Physiatry/Physical Medicine & Rehabilitation
Physical medicine and rehabilitation (PM&R) physicians, also known as physiatrists, treat a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons.
Physiatrists are medical doctors who have completed training in the specialty of physical medicine and rehabilitation, and may be certified in additional sub-specialties, such as:
- Brain injury medicine
- Hospice and palliative medicine
- Neuromuscular medicine
- Pain medicine
- Pediatric rehabilitation medicine
- Spinal cord injury medicine
- Sports medicine
In general, our PM&R physicians:
- Treat patients of all ages
- Focus treatment on function
- Have a broad medical expertise that allows us to treat disabling conditions throughout a person’s lifetime
- Diagnose and treat pain as a result of an injury, illness or disabling condition
- Determine and lead a treatment/prevention plan
- Lead a team of medical professionals, which may include physical therapists, occupational therapists and/or physician assistants
- Work with other physicians, which may include primary care physicians, neurologists, orthopedic surgeons and many others.
- Treat the whole person, not just the problem area
Braces & Orthotics
Your doctor may prescribe a neck or back brace for you to wear after a spinal injury or surgery. A brace immobilizes your spine during healing, stabilizes injured areas and controls pain by restricting movement.
Chiropractic medicine helps restore structure and function to the spine and other joints. Stress, accidents, overexertion and other injuries may cause minor displacement of the spinal vertebra. This can cause muscle tension or irritation to the spinal nerves. This can lead to pain in the neck or back, headaches, whiplash and other issues that impair health. Chiropractic care is a conservative, natural approach to health care. It can help reduce pain, muscle spasms, tightness or joint inflammation. It can also improve muscle balance and help maintain healthy discs.
Epidural Steroid Injections
An epidural steroid injection (ESI) is a minimally invasive procedure. It can help relieve neck, arm, back and leg pain caused by inflamed nerves in your spine. ESI may be performed to relieve pain caused by spinal stenosis, spondylolysis or disc herniation. Medicine is delivered to the spinal nerve through the epidural space. This is the area between the protective covering of the spinal cord and vertebrae. The effects of ESI tend to be temporary. Pain relief may last for several days or even years.
Joint Steroid Injections
A steroid injection can temporarily relieve pain caused by an inflamed joint. The cause of joint pain (arthritis, injury, degeneration) is not well understood. The procedure has two purposes. First, it can be used as a diagnostic test to see if the pain is actually coming from the joint. Second, it can be used as a treatment to relieve inflammation and pain caused by various conditions.
Nerve Block Injection Test
A nerve block injection, also called a pain receptor block injection, is a minimally invasive procedure. It can temporarily relieve joint or nerve pain. The procedure is used as a diagnostic test to determine if the pain is actually coming from the nerve or joint. The effects of a nerve/pain receptor block tend to be temporary and are rarely long term. If the block is successful, then a radiofrequency ablation may be recommended.
A radiofrequency ablation is a minimally invasive procedure. It destroys the nerve fibers carrying pain signals to the brain. It can provide lasting relief for people with chronic pain. It's especially used for pain in the lower back, neck and arthritic joints. This could be a good option if you suffer recurrent pain and experienced good relief with a nerve block injection.
Acute pain starts suddenly and improves over time with healing. Chronic pain persists and is often present in ongoing conditions such as arthritis or cancer. Pain management is an integrated approach to making pain tolerable by learning coping skills. This may include exercise, physical therapy, medication, holistic therapies and counseling.
Physical therapy is an important part of a nonsurgical approach to maintain, restore and improve overall physical health. Pain-free mobility is crucial for physical independence, earning a living, quality of life and well being. Working with a doctor and a physical therapist can help patients who have suffered an injury, disease or those recovering from surgery.
Spinal Cord Stimulation
Spinal cord stimulation delivers low voltage current to block the feeling of pain. A small device implanted in the body transmits an electrical current to the spinal cord. When turned on, the stimulation feels like a mild tingling in the area where pain is felt. It helps patients with chronic pain better manage symptoms and potentially decrease use of pain medications.
Sympathetic Nerve Block
A lumbar sympathetic block is an injection of a local anesthetic that can help relieve chronic leg and foot pain. This pain can be caused by conditions such as complex regional pain syndrome, reflex sympathetic dystrophy, vascular insufficiency and shingles. Medication is delivered to the sympathetic nerves along the front side of the spine. The goal is to reduce pain so you can resume normal activities and physical therapy.
Transcutaneous Electrical Nerve Stimulation
Transcutaneous Electrical Nerve Stimulation (TENS) is a noninvasive device. It's placed on the skin to help control pain. This small, battery-operated device can block pain signals from reaching the brain. This can help reduce pain medication. It's important to remember that TENS does not cure or eliminate the cause of pain. It's also not effective for every patient.