Physician writing down treatment options

I’m in pain but don’t need surgery. What kind of doctor should I see?

The chances are good that you need the care of a competent physiatrist like the doctors at Long Island Spine Rehabilitation Medicine. If the term is unfamiliar to you, you’re not alone. Even some spell-check devices “correct” physiatrist to psychiatrist! The fact is, the terms pertain to two very different specialties. 

Are physiatrists real doctors?

A physiatrist is a highly trained medical doctor who focuses on the diagnosis and nonsurgical treatment of pain and dysfunction resulting from injury, illness, or congenital conditions. Physiatrists use many traditional and complementary medical techniques to provide their patients with pain relief and restored mobility. The goal of a physiatrist is to heal musculoskeletal problems without surgery.

What kind of problems do physiatrists treat?

Like most other medical professionals, physiatrists diagnose and treat both serious and relatively minor conditions. They tend to patients who have:

  • Suffered sudden sports, work-related, or household injuries
  • Been made miserable by mysterious aches and pains
  • Painful and/or disabling congenital defects
  • Chronic illnesses or conditions

In most cases, consulting with a physiatrist is the quickest path to pain relief, restored functionality, and a general sense of well-being. As we all know, being in pain and inactive can lead to frustration, depression, and hopelessness, so physiatrists are known to improve their patients’ outlooks as well as their physical health.

Specific Injuries and Conditions Physiatrists Diagnose and Treat

As long as you are in pain involving your muscles, bones, or joints, a physiatrist is likely to be able to help you recover, or, in the case of chronic disorders, improve your life substantially. Patients come to physiatrists’ offices with pain and dysfunction due to:

  • Sprains, strains, and fractures
  • Back pain (sciatica, herniated discs, pinched nerves)
  • Joint pain (neck, ankle, wrist, knee, hip, shoulder, vertebral)
  • Fibromyalgia, rheumatoid arthritis, neuropathy, carpal tunnel syndrome
  • Osteoarthritis, osteoporosis, and stenosis
  • Car accident injuries, such as whiplash or bone dislocation
  • Congenital defects or disorders such as cerebral palsy or muscular dystrophy
  • Catastrophic spinal cord injuries (e.g. paraplegia, quadriplegia)
  • Conditions resulting from past illnesses like polio (post-polio syndrome)
  • Ongoing illnesses like multiple sclerosis, ALS, or cancer

As you can see, physiatrists handle a wide range of medical issues, always without surgery. In fact, surgeons often refer their patients to physiatrists before and after surgical procedures like joint replacements to prepare their bodies for the trauma and to accelerate the healing process after the operation. Among doctors, physiatrists are known for being pragmatic practitioners. They are holistic professionals whose priority is always making the patient feel better.

Physiatrists Are Careful and Precise Diagnosticians

Like all astute doctors, physiatrists know that it is impossible to treat pain properly if you don’t know its source. This is where correct diagnosis becomes essential. Some of the tools used by physiatrists are also used by other physicians, but many are more specialized. Physiatrists use routine and advanced diagnostic tools, including:

  • Thorough medical history
  • Physical examination
  • Imaging tests like X-rays, CT and MRI scans, bone scans 
  • Electromyography (EMG)
  • Nerve conduction studies 
  • Musculoskeletal ultrasound
  • Discography
  • Injections guided by ultrasound or fluoroscopy to pinpoint pain origin

These tests are very specific, helping the doctor to differentiate, for example, between nerve and muscle disorders.

Physiatrists Offer a Broad Spectrum of Treatment Options

Beyond immediate advice to rest, modify your activity, and use ice and heat packs for pain relief and to increase circulation, they may recommend NSAIDs (e.g. aspirin or ibuprofen) to reduce pain and swelling or prescribe short-term anti-inflammatory medications. They have a great many more tricks up their sleeve though, including:

  • Acupuncture to control pain and inflammation
  • Assistive devices, such as braces, walking boots, canes, walkers to allow mobility
  • Taping to relax muscles and reduce inflammation
  • Physical therapy to stabilize and strengthen joints and improve range of motion*
  • Ultrasound-guided injections of corticosteroid and analgesics to relieve pain and reduce inflammation
  • Gel injections to lubricate an affected knee joint with hyaluronic acid
  • Platelet-rich plasma therapy (PRP) in which platelets in the blood are concentrated and injected to stimulate cell growth, decrease pain, and enhance healing
  • Pulsed electromagnetic field therapy (PEMF), a safe treatment that uses natural electromagnetic fields (as, for example, do EKGs) to provide many therapeutic effects

Although they do not operate, physiatrists don’t hesitate to send patients on to surgeons if diagnosis shows that surgical intervention is necessary. 

Looking for Relief Without Surgery? Check Out a Well-Recommended Physiatrist

As you probably already know from experience, when looking for the right doctor strong credentials and a good reputation among peers are both important. Testimonials and personal recommendations, however, are even more important. In most cases, a well-recommended physiatrist will not be difficult to find because individuals who go into this specialty are usually natural healers whose primary goal is to relieve your pain and greatly improve your quality of life.