Because many people are not familiar with physiatry, they may wonder what kinds of treatment options they can expect. If you have been referred to a physiatrist by your primary care doctor, you may have the same questions. I have had patients who walked in the door confusing physiatry with psychiatry or podiatry. The first group tends to be relieved when I tell them I will treat their back pain, and their primary doctor didn’t send them to me because he thought it was all in their head. The second group is usually relieved that all though they aren’t at a podiatry office, I still treat foot and ankle conditions.
When you come to my office, the first thing we will do is a thorough history and physical exam to determine the correct diagnosis. From there, we will base your treatment on your specific underlying problem. Like other physicians, a physiatrist may prescribe anti-inflammatory medicine or muscle relaxers for a while after an acute injury. These medicines may be oral or topical and can be prescription or natural remedies. After addressing the pain and inflammation of the initial injury, I usually prescribe an exercise program to strengthen the affected region. This is important because we often are injured at our weakest link in the musculoskeletal chain.
For conditions such as tendonitis, bursitis or arthritis that have become more chronic or are still painful despite more conservative measures, a targeted injection may be the next step. This allows me to put the medication right where I want it, which is typically more effective than taking a pill by mouth. Thanks to musculoskeletal ultrasound I can now see exactly where I am placing the medicine, the structures I want to target and the ones I want to avoid. In most cases this makes the injection more effective, safer and less painful.
In physiatry we also use modalities like heat, ice, sound waves and electrical stimulation to decrease pain and improve healing. Physiatrists have been using these in their treatment programs since the specialty first began. These also are safer and in some cases as effective as medication in relieving pain. In future blog posts I will talk specifically about each of these modalities, how they work and what conditions for which they are most effective.
If you have a general question about any treatment options offered, please leave a comment below. If it is a question specifically related to your medical condition, for privacy reasons, please contact me for an appointment.
