What is a Physiatrist? Understanding Physical Medicine and Rehabilitation

08/27/2008
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Helping patients restore function and improve the quality of their life is a hallmark of the multi-disciplinary care at D.I.S.C.  Learn how Dr. Katrina Vlachos, a conservative orthopedic care specialist provides an array of non-surgical and alternative treatments for a variety of ailments and injuries to the musculoskeletal system.
 
 katrina_vlachos_2 Dr. Katrina Vlachos is board certified in the field of physical medicine and rehabilitation (PM&R) or physiatry (fiz-i-uh-tre).  Physiatry is a lesser known field of medicine that has been in existence for over 80 years. Physiatrists focus on increasing a person’s function. Similar to a cardiologist being a heart doctor and an orthopedic surgeon being a bone doctor, a physiatrist can be considered as a doctor of function. 
The field of PM&R is a recognized medical specialty with its own Board, the American Board of Physical Medicine and Rehabilitation.  It is a four year residency program including a one year internship and three years of specialty training.  Board certification requires completing a four year residency as well as passing written and oral examinations.  Most importantly, a multidisciplinary approach is used to improve functional status including physicians, physical therapists, occupational therapists, speech therapists, nurses, psychologists, and others.
There are actually two different aspects to the field of PM&R:
1. Physical medicine which involves addressing musculoskeletal pain with physical modalities, assessing biomechanics, and muscular stretching and strengthening.  Functional status is improved by decreasing pain and increasing strength and quality of life.
2. Rehabilitation emphasizes recovery after a devastating illness or injury such as stroke, spinal cord injury, brain injury, etc. where one is unable to function at his or her previous level. 

Primary Responsibilities of a Physiatrist: 

  1. Experts at diagnosing and treating musculoskeltalpain
  2. Restore maximum function lost through injury, illness or disabling conditions
  3. Treat the whole person, not just the problem area
  4. Lead a multidisciplinary team of medical professionals
  5. Provide non-surgical treatments for spinal and orthopedic conditions.
  6. Explain medical problems and treatment plan
  7. Work not only on treatment but also prevention
  8. Electrodiagnostic testing
 

Exercise is the Best Medicine for Pain

“Exercise IS the best medicine.”  Dr. Vlachos believes in empowering oneself with education and the means to treat one’s symptoms.  While exercise may not be the fastest way to achieve a pain free-status, it is the best way to maintain a pain-free status.  Exercise involves stretching as well as strengthening, educating muscles to help distribute force so that less stress is placed on the involved area.  Therefore, less pain is experienced. 
What most people don’t realize is that exercise needs to be maintained on a regular everyday basis in order to reap the benefits…even if one is already pain-free.  Many people have a false sense of security and stop their exercise program.  Their pain returns and they experience the frustration of recurring symptoms.  Exercise is not a guarantee that pain will never return, but it can lessen the frequency and intensity of painful events and can provide a proactive approach to relieving pain on a long-term basis.
Dr. Vlachos has specific exercise programs that she has developed depending on the involved area.  Dr. Vlachos also has relationships with many physical therapists in a number of locations to fit each individual person with the right therapist and to make going to therapy convenient.  Many people believe that physical therapy has been a treatment failure because it did not help or alleviate their symptoms.  The most important thing to realize, and that Dr. Vlachos emphasizes, is that physical therapy is an educational process to teach the right body mechanics and home program that can be continued on a daily basis at home.  While therapy may help resolve symptoms, it is not a long term solution—it is a means to an end.    It may take months of doing a specific exercise program before benefits are noticed.  Muscle strengthening takes place over months and requires regular upkeep to see ongoing benefits, otherwise, symptoms will likely return.

Convenience

One important aspect of the exercise program is to make it convenient for the individual person.  With busy schedules, family obligations, and other commitments that are present in people’s lives, exercise tends to take a back seat.  With a home exercise program, it may take a maximum of one-half hour out of the day as opposed to up to two hours at a gym.  Find a time that works best in your daily schedule and be consistent.  This helps make it a part of your regular routine and you are less likely to skip.  Many who are working may work long hours and not feel like exercising when they return home.  Stretching early in tehmorning or during breaks at work or at lunchtime may be a viable alternative

Motivation

Motivation is an important factor in starting an exercise program.  Pain is a great motivator.  Find what motivates you whether it’s symptom management, weight loss, or a healthier lifestyle and get started.  Often getting started is the hardest part of and exercise program and once you get moving you can make a specific time in your daily routine.  Sometines it’s helpful to exercise with a friend.  If someone is waiting for you or relying on you, you are more lkely to participate.

Finding Something You Like

Lastly, finding an exercise program that you like will enhance adherence.  If swimming is not your thing, the likelihood of continuing on a long term program is low.  If walking or biking is more appealing, then consider purchasing a treadmill or exercise bike for home use so they can be used on your schedule.  Be aware, however, that aerobic exercise alone is not enough and needs to be coupled with specific muscle stretching and strengthening as well.
A home exercise program can be performed at home or word, in sickness and in health, while traveling or at home and there is essentially no excuse not to do it.  Extensions of the exercise program can also be incorporated such as Pilates, yoga, gyrotonics, etc., but they are not a substitute for the daily program.
 
 
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