Physical health has a major impact on quality of life. While getting a sore muscle or a small cut on your arm might not be enough to completely turn your life upside down, chronic conditions can take a heavy toll on both the mind and body.
Physiatry is a specialized area of medicine focused on preventing, diagnosing, treating, and rehabilitating conditions that complicate living comfortably and independently. Obstacles to accomplishing those things that are important to any one individual may take the form of pain, weakness, or stiffness, or they may have to do with a person’s environment. Lack of proper assistive equipment or properly-fitted prosthetics or orthotics are just a couple of examples of the many ways in which people can be prevented from reaching their potential that can be addressed by a physiatrist.
The involvement of a physiatrist is important both to those recovering from an acute injury and those rehabilitating a chronic condition like arthritis or neuropathy. Physiatrists are uniquely equipped to apply the feedback of all of the specialists who may be involved in a person’s care to the design of a truly collaborative treatment plan. From physical and occupational therapists to orthopaedists, neurologists, and many others, physiatrists are familiar with the interplay of a wide range of specialties.
What Conditions Do Physiatrists Treat?
Physiatrists can be medical doctors (MDs), or doctors of osteopathic medicine (DOs), and they can work to bring relief to a number of different musculoskeletal conditions, some of which are more prominent among older populations.
Arthritis
Arthritis is an umbrella term that refers to joint inflammation. While anyone can experience arthritis, it is much more common with age. In fact, nearly half of all adults over age 65 experience arthritic symptoms.
Physiatrists may prescribe anti-inflammatory medications to help bring relief to those with arthritis. They’re also likely to prescribe physical therapy to enhance the effects of the medicine and to recommend specific at-home exercises to alleviate flare-ups when they arise.
Physiatrists can educate patients and caregivers about how to optimize the intended effects of an exercise routine and how to minimize the risks of falls, muscle strains, or other unintended effects.
Sprains, Strains, and Broken Bones
Elderly individuals are particularly susceptible to falls, with 95% of hip fractures in older adults occurring as a result of tripping or falling. The restoration of strength and range of motion following a fall is crucial to avoiding the complications too often observed in the months after the initial injury.
Physiatrists can prescribe medications for the relief of pain, physical therapy, and occupational therapy. They can also identify assistive equipment that can help your loved one to walk, shower, or climb stairs with a much lower risk of falling again or sustaining another injury. Lastly, physiatrists can supply patients with strategies and resources to help reduce the risk of falls in the future.
Parkinson’s Disease
Parkinson’s Disease is the second most common neurodegenerative disease behind Alzheimer’s. It affects the central nervous system and can ultimately lead to intense, rigid muscular tremors with a profound impact on day-to-day life.
Exercise is a proven strategy for lessening the symptoms of Parkinson’s Disease and physiatrists are knowledgeable about the risks and benefits of a variety of exercise options. Because Parkinson’s increases one’s risk of falling, familiarity with the ways in which exercise and the activities of daily living can be modified to minimize fall risk while preserving one’s independence and morale is imperative.
Post-Operative Care
Elderly individuals may require surgeries and invasive procedures such as joint replacements or cardiovascular surgeries. Bedrest in the immediate post-operative phase can decondition seniors more quickly than their youthful and middle-aged counterparts, which makes the safe resumption of activity especially important.
This might include crafting a personalized treatment plan, prescribing medications or physical therapy, or recommending occupational therapy to help individuals return to their normal life as fast as possible.
Physiatry vs. Physical Therapy
Physiatry is often used interchangeably with physical therapy, and while there are fundamental similarities, there are key differences that make them each unique.
A common misconception is that physiatrists are the ones who are actually performing the physical therapy regimens. Physical therapists are trained in the clinical intricacies of musculoskeletal pathology and are able to implement a number of therapies and exercises to alleviate discomfort from physical pain. They are not able to make medical diagnoses in most states, but they are able to follow a written prescription from physiatrists to treat conditions.
Alternatively, physiatrists are doctors who specialize in diagnosing and recommending courses of treatment for individuals with musculoskeletal conditions — so they prescribe the physical therapy but aren’t the ones leading it. Physiatrists can also manage co-occurring conditions like COPD or heart disease that might be affecting the patient’s road to recovery.
Treatment Procedures
A physiatrist can administer a variety of treatment methods to improve quality of life.
Treatment and diagnostic methods include:
- Ultrasound procedures
- Spinal injection
- Discography
- Prosthetics
- Disability and impairment assessment
- Alternative medicine, such as acupuncture
- Nerve and muscle biopsy
- Botox injections
Keep in mind that physiatrists are normally the ones who prescribe a course of treatment, rather than actually conducting the treatment themselves. This is why a number of their procedures are less invasive and are more reliant on finding a proper diagnosis.
Importance of Physiatrists for Seniors
Physiatrists are an essential component of collaborative healthcare. Their consideration for the “whole person”, rather than just the disease being treated, distinguishes them from the fragmentation that can seem to plague the health system, at large.
Physiatrists also work closely with other team members like physical therapists and orthopedic surgeons, to ensure that their patients are getting the highest quality of holistic care.
Finally, physiatrists can serve as an advocate for someone to receive physical therapy or other services, in spite of cognitive impairments like dementia that can risk obstructing their access to crucial resources.
Related Fields
Physiatrists are just one component of a healthcare system which includes a vast array of specialties to provide patients with holistic care.
Knowing more about the resources and specialists that a physiatrist might recruit can help to fully understand the value that a physiatrist can add.
Occupational Therapists
As individuals age, functional and cognitive impairments may make it difficult for them to participate in activities that they once enjoyed.
Occupational therapists use therapeutic techniques to help individuals return to leisure activities, as well as activities of daily living.
For example, this might mean helping someone recover from falls or other injuries, as well as finding new ways to complete daily tasks given their cognitive or physical impairments. Occupational therapists will likely work with the caregiver as well to ensure that they can help instill healthful practices with once outside a controlled office setting.
Geriatric Psychiatrists
Dedication to mental health can dramatically influence one’s energy and motivation levels, with measurable impact on physical health. Geriatric psychiatrists are specialized mental health workers with a focus on caring for the conditions that detract from aging including depression, anxiety, delirium and dementia, mood disorders, and substance use disorders.
Geriatric psychiatrists are experienced in communicating with older patients, who may have varying degrees of cognitive impairment.
Additionally, geriatric psychiatrists are especially familiar with the feelings of loneliness, abandonment, and loss of independence that plague seniors disproportionately.
Social Workers
Social workers are professionals who help people work through problems in their everyday lives. They can help aging persons evaluate problems in their lives as well as identify some healthful ways to approach them.
Social workers may work hand in hand with physiatrists and occupational therapists to come up with a plan to help individuals complete activities of daily living that may be made difficult due to physical or cognitive impairment.
Likewise, social workers can be helpful in improving relationships between elderly individuals and their family members as they navigate the stresses of caregiving.
When Should Someone Visit a Physiatrist?
If someone is experiencing physical pain or discomfort, a trip to the physiatrist might be due.
A Physiatrist could benefit anyone who:
- Is recovering from a surgery
- Has a chronic condition that impairs their functioning
- Is suffering from the effects of heart attack or stroke
- Is having difficulty completing activities of daily living
- Has an illness that is making it difficult to move properly
- Thinks they might be too old to exercise
Regardless, a physiatrist can also help individuals plan for continued care, as they can help craft a personalized treatment plan that works best. Additionally, they are practiced at caring for senior populations and may be able to diagnose physical conditions that someone has been unable to articulate.
In Conclusion
Many primary care physicians are ill-equipped to handle the individualized challenges of aging, though physiatrists can offer helpful guidance.
Here are the takeaways:
- Physiatry is the medical specialty focused on diagnosing and treating musculoskeletal disorders, such as arthritis, muscle strains, and neurodegenerative disorders.
- Physiatrists are different from physical therapists, who are focused on physical rehabilitation.
- Physiatrists are a valuable part of allied healthcare and they work alongside occupational therapists, geriatric psychiatrists, and social workers to provide quality care.
- A major benefit of physiatrists is that they treat the “whole person” rather than just a single condition.
If you’re looking for enhanced care to improve someone’s quality of life, Lightyear Health is committed to redefining what it means to age. From physical medicine and rehab to geriatric psychiatry, our team of professionals will work to bring individuals the care they need most.
Sources:
Arthritis Related Statistics | CDC
What is a Physiatrist | American Academy of Physical Medicine and Rehabilitation
What is Dementia? Symptoms, Causes & Treatment | Alz.org
Geriatric Psychiatry- An Emerging Specialty | NCBI
Social Workers : Occupational Outlook Handbook | US Bureau of Labor Statistics.
