Improving Function and Reducing Pain With the Help of a Physiatrist

 For some people the aches and pains of getting older are gradual – a little more stiffness every time they stand up, or bend over to tie their shoes. For others, pain comes on suddenly; a strain when lunging for a tennis ball or a shooting pain in the back when lifting a heavy box at work. Others find themselves unable to do the normal day-to-day activities like dressing themselves as a result of a stroke or a degenerative condition like multiple sclerosis. The key to minimizing pain and improving function comes with understanding the source of it. For many, relief is often available through the resources of a physiatrist.

A physiatrist is someone who has studied general medicine, and then goes on to specialize in physical medicine and rehabilitation. I have focused my practice on painful spine conditions and sports injuries. Many of the patients who see physiatrists are industrial workers who may suffer pain from the rigors of their work. Heavy lifting and repetitive tasks can have an impact on someone’s well-being. A physiatrist can address what is causing the pain, help improve function and even make recommendations to reduce the wear and tear on the body.

Athletes of all levels also can benefit from the services of a physiatrist. More than just helping them overcome a sports injury, a physiatrist provides assistance by exploring ways to prevent future injuries and improve athletic performance. It is much more than the medical treatment of an injury or illness, physiatry is about addressing the whole person – their physical, emotional and social needs – with the intent to promote healing. If we fix a problem that was caused by the strain of their job, but don’t explain to them how to prevent it from happening again, the patient will be back in no time with the same injury. We look at the ergonomics of their work and home environment and teach body mechanics to reduce the likelihood of repetitive injuries.

Our approach is two tiered. First the focus is on relieving the pain, then we look to healing the injury and preventing future injuries. A typical appointment with a physiatrist will begin with compiling a medical history. This often includes an in-depth, detailed evaluation that addresses possible causes of the condition, determining an accurate diagnosis, and even evaluating the social dynamics like how their work or hobbies might be impacted by the condition.

Physiatrists have advanced training to diagnose and treat conditions including, but not limited to:

• back pain and sciatica

• sports injuries

• workplace injuries

• stroke and traumatic brain injury rehabilitation

• chronic pain

• neck pain

• arthritis

• cerebral palsy

• multiple sclerosis

• disabling conditions

• nerve entrapment conditions such as carpal tunnel syndrome

Finding Relief from the Pain 

For many people, the pain can be debilitating. Bringing relief to the patient is one of the top priorities. Dependent on the source of the pain, there are many options for reducing it. Typically, by the time patients are seen by a physiatrist, they have found the use of over-the-counter pain medications to be ineffective in managing their pain. Utilizing medications that target the source of the pain will provide relief for many patients. Others benefit from injections like epidurals – especially for patients experiencing pain associated with conditions like sciatica. In select cases, radiofrequency ablation treatments can be conducted on an outpatient basis to provide long-term relief from conditions like back pain. 

Coordinating a Patient’s Care 

Once a patient is not as debilitated by the pain, we can address how to correct the problem and improve function. An individual’s treatment plan is customized to address the unique factors of an individual’s lifestyle and livelihood. A physiatrist may recommend any of the following:

• medications

• therapeutic exercise and rehabilitation

• injections

• assistive devices including a brace or prosthesis

• heat and cold therapy

• massage therapy

• biofeedback, electrotherapies or neuromuscular reeducation 

When necessary, the physiatrist will coordinate care with other specialists including physical and occupational therapists, speech therapists and, in select cases, surgeons. Fortunately, there are a multitude of treatment options available which will improve even the most painful conditions of the back and neck without the need for surgery. 

The role of a physiatrist is really about improving an individual’s livelihood. For some that may mean helping them overcome an injury that is preventing them from working, for others it is about being able to return to a sport they enjoy. In some cases it is helping them regain the ability to walk or talk following a stroke or spinal cord injury.  

Understanding how pain or limited motion can impact all areas of a person’s life allows a physiatrist to address the person’s condition in relationship to their physical health, mental health, work responsibilities and family life.