an essential part of the treatment team that provides postoperative care to patients undergoing heart and brain surgeries, organ transplants, and joint replacement procedures.
When should you consult a physiatrist?
Since physiatrists are masters at diagnosing and treating pain, one should consult them for any condition that leads to long-term pain and discomfort. It can be health issues such as obesity, back pain, and arthritis that cause extreme fatigue and limit the patient's ability to get through daily activities comfortably. Physiatrists also help stroke or traumatic brain injury patients get back to normal functioning. They also help patients recovering from amputation or joint replacement procedures to recuperate from pain and mobility problems. Changes in life, such as childbirth, menopause, and aging, are associated with physical body changes. Physiatrists can teach exercises and lifestyle changes to help the body adapt to these changes.
What to expect at a physiatrist appointment?
Finding physiatrists near you is only the first step towards improving your condition. Learning what to expect at your initial physiatrist appointment can help you get the most out of it and save on future medical costs.
During the first appointment, physiatrists ask questions about the patient's personal and family medical, medication, and surgical history. They will also ask about the patient's personal goals for the treatment, which can include relief from pain or restoring functionality in certain body parts.
After carefully considering your history and personal goals, physiatrists perform physical examinations and run diagnostic tests. These tests can include X-rays, electromyography, and nerve conduction studies to detect the cause of the pain and dysfunction and then develop a treatment plan that addresses your needs and requirements.
The treatment can involve home exercise programs, physical and occupational therapy, acupuncture therapy, or a combination. Physiatrists can also refer patients to specialists, such as orthopedists and neurosurgeons, for appropriate tests and treatment. They also administer injections in the office, such as trigger point injections and spinal injections, for pain relief.
What kind of treatments do physiatrists offer?
After making a diagnosis, your physiatrist will create a treatment plan that may include one or more types of procedures depending on the severity and progression of your condition. While physiatrists cannot perform surgeries, they may have additional or fellowship training and can offer the following treatments-
- Therapeutic exercises - These help increase flexibility and the range of motion. Some activities require the patient to relax, while others require pressure to be applied to a body part (active exercises). Typical exercises include stretches, balancing exercises, developmental activities training, and coordination exercises.
- Joint injections - Certain injections, such as corticosteroids or hyaluronic acid (HA), can help ease pain associated with arthritis. HA injections act as a shock absorber and lubricant to help relieve joint pain. Steroid injections may be recommended in cases where oral pain medications and physical therapy are not as helpful in providing pain relief. During this treatment, your physiatrist will numb the area of pain using a local anesthetic and insert a needle. They may also use a fluoroscope that helps to check whether the injection is being inserted into the correct location. Depending on your condition and its severity, you may need to repeat the injection periodically.
- Trigger point injections are typically given to treat myofascial pain in the neck, shoulders, arms, and lower back. When touched, trigger points feel like small bumps, knots, or nodules in the muscles and can cause pain and other issues. For example, trigger points affecting the trapezius muscle can cause tension headaches. Trigger point injections contain local anesthetic with or without corticosteroid and botulinum toxin. They are recommended for patients who have pain despite having gone through other treatment options, such as oral medication, massage therapy, physical therapy, and heat therapy.
- Heat or ice therapy - Heat therapy aims to increase blood circulation and flow to the affected body part. Increasing temperature improves flexibility and soothes discomfort. Cryotherapy or cold therapy works in the opposite way and reduces blood flow to the affected body part, which helps reduce swelling and inflammation. Ice packs and massages also help relieve pain.
Physiatrists vs. physical therapists
Before visiting a physical therapist or physiatrist near you, understand the differences between them. Both professionals play vital roles in the rehabilitation process but differ significantly in their education, roles, approach to diagnostics, and frequency of visits.
Education:
Physiatrists are medical doctors who have completed medical school, internship, and residency training and specialize in physical medicine and rehabilitation. Their extensive medical training gives them a deep understanding of the human body's musculoskeletal system and its interaction with other bodily systems.
In contrast, physical therapists undergo three years of post-graduate education in physical therapy to earn their certification. While both professions are knowledgeable about musculoskeletal issues, physiatrists have a broader scope of medical expertise and are licensed to prescribe medication and administer non-surgical therapies.
Role:
Physiatrists take the lead in diagnosing, treating, and managing musculoskeletal conditions. They develop comprehensive treatment plans, oversee their execution, and evaluate their effectiveness. Physical therapists implement these treatment plans, using physical rehabilitation techniques such as exercises and hands-on procedures during therapy sessions.
Initial visit:
Patients typically see a physiatrist before beginning physical therapy. During the initial visit, the physiatrist conducts a thorough evaluation, gathering information from medical history, physical exams, and diagnostic tests to formulate a treatment plan. They may also coordinate with other healthcare providers, including physical therapists, to optimize the patient's rehabilitation process. After the psychiatrist's assessment, patients may undergo evaluations by physical therapists, who then commence therapy based on the psychiatrist's recommendations.
Diagnosis:
Physiatrists can diagnose medical conditions using X-rays, nerve conduction studies, and electromyography. When designing treatment protocols, they consider the patient's overall health and co-existing conditions. Physical therapists do not diagnose medical conditions but utilize diagnostic information provided by physiatrists to guide their treatment approach, adapting therapy sessions to address specific rehabilitation needs.
Frequency of visits:
Patients typically have fewer visits with physiatrists compared to physical therapists. Physiatrists conduct initial evaluations and occasional check-ins until rehabilitation goals are met. In contrast, physical therapists see patients regularly, often daily or bi-weekly, over several weeks to provide ongoing support and adjust treatment plans when necessary.
While physiatrists focus on medical diagnosis and treatment planning, physical therapists implement rehabilitation techniques to restore function and mobility. Collaboration between the physiatrist near you and the physical therapist ensures comprehensive care and optimal outcomes for rehabilitation patients.
Subspecialties in physiatry
Physiatrists specialize in various subspecialties to address specific conditions affecting physical function and quality of life.
Brain injury medicine: Physiatrists in this subspecialty focus on managing rehabilitation for individuals aged 15 and older who have sustained brain injuries. Their expertise includes addressing injury-related psychosocial, educational, and vocational issues, as well as conditions affecting the central nervous system. They collaborate with interdisciplinary teams to promote recovery and enhance patients’ overall health and functionality. Prevention of brain injuries is also a key component of their work.
Neuromuscular medicine: Specialists in this field evaluate and treat conditions involving nerves, muscles, or neuromuscular junctions. Common conditions include amyotrophic lateral sclerosis (ALS), diabetic neuropathy, various forms of muscular dystrophy, inflammatory myopathies, and myasthenia gravis.
Pain medicine: These physiatrists diagnose and treat acute and chronic pain, including cancer-related pain, in both hospital and outpatient settings. They work closely with other specialists to manage complex pain conditions effectively, often coordinating multi-modal care plans.
Pediatric rehabilitation medicine: This subspecialty focuses on congenital and childhood-onset disabilities like cerebral palsy, spina bifida, and spinal cord injuries. Specialists aim to improve children’s mobility and daily function by prescribing therapies and equipment and managing conditions such as spasticity, pain, and bladder or bowel dysfunction. Their work supports children at home, in schools, and communities.
Spinal cord injury medicine: Specialists in this area care for patients with spinal cord injuries resulting from trauma or medical conditions like multiple sclerosis, transverse myelitis, or cancer. They manage related complications such as pressure ulcers, spasticity, and respiratory health. Working with interdisciplinary teams, they focus on enhancing patients’ mobility, self-care, and reintegration into society.
Sports medicine: These physiatrists prevent, diagnose, and treat sports-related injuries and illnesses that impact physical performance. Their care extends to athletes and individuals engaged in routine physical activities to optimize health and recovery.
Locating the best physiatrists in Forest Hills, NY
Physiatrists develop comprehensive treatment plans that treat patients holistically, not just pain symptoms. However, finding the best physiatrist who is experienced in handling your condition can be a hassle. Worry no more! Zocdoc is here to help you find the best-qualified physiatrist in Forest Hills with just a few simple steps. On the Zocdoc website, enter your condition, preferred date and location, and insurance details. Once you enter your details into the search boxes, Zocdoc will filter through the results and present you with a curated list of the best physiatrists near you.
Zocdoc also includes a detailed profile page for every physiatrist on the website. The profile has complete information on the doctors' educational training and qualifications, licenses and certifications, affiliations and accreditations, and awards or recognitions received in the past. It also tells you about the languages the specialists are fluent in, the age group of patients and illnesses or conditions they generally treat, and places, days, and times they are available for consultation.
Using Zocdoc, you can easily make in-person and online appointments with physiatrists near you. Zocdoc also allows you to check if the physiatrist you choose accepts your insurance. You can select your medical insurance plan and policy from the drop-down menu, and Zocdoc will immediately tell you if the doctor of your choice is in-network. Uploading a photo of your medical insurance card on Zocdoc is optional but can help you accurately select your insurance plan. If you prefer not to upload a photo, you can manually provide your insurance details by selecting your plan from the available list. For more insurance-related questions, you can visit Zocdoc's patient help center.
All bookings on Zocdoc are fast, free, and secure!
Physiatry-related statistics in New York
The New York Department of Health published an action plan titled "Injury Prevention: An Injury Action Plan for New York State 2012-2021." According to this report, between 2010-2012, around 7,784 people died in New York due to injuries, and 29% suffered a traumatic brain injury. During the same period, 161,270 people were admitted to the hospital for injuries, and here, traumatic brain injury was responsible for 12% of the cases.
The same report stated that while the statewide average for traumatic brain injury per 100,000 New Yorkers was close to 100, the rate for Queens County (the city of Forest Hills comes under Queens County) was over 50 but much less than the state average. The report further expressed that an average of 2,279 people died yearly due to traumatic brain injuries. Around 19,368 people were hospitalized for the exact cause.
The report also discussed injuries caused by sports. In New York, 15-—to 19-year-olds had the highest number of visits to the emergency department (45%) and hospitalizations (52%) because of sports-related injuries.
According to the Centers for Disease Control and Prevention (CDC), 6,685 New Yorkers died in 2021 due to stroke, the death rate being 25.7 for every 100,000 people in the state. The numbers slightly increased from the previous year, when 6,486 people had died from a stroke, and the death rate stood at 24.8 for every 100,000 population.
Sources
WebMD
Penn Medicine
Spine-health[1]
New York State Department of Health Bureau of Occupational Health and Injury Prevention
Centers for Disease Control and Prevention
American Academy of Physical Medicine and Rehabilitation[1]
Spine-health[2]
Healthline
Sutter Health
Cleveland Clinic[1]
Cleveland Clinic[2]
Mayfield Brain & Spine
Rehab Select
American Academy of Physical Medicine and Rehabilitation[2]
American Board of Medical Specialties
