1. What in the world is aWhat in the world is a
physiatrist?physiatrist?
Danielle Groves, M.D.Danielle Groves, M.D.
Premier Orthopedics andPremier Orthopedics and
Sports MedicineSports Medicine

2. PhysiatristPhysiatrist
 A physiatrist (fizz ee at' trist) is a doctorA physiatrist (fizz ee at' trist) is a doctor
that specializes in physical medicine andthat specializes in physical medicine and
rehabilitation. Physiatrists treat problemsrehabilitation. Physiatrists treat problems
that range from a sore shoulder to spinalthat range from a sore shoulder to spinal
cord injury. They see patients in all agecord injury. They see patients in all age
groups and treat problems that touchgroups and treat problems that touch
upon all the major systems in the body.upon all the major systems in the body.
 A physiatrist focuses on improving aA physiatrist focuses on improving a
patient’s function and quality of life.patient’s function and quality of life.

3. EducationEducation
 4 years of medical school4 years of medical school
 1 year internship in medicine or1 year internship in medicine or
surgerysurgery
 3 years of residency in physical3 years of residency in physical
medicine and rehabilitationmedicine and rehabilitation
 Some do an added 1-2 yearSome do an added 1-2 year
fellowship in a specific area of thefellowship in a specific area of the
specialtyspecialty

4. Specialty AreasSpecialty Areas
 Traumatic Brain InjuryTraumatic Brain Injury
 StrokeStroke
 Spinal Cord InjurySpinal Cord Injury
 Neuromuscular DisordersNeuromuscular Disorders
 PediatricsPediatrics
 Amputee MedicineAmputee Medicine
 ElectrodiagnosisElectrodiagnosis
 Sports MedicineSports Medicine
 Pain ManagementPain Management

6. ArthritisArthritis
 Arthritis is a condition of wear and tearArthritis is a condition of wear and tear
that causes gradual damage to thethat causes gradual damage to the
cartilage of the joints.cartilage of the joints.
 It can be treated by:It can be treated by:
• Physical therapy and lifestyle modificationPhysical therapy and lifestyle modification
• MedicationMedication
• InjectionsInjections
• BracingBracing
• SurgerySurgery

9. How can a physiatrist help?How can a physiatrist help?
 The physiatrist can perform a detailedThe physiatrist can perform a detailed
examination and with the occasionalexamination and with the occasional
assistance of x-rays make the appropriateassistance of x-rays make the appropriate
diagnosis.diagnosis.
 Treatment can then be started by theTreatment can then be started by the
physiatrist who will discuss options withphysiatrist who will discuss options with
the patient and develop a plan of attack.the patient and develop a plan of attack.
 Therapy, medication, injections, andTherapy, medication, injections, and
bracing are all things a physiatrist maybracing are all things a physiatrist may
offer.offer.

10. TendonitisTendonitis
 Many patients sustain a one timeMany patients sustain a one time
injury to a part of the body, butinjury to a part of the body, but
more patients actually injuremore patients actually injure
themselves by a repetitive irritatingthemselves by a repetitive irritating
activity. This type of injury oftenactivity. This type of injury often
results in tendonitis.results in tendonitis.
 Tendonitis is a condition that can beTendonitis is a condition that can be
managed with conservativemanaged with conservative
measures.measures.

11. Back PainBack Pain
 Back pain is the second mostBack pain is the second most
common reason a patient goes to thecommon reason a patient goes to the
doctor.doctor.
 Many physiatrists specialize inMany physiatrists specialize in
treating back pain without surgery.treating back pain without surgery.
 This may include physical therapy,This may include physical therapy,
specific medications, epiduralspecific medications, epidural
injections, nerve testing-EMG, andinjections, nerve testing-EMG, and
acupuncture.acupuncture.

13. Spinal StenosisSpinal Stenosis
 This is a narrowing of the spinalThis is a narrowing of the spinal
canal.canal.
 The spinal nerves are left with aThe spinal nerves are left with a
smaller space due to this narrowingsmaller space due to this narrowing
and sometimes increased pressure isand sometimes increased pressure is
put on the nerves.put on the nerves.
 This causes pain down the legs.This causes pain down the legs.

15. Herniated DiscHerniated Disc
 The disc is the soft gel structure betweenThe disc is the soft gel structure between
the bones of the spine.the bones of the spine.
 Sometimes the soft gel pushes out intoSometimes the soft gel pushes out into
the spinal canal and can put pressure on athe spinal canal and can put pressure on a
nerve root causing pain.nerve root causing pain.
 Sometimes the pain travels down theSometimes the pain travels down the
associated leg.associated leg.
 Epidural injections can often reduce pain ifEpidural injections can often reduce pain if
therapy and medications are not enough.therapy and medications are not enough.

19. Facet ArthritisFacet Arthritis
 The facets are the small joints of theThe facets are the small joints of the
spine.spine.
 The provide a lot of support to the backThe provide a lot of support to the back
and prevent us from being able toand prevent us from being able to
hyperextend our back.hyperextend our back.
 These joints can get arthritis and cause aThese joints can get arthritis and cause a
lot of back and sometimes leg pain.lot of back and sometimes leg pain.
 Injections into and around these joints canInjections into and around these joints can
often help.often help.

22. The MusclesThe Muscles
 The majority of back pain is actuallyThe majority of back pain is actually
caused by the muscles.caused by the muscles.
 The back has a complex system ofThe back has a complex system of
muscles that are prone to injury.muscles that are prone to injury.
 These muscles can cause pain byThese muscles can cause pain by
themselves but can also cause pain inthemselves but can also cause pain in
response to an underlying problem thatresponse to an underlying problem that
makes them spasm.makes them spasm.
 Muscle pain can be just as severe as anyMuscle pain can be just as severe as any
other cause of pain.other cause of pain.

24. EMGsEMGs
 In many instances a patient is told theyIn many instances a patient is told they
may have nerve damage.may have nerve damage.
 The EMG is a test that can identify nerveThe EMG is a test that can identify nerve
damage. It can diagnose problems suchdamage. It can diagnose problems such
as carpal tunnel syndrome, neuropathy,as carpal tunnel syndrome, neuropathy,
ulnar nerve injuries, and even pinchedulnar nerve injuries, and even pinched
nerves from the neck and back.nerves from the neck and back.
 A physiatrist is often the one to performA physiatrist is often the one to perform
this test.this test.

26. BracingBracing
 When a nerve has been damaged itWhen a nerve has been damaged it
can lose its ability to control acan lose its ability to control a
muscle. When the muscle no longermuscle. When the muscle no longer
functions correctly certain joints mayfunctions correctly certain joints may
malfunction.malfunction.
 A brace is a way to compensate forA brace is a way to compensate for
this.this.
 A brace can also help provideA brace can also help provide
support to a painful joint.support to a painful joint.

28. SummarySummary
 A physiatrist treats many commonA physiatrist treats many common
and uncommon conditions.and uncommon conditions.
 They focus on pain reduction andThey focus on pain reduction and
increased quality of life.increased quality of life.
 The physiatrist tries to accomplishThe physiatrist tries to accomplish
these goals without surgery but maythese goals without surgery but may
refer a patient to a surgeon when itrefer a patient to a surgeon when it
is necessary.is necessary.

29. SummarySummary
 In an orthopedic setting, theIn an orthopedic setting, the
physiatrist treats arthritis, tendonitis,physiatrist treats arthritis, tendonitis,
back pain, neck pain, nerve injuries,back pain, neck pain, nerve injuries,
and various sprains and strains.and various sprains and strains.