Pain Management

Physical medicine and rehabilitation (PMR), or physiatry, is a branch of medicine which aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician who has completed training in this field is referred to as a physiatrist. In order to be a physiatrist in the US, one must complete four years of Medical school, one year of internship and three years of residency. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients) Physical medicine and rehabilitation involves the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement & activities modification, adaptive equipment and assistive device, orthotics (braces), prosthesis, and experiential training approaches.

Physical Medicine & Rehabilitation physicians may also perform electro diagnostics which are used to provide nervous system functional information for diagnosis and prognosis for various neuromuscular disorders. The common electro diagnostic tests performed by physiatrists are nerve conduction studies (NCS) and needle electromyography’s (EMG). The nerve conduction study involves electrical stimulation to peripheral nerves, and the nerves’ responses are measured including such things as onset latency, amplitude, and conduction velocity. Needle electromyography requires needle electrode insertion into the muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials, such as fibrillation potential or positive sharp waves, detected by EMG needles indicate the presence of muscle fibers that have abnormal nerve supplies.