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Accidents and injuries that impair our basic everyday functions such as walking, breathing and eating can be particularly scary, both physically and emotionally. Physiatry, or Physical Medicine and Rehabilitation (PM&R), is a field of medicine that is designed to improve and maximize function lost through injury, illness or disabling conditions. Physiatrists are experts on the bones, muscles and nerves that control how your body is affected by trauma like spinal cord damage, sports injuries, limb amputations, strokes and other musculoskeletal conditions.

But how do you know when to see a physiatrist, or what conditions are appropriate for physiatry? For answers, we went straight to one of OrthoCarolina’s in-house experts, Dr. Alexander Chasnsis, a physiatrist who sees patients at OrthoCarolina’s Spine Center, Huntersville and Mooresville locations.

A physiatrist is a physician specialized in the field of Physical Medicine and Rehabilitation (PM&R). He treats a wide range of conditions that affect the spinal cord, back, brain, ligaments, nerves, joints, bones, and tendons. After regular medical training, psychiatrists go through a 4-year residence training in their chosen field, which helps them specialize. A physiatrist should be the first option to consider when pain, disability, or weakness is limiting movement or function. The physician helps maximize the patient’s functional capabilities while assisting them in adapting or strengthening their weaknesses. Physiatrists work in outpatient, inpatient setups, and as consultants. Key to note is that they offer non-surgical treatment plans.

Are Physiatrists Real Doctors?

Yes, physiatrists are real doctors. To get their board certification, they have to go through several years of medical school, internship and residency. Their medical training allows them to diagnose illnesses, design treatments and prescribe medication.

What Is the Difference Between a Physical

Therapist and A Physiatrist?

Although physical therapists and physiatrists work together, their roles are different. Physiatrists consult with patients, diagnose and manage conditions, and prescribe appropriate therapy options that physical therapists perform. Physical therapists, on the other hand, concentrate on rehabilitation efforts as guided by the physiatrist. A physiatrist needs to access a patient to give the go-ahead for the therapy.

The difference between physiatrists and physical therapists can be outlined in two key areas:

1.      Their Education

While both physiatrists and physical therapists are highly trained professionals, there is a major difference in their education.

A physiatrist has to go through medical school, internship and residency to get board-certified as a medical doctor. On the other hand, physical therapists only require a post-graduate degree in physical therapy to earn their certification.

While both physiatrists and physical therapists are professionals in their own fields, physiatrists undergo more extensive training which gives them greater in-depth knowledge of the human body.

2.      Their Roles

Physiatrists are responsible for diagnosing, treating and managing patients with musculoskeletal issues. This involves assessing patients, prescribing relevant treatments based on the findings and finally overseeing the administration of the treatment and gauging its effectiveness.

To do this, physiatrists leverage their medical training to look at and take account of your entire medical history before they prescribe treatment. In most cases, physiatrists have to work around pre-existing conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cancer and so on.

On the other hand, physical therapists are responsible for executing the treatment plans prescribed by physiatrists. They do this by using the diagnostic information that has been provided by your physiatrist. Most of the treatment plans that physical therapists are tasked with administering usually include specialized exercises and other hands-on procedures.

Who Needs a Physiatrist

Because physiatrists specialize in diagnosing and treating musculoskeletal problems, they should be the first option sought when suffering from any form of disability, including congenital disabilities, muscular pain, strained mobility, or any issue affecting everyday body functionality.

Anyone suffering from any type of injury, including sports injuries, illnesses, or conditions that limit movement, should consult a physiatrist. Some of the conditions that physiatrists specialize in include arthritis, back pain, fibromyalgia, multiple sclerosis, osteoporosis, spinal cord injuries, fractures, muscular dystrophy and so on.

In some instances, physiatrists can also diagnose and treat conditions such as diabetes and hypertension when they affect functionality, but they usually focus on treating musculoskeletal pain and disorders.

Physiatrists treat patients of all ages and sometimes have to work with other physicians such as neurologists, pediatricians, orthopedics, and surgeons. They focus not only on the problem area but also on restorative treatments that include diagnosing the root cause of the problem and preventing a reoccurrence after a successful treatment plan.

What is a Physiatrist Assessment?

A physiatrist evaluation looks into a patient’s current health status, symptoms, and medical history and then carries out tests to achieve the correct diagnosis. A physiatrist has the required skills and equipment to check into any suspected neurological issues and offer the required treatment plan. If need be, he may involve other physicians, including physical therapists but at the appropriate treatment stage. 

A physiatrist may use either or both imaging and electrodiagnostic tests when evaluating and diagnosing the problem.

Physiatrists use electrodiagnostic tests to examine a patient’s muscles and nerves. Some of the most common types of electrodiagnostics include electromyography (EMG), nerve conduction studies (NCS) and somatosensory evoked potentials (SSEPS). Physiatrists also use imaging studies such as CT scans, MRIs and musculoskeletal ultrasounds to assess and diagnose musculoskeletal injuries.

By using these methods to conduct tests, physiatrists get more information on injuries and diseases affecting the nerves and muscles. This helps physiatrists to prescribe the most effective treatment for whatever musculoskeletal ailments a patient may have.

More about physiatry


February 20, 2019

Is Dr. Chasnis a physiatrist?
- Jane Clark
Reply From: OrthoCarolina

February 21, 2019

Hi Jane. Yes he is. Thank you.