Physical medicine and rehabilitation (PM&R), also known as physiatry /f?'za?.?tri/ or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a physiatrist. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, and nervous system.
Scope of the field
Common conditions that are treated by rehabilitation therapists include amputation, spinal cord injury, sports injury, stroke, musculoskeletal pain syndromes such as low back pain, fibromyalgia, and traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through a multidisciplinary approach involving psychologists, physical therapists, occupational therapists, exercise therapists, anesthesiologists, and interventional procedures when indicated. In addition to the previous methodology, stroke is often treated with the help of a speech therapist and recreational therapist when possible. Physical medicine and rehabilitation physicians utilized electrodiagnostic medicine studies to help diagnose patients with symptoms of numbness, cramps or tingling.
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History
The term 'physiatry' was coined by Dr. Frank H. Krusen in 1938. The term was accepted by the American Medical Association in 1946. The field grew notably during World War II to accommodate the large number of injured soldiers.
Treatment
The major concern that PM&R deals with as a medical field is the ability of a person to function optimally within the limitations placed upon them by a disabling impairment or disease process for which there is no known cure. The emphasis is not on the full restoration to the premorbid level of function, but rather the optimization of the quality of life for those not able to achieve full restoration. A team approach to chronic conditions is emphasized to coordinate care of patients. Comprehensive Rehabilitation is provided by specialists in this field, who act as facilitators, team leaders, and medical experts for rehabilitation.
Training
Subspecialties
Six formal sub-specializations are recognized by the field in the United States:
- Hospice and palliative medicine
- Neuromuscular medicine
- Pain medicine
- Pediatric rehabilitation
- Spinal cord injury medicine
- Sports Medicine
- Brain Injury Medicine
Other subspecialties within the field that are recognized include the following:
- Musculoskeletal pain management
- Intervention physiatry
- Surgical rehabilitation
- Rheumatological rehabilitation
- Obesity and other lifestyle disease modifications
- Cardiopulmonary rehabilitation
- Amputee care
- Electrodiagnostic medicine
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