What is Physiatry?

A physiatrist (FIZZ-eye-a-trist) is a physician specializing in physical medicine and rehabilitation. Physiatrists treat a wide range of problems from sore shoulders to spinal cord injuries. They see patients in all age groups and treat problems that touch upon all the major systems in the body. These specialists focus on restoring function to people.

Physiatrists treat acute and chronic pain and musculoskeletal disorders. They may see a person who lifts a heavy object at work and experiences back pain, a basketball player who sprains an ankle and needs rehabilitation to play again, or a knitter who has carpal tunnel syndrome. Physiatrists' patients include people with arthritis, tendinitis, any kind of back pain, and work- or sports-related injuries.

Physiatrists also treat serious disorders of the musculoskeletal system that result in severe functional limitations. They would treat a baby with a birth defect, someone in a bad car accident, or an elderly person with a broken hip. Physiatrists coordinate the long-term rehabilitation process for patients with spinal cord injuries, cancer, stroke or other neurological disorders, brain injuries, amputations, and multiple sclerosis.

Physiatrists practice in rehabilitation centers, hospitals, and in private offices. They often have broad practices, but some concentrate on one area such as pediatrics, sports medicine, geriatric medicine, brain injury, or many other special interests.

The History of Physiatry

Physical Medicine and Rehabilitation (PM&R) is the branch of medicine emphasizing the prevention, diagnosis and treatment of disorders, particularly those of the musculoskeletal, cardiovascular, and pulmonary systems, that may produce temporary or permanent impairment.

PM&R is a subspeciality of internal medicine and provides integrated care in the treatment of all neurological and musculoskeletal disabilities from brain injury to lower back pain. These injuries and conditions may be congenital or traumatic in nature. The speciality focuses on the restoring people to their highest level of physical, vocational, occupational, educational and recreational ability. The patients treated by a specialist in physical medicine and rehabilitation, called a physiatrist, ranging from individuals with simple physical mobility issues to patients with severe cognitive involvement.

PM&R began in earnest in the 1930s with the physical treatment of musculoskeletal and neurological conditions, and broadened its scope during World War II when thousands of veterans came home with catastrophic disabilities. The goal of restoring veterans to productive lives triggered expansion of the field into a speciality that deals with all functional aspects of people with disabilities. The Advisory Board of Medical Specialties granted PM&R its approval as a speciality of medicine in 1947.

Today, physiatry is a diverse specialty. Physiatrists practice in major rehabilitation centers, in acute care hospitals, and in outpatient settings. Their approach to patients requires listening and observing, but also employs state-of-the-art technological support to assist in the healing process. In recent years, physiatry has seen an increased focus on musculoskeletal medicine and industrial medicine, pain management, sports medicine, and electromyography (EMG).

Howard A. Rusk

Dr. Rusk is often considered to be the father of comprehensive rehabilitation medicine.