May 25, 2022
Physical Medicine and Rehabilitation (PM&R) is a medical specialty that seeks to improve and restore the functional ability and quality of life to those with impairments affecting the brain, spinal cord, nerves, muscles or joints.
A Distinct Medical Specialty
Patients seek PM&R physicians (also called physiatrists) for a variety of reasons. Some common reasons include a recent neurologic injury such as a stroke, traumatic brain injury or spinal cord injury. Additionally, patients with injuries to bones, muscles and joints, and those with pain related to arthritis, may seek out a physiatrist. The common thread among these patients is that they are looking for assistance in improving their quality of life through the use of exercise, adaptive equipment, medical management, nonsurgical procedures and coordinated care with other health care providers.
PM&R is its own distinct medical specialty. While a physiatrist may primarily treat orthopedic conditions or primarily treat neurologic conditions, the basic tools and approach are the same. Being united in one department at Washington University Orthopedics allows for an increased opportunity to share rehabilitation methods and develop new ones.
Coordinated Care Opportunities
Each specialist understands and complements the skills of the other. For example, a patient with a new spinal cord injury would likely receive coordinated care with orthopedic spine surgeons and PM&R specialists. The immediate care of the spine injury is the responsibility of the surgeon: he or she will focus on determining the structural stability of the spine and possibly intervene surgically. After surgery, the patient may have to learn how to move and function in a new way. Daily activities such as dressing, getting around the house, driving, and working will require the coordinated care of many health care professionals. Additionally, medications may be necessary to control spasms and pain. These are the responsibility of the physiatrist. Should a patient develop new neurologic symptoms, the physiatrist may initiate a diagnostic work up and then consult with a surgeon whether or not there is a need for additional surgery.
Improving Function is the Goal
PM&R is different from other specialties in that the focus isn't on one area or system of the body. Rather, the focus is on determining a patient’s current level of function and then determining what may be in the way of improvement. Many of the tools and methods are those used by other specialists (e.g. imaging, medications, injections of cortisone) and some are more unique to PM&R (e.g. driving evaluations, electrical stimulation, platelet rich plasma injections). Each patient is unique and careful consideration is given to each patient’s goals.
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