Physical medicine and rehabilitation (PM&R), also called physiatry, is
the branch of medicine emphasizing the prevention, evaluation, and
treatment of disorders that can produce disabling conditions,
particularly those related to the nerves, muscles and bones.
Physical medicine and rehabilitation is one of 24 medical
specialties certified by the American Board of Medical
Physical medicine and rehabilitation provides integrated care in
the treatment of a wide variety of conditions, from brain injury to
low back pain. Physiatrists complete four years of additional
training after medical school prior to beginning their medical
practice. Those with subspecialty certification have additional training as well.
Rehabilitation physicians take the time needed to accurately
pinpoint the source of an ailment.
Their specific diagnostic tools are the same as those used by
other physicians (medical histories, physical examinations,
laboratory tests, and imaging studies), with the addition of
special techniques such as electrodiagnosis (EMG/NCS) that assist
in understanding nerve and muscle function.
After a diagnosis is made, rehabilitation physicians design a
treatment plan, along with the involved individual, that can be carried out by the individual, or with the help of the rehabilitation team.
This team may include other medical professionals, such as
neurologists, psychiatrists, orthopedic surgeons, and urologists;
and other health professionals, such as nurses, physical
therapists, occupational therapists, speech-language pathologists,
therapeutic recreation specialists, vocational counselors,
psychologists and social workers.
PM&R physicians may also inject medications into soft tissues,
joints, or the spinal column to decrease pain, spasticity or
Physical medicine and rehabilitation is often called the
quality-of-life profession because its aim is to enhance quality of life and ability to participate in the community.
The job of a rehabilitation physician is to treat any disability
resulting from disease or injury involving any organ system.
The focus is not on one part of the body, but instead on the
development of a comprehensive treatment program for putting the
pieces of a person's life back together - medically, socially,
emotionally and vocationally - after injury or disease. That may involve a team. The rehabilitation physician’s role is to help facilitate that team’s functioning and effectiveness, in part by managing the medical issues that can influence function and the ability to participate in a rehabilitation program.
Courage Kenny Rehabilitation Institute
Karl J. Sandin, MD, MPH, Courage Kenny Rehabilitation Institute