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What Is PM&R? Everything You Need To Know

With aging, comes increased risk of persistent joint, back, and muscular pain that may have come and gone throughout early adulthood.  While primary care providers an integral to healthcare, a specialist can offer an even wider range of treatment options.

 

 

A specialty field of medicine known as Physical Medicine and Rehabilitation (PM&R) has a direct focus on improving comfort, stamina, and mobility and can provide persons discharged to post-acute care a great deal of relief from acute and chronic pain. Here’s everything you can expect from a PM&R specialist.

What Is PM&R?

PM&R (often referred to as physiatry) specialists focus on providing care for a variety of conditions related to the brain, spinal cord, muscles, nerves, and bones. By identifying and addressing the origin of symptoms, PM&R specialists seek to restore the independence and quality of life that may have been compromised due to injury or a chronic condition.  Physiatrists can be necessary for anyone at any point in their life, though their expertise may be especially beneficial for seniors who are at risk of developing more severe joint dysfunction related to cumulative wear and tear. 

What Encompasses PM&R?

Seeking out a PM&R specialist can be a daunting task, as there are a number of individuals who you may encounter within this field. Each field has its own specific purpose, so it’s important to determine the appropriate course of treatment for each individual. With that said, all of these individuals will work together to provide holistic care.

Physiatrists

Physiatrists are medical doctors that specialize in diagnosing and treating conditions that relate to the musculoskeletal system. They are able to prescribe medications and design treatment plans to help put your family member on the right track to a more functional life.

 

For example, if someone were to see a physiatrist due to back pain, the physiatrist might run a number of diagnostic tests to uncover the root problem. They may prescribe one or a combination of treatment options including medication, physical therapy, occupational therapy, an exercise regimen, or assistive equipment.

 

Physiatrists take into account the “whole person” rather than just the problem area, which can be particularly beneficial for aging patients for whom co-occurring conditions are more common and confounding. A physiatrist is uniquely positioned to “quarterback” the team of providers that may be recruited to aid in someone’s recovery, thanks to their comprehensive and holistic perspective. 

Physical Therapists

Physical therapists are movement experts who use exercise, hands-on care, and education to relieve pain and improve a patient’s quality of life.

 

Physical therapists implement treatments that have been prescribed by physiatrists or primary care physicians. They are not able to prescribe medication or make a diagnosis on their own in most states. Physical therapy, however, has been shown to significantly improve symptoms in those who regularly attend treatment sessions.

Occupational Therapists

Occupational therapists are similar to physical therapists but focus more on generally improving  patients’ functional abilities.  Occupational therapists can adapt traditional techniques and recommend helpful equipment for minimizing the risks associated with performing tasks independently.

 

With age, cognition and motor skills steadily decline. This might make it difficult for seomone to be able to participate in a number of leisure activities, like tennis or golf, as well as activities of daily living, like opening a pillbox or writing down a note.

 

Occupational therapists help patients and their families find new ways to accomplish tasks that may have formerly seemed manageable but are less so due to stiffness, pain, or weakness. They take on a holistic perspective, considering all limitations and barriers that might be preventing someone from doing the things they love most.

 

There’s also a subsection of occupational therapy that can be especially beneficial for individuals that experience language barriers due to dementia or another cognitive disorder. Speech therapy is a narrowly focused specialty that treats complications that affect speech, language, memory, or even the ability to swallow.

Orthopedists

Orthopedists are doctors who focus on caring for bones, joints, ligaments, tendons, muscles, and nerves. They help manage both chronic and acute conditions.

 

While they bear many similarities to physiatrists, the main difference is that orthopedists can offer surgical treatment options. In some cases, a physiatrist may even refer someone to an orthopedist for the consideration of surgery.

Neurologists

Neurologists focus on the origins of pain, immobility, altered sensation, and cognitive disorders that stem from the brain and spinal cord.  Neurologists can play a vital role in addressing the unique challenges posed by neurodegenerative disorders such as dementia, especially in regards to how they affect quality of life. They may be able to provide a wide variety of both invasive and non-invasive treatment options to relieve symptoms of neurological decline.

When Should Someone See a PM&R Specialist?

It never hurts to visit one of the many professionals who work in this sector of healthcare. However, there are some specific instances where specialized help could dramatically improve health outcomes.

 

Injuries or conditions that may require treatment by a PM&R specialist include:

  • Arthritis
  • Back / spinal cord pain
  • Fractures or broken bones
  • Multiple sclerosis
  • Parkinson’s disease
  • Osteoporosis
  • Joint pain
  • Prosthetics or Orthotics

Additionally, PM&R can be beneficial for those who are overweight and may have difficulty exercising, are recovering from the effects of nerve damage or stroke, or are experiencing difficulty moving due to medication or surgery.

Essentially, PM&R can be helpful for almost anything and anyone. 

What Treatments Do PM&R Specialists Perform?

Each specialist within the field of PM&R will be responsible for administering a number of different treatments.

  • Physiatrists order diagnostic tests like nerve conduction studies, musculoskeletal ultrasounds, or electromyography and perform non-surgical treatments like joint injections.

  • Physical therapists utilize exercises and assisted stretching to help bring relief to joint and muscular pain. Physical therapy may be helpful for alleviating chronic pain due to conditions like arthritis or it may be rehabilitative to help restore movement and comfort to a broken bone. Physical therapists can equip you with exercises and lifestyle modifications that can both prevent flare-ups and help to address them if and when they occur.

  • Occupational therapists will give you detailed exercises and alternative movements to make it easier for your loved one to accomplish daily tasks. They take environment and accessibility into consideration to help you and your loved one find modified methods for accomplishing previously difficult or dangerous tasks.

Benefits of PM&R for Seniors

A PM&R specialist can provide special value in the care of seniors. In addition to their knowledge of conditions disproportionately affecting seniors, physiatrists can also ensure that patients’ time, money, and energy are spent on the specialist visits and therapies that will be most helpful.  

 

Some PM&R professionals are specially trained to work with aging patients, which can be particularly helpful if they also struggle with dementia or another neurodegenerative disorder. They may have fine-tuned strategies for overcoming challenges to traditional care related to language or cognitive impairment.  Ultimately, a physiatrist should offload many of the aspects of care management that may otherwise fall unto devoted family members.

How Do I Find a Physiatrist?

More often than not, a primary care physician can refer appropriate PM&R professionals.

 

However, there are other resources you can use if that option isn’t available.

The American Academy of Physical Medicine and Rehabilitation has a great resource for you to look up a PM&R physician in your area, and even to hone your search based on their area of expertise

In Conclusion

Here are our takeaways about PM&R:

  • PM&R stands for Physical Medicine and Rehabilitation, and it’s an important specialty of medicine that focuses on musculoskeletal conditions. 
  • Chronic conditions like arthritis, or acute injuries like broken bones, are just two examples of the many conditions that PM&R specialists can treat.
  • There are a number of different areas within this field, including physiatry, occupational therapy, physical therapy, speech therapy, orthopedics, and neurosurgery. While all of their treatment methods differ, each of these individuals works closely together to help provide patients with the best care possible.

Physiatrists who are specifically trained to meet the needs of seniors can add special value to the experience of both patients and their caregivers.  Lightyear Health is committed to improving the process of aging by offering creative, compassionate, and evidence-based specialty care.

 

Sources:

What is PM&R? | Foundation for PMR

Physical Medicine and Rehabilitation FAQs | Penn Medicine

Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial | NCBI

About Occupational Therapy | AOTA

What Is an Orthopedic Doctor? | University of Utah Health

Arthritis Related Statistics | CDC.

Find a PM&R Physician | AAPM&R

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