What is Physical Medicine & Rehabilitation?

The specialty of Physical Medicine and Rehabilitation (PM&R) is not one that many people are immediately familiar with, yet it is one that serves thousands of people every year. Also known as Physiatry, it is sometimes simply referred to as Rehabilitation or Rehab. This specialty focuses on restoring quality of life for patients who are experiencing physical pain or loss of function after a traumatic illness or injury. After major surgery, a car accident, a long illness such as cancer, or a major change to the body (such as the loss of a limb), it is the PM&R physicians who help patients begin to feel better and put the pieces of their life back together again.

PM&R physicians work with patients who have been disabled by pain or the loss of motion or cognition, and they find ways to restore function. They may consult with other physicians such as neurologists, orthopedists, physical therapists, or psychiatrists. PM&R specialists treat the whole person, not specific symptoms or illnesses, and their goal is to help patients lead active and able lives.

One example of services performed by a physical medicine and rehabilitation physician is teaching a patient who just had a leg amputated how to get around the house, use the bathroom, bathe, and care for themselves. A different example might be helping a patient learn how to walk again after a traumatic brain injury. Because there are so many different causes of pain and disability, the list of services provided by PM&R physicians is nearly endless. Generally, services that are provided by a PM&R specialist can fall into one of the following care categories:

• Self-care skills (bathing, grooming)
• Physical care (feeding, taking medication)
• Mobility
• Respiratory care (ventilator care, exercises for lung function)
• Communication
• Cognitive skills (memory, problem solving)
• Vocational training
• Pain management
• Psychological counseling (adapting to a disability)

Because there are so many options, it can be a very creative specialty. When accidents, pain, or illness cause disability, it is the physical medicine and rehabilitation specialists who are there to give patients their life back.

What is Chiropractic?

A chiropractor is a licensed healthcare professional that focuses on restricted movement or inflammation in the joints of the musculoskeletal system that may be putting pressure on the spinal column and nerves. These impingements, as they are known, are thought to affect the health of the entire body. Chiropractors use non-invasive techniques to adjust the restricted joints with the goal of reducing pain and increasing mobility. Chiropractic is generally categorized as alternative or complementary medicine.

Patients may see a chiropractor for any variety of complaint, but most commonly, they seek treatment for back pain, neck pain, headaches, or joint issues. Chiropractors are specially trained to examine the joints, bones, and muscles of the body and to notice misalignment, tenderness, or asymmetry. They also check their patients for range of motion, stability, and muscle tone. Chiropractors are trained in using imaging (such as xrays) and orthopedic or neurologic testing to gain a good understanding of the problems affecting their patients.

When joints have become restricted in their ability to move by injury or inflammation, a chiropractor may perform what is called an adjustment to try and restore motion. When applied to the vertebrae of the spine, this technique is called spinal manipulation. It involves the application of a small amount of force directly to the joint, either by hand or with chiropractic tools (such as a spring-loaded activator). This allows the joint to begin moving freely again, frees up nerve tissues that may have been caught by an inflamed joint, and increases blood flow, all of which encourage healing. When it comes to the spine specifically, the belief is that restoring its structural integrity reduces pressure on surrounding neurological tissues of the spinal column and nerve branches, which reduces pain and improves health.

Chiropractic is one of the fastest growing health specialties in the United States. It can often treat problems with pain and joint mobility effectively, without the use of surgery or medications. Because of this, it continues to gain in popularity.

What is Psychology?

Psychologists are not medical doctors, but they are important workers in the mental health field. A psychologist studies the way people feel and think, as well as how thoughts and feelings change the way people act. When psychologists work with patients directly to help them feel better, they practice clinical psychology. Clinical psychologists diagnose mental health disorders and provide treatment in the form of therapy.

A clinical psychologist might work with individuals, families, groups, or organizations. They may see people who are struggling to work through difficult circumstances, trying to overcome bad habits or patterns in their lives, recovering from a brain injury, or suffering from mental illness such as depression.

Clinical psychologists are skilled assessors. Through talking to their patients they can: (1) identify which thoughts or feelings are causing the problems in their patient's life, (2) help their patient acknowledge what emotional strengths they bring to face those problems, and (3) make plans for treatment.

Treatment varies widely depending on the patient's problems and the psychologist's areas of expertise. There hundreds of recognized modes of therapy; in addition, a patient may need to see a psychiatrist (medical doctor) for medication treatment. Whichever therapies a psychologist uses, the goal is to help patients see areas in their life where their thoughts or feelings are holding them back and causing distress. Through therapy, psychologists can encourage their patients to develop new ways to adapt so that they can lead happier lives.

What is Physical Therapy?

When injury or disease limit a patient’s ability to move and enjoy day-to-day activities without hurting, physical therapy helps restore movement and function. Physical therapy can increase strength, balance, and range of motion while reducing stiffness and pain. In some cases it may even be a safe and non-invasive alternative to pain medications or surgery.

Because physical therapy is used to treat an incredibly wide variety of ailments, each patient’s experience may be slightly different. In general, however, physical therapy appointments will consist of an examination, physical therapy treatments, and instructions about helpful ways to move or techniques to approach physical challenges.

The treatments used in physical therapy help to increase movement, reduce pain, and speed healing. They may include, among others:

• Stretching
• Strength exercises
• Massage
• Water therapy
• Ultrasound therapy
• Heat or cold therapy

Physical therapy is useful for many different problems. Almost any injury or disease that makes it painful or difficult to move can be treated with physical therapy. A few examples of conditions regularly seen by physical therapists include:

• Injuries, including fractures, sprains, and strains
• Lower back pain
• Post-surgical care
• Amputation
• Stroke or brain injury
• Dizziness and loss of balance
• Muscle disorders
• Developmental delays

Being able to go about your daily life effectively and comfortably is a key component of independence. Restoring that function is the work of physical therapists.