Physiatrist (Rehabilitation doctor) | Back Pain Doctor
A physiatrist is an (MD) who specializes in problems of the muscles and bones. While doctors such as Rheumatologists and Neurologists are more specialized to look an underlying systemic diseases behind arthritis or possible nerve compression of the spinal nerve roots, Physiatrists are more likely to deal with structural imbalances and degenerative disorders that can be healed through physical therapy. Generally, Physiatrists do not prescribe medication (though they are qualified to) and they do not perform surgery. Physiatrists are more likely to be involved in the physical rehabilitative process, ordering a course of physical therapy for patients, and monitoring the patient's progress. Physiatrists focus more on a non-medication rehabilitation approach to musculoskeletal problems and back pain. Physiatrists are the most recommended specialists and the most commonly seen for treating back pain and other disorders involving the joints. Physiatrists specialize in restoring a comfortable level of function, abilities, pain levels, and functioning for patients with injuries or degenerative processes to the nervous system (such as with stroke patients and spinal stenosis), soft tissues, bones, and muscles. Most patients will be able to improve their functioning and quality of life through compliance with programs, created for patients by the physiatrist, to improve muscle strength, flexibility, and range of motion through certain physical therapy techniques and physical therapy exercises.
In a typical course of treatment for patients, beginning from their first experience of acute back pain, to when the patient is able to resume a healthy level of functioning, the process will develop like this for many patients.
- The patient will begin to experience back pain that doesn't heal on its own, or has symptoms that become increasingly worse.
- The patient will first see their primary care physician, who will usually do an examination and order medical images if a musculoskeletal disorder is suspected. Additional tests such as blood tests may be ordered if the patient with back pain is suspected of having an infection, tumor(s) or autoimmune disease such as rheumatoid arthritis. If the primary doctor thinks that the patient is not a surgical candidate, and doesn't have an underlying disease behind the back pain, he may recommend that the patient see a physiatrist.
- Once the doctor decides the patient may be a strong candidate to respond well to physical therapy/rehabilitation, the patient may have one of two options, depending on their insurance provider. A likely scenario is that the doctor will recommend a patient to a physiatrist that they often refer for musculoskeletal injuries and have confidence. Or it is possible that the patients are able to select their own Physiatrist (Rehabilitation doctor). To find a local physiatrist, you may use the resources provided by the webpage of the American Academy of Physical Medicine and Rehabilitation at www.aapmr.org.
- The physiatrist will examine the patient and make a recommendation whether or not they will respond well to physical therapy. If the Physiatrist does recommend physical therapy, they will recommend a PT center and program, and prepare to monitor the patient's progress in it, by reading progress reports from the physical therapist providing the therapy, and by meeting with the patients at regular intervals throughout the process.