physiatry

Physiatry, or physical medicine and rehabilitation (PM&R), is a medical specialty focused on restoring functional ability and quality of life for people with physical impairments or disabilities. Physiatrists evaluate and treat brain, spine, nerve, and musculoskeletal injuries and illnesses using nonoperative care, optimization of medical health, and coordinated rehabilitation programs.

The field emphasizes maximizing function rather than curing disease. Treatment plans may combine physical and occupational therapy, assistive devices, orthotics and prosthetics, medications, injections, pain management, and strategies for community reintegration. Physiatrists collaborate with therapists, nurses, social workers, and other specialists to address physical, cognitive, and emotional aspects of disability.

Common conditions include spinal cord injury, stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, amputations, chronic pain, and orthopedic injuries or degenerative conditions. Physiatrists work in inpatient rehabilitation facilities, outpatient clinics, and academic centers, guiding long-term rehabilitation and device optimization across age groups.

Procedures may include joint and nerve injections, botulinum toxin for spasticity, and intrathecal baclofen pump management. They use electromyography/nerve conduction studies and may prescribe functional electrical stimulation, orthotics, prosthetics, and custom seating. They coordinate vocational rehabilitation and disability assessments.

Training consists of a medical degree followed by a four-year residency in physical medicine and rehabilitation. Board certification is offered by the American Board of Physical Medicine and Rehabilitation. Subspecialty fellowships include spine medicine, pain medicine, brain injury, stroke, pediatric rehabilitation, and sports medicine.