Few Americans Are Familiar With Medical Specialty That Could Decrease Pain

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American Academy of Physical Medicine and Rehabilitation has told family physicians that rehabilitation physicians, also known as physiatrists, can be important allies in helping patients decrease pain and improve function without extreme interventions or costly procedures.

At a session of the American Academy of Family Physicians (AAFP), doctors learned that despite the value rehabilitation physicians (physiatrists) offer patients, very few Americans are even aware of the specialty or know to ask about it. Family practitioners, the first contact for most people with undiagnosed health concerns, could play a key role in guiding patients to talk to rehabilitation physicians who are nerve, muscle and bone experts, treating injuries or illnesses that affect how patients move.

The AAPM&R, the national medical society representing more than 7,500 rehabilitation physicians, highlighted the results of a survey that showed only one percent of 1,000 American adults polled even knew the term "physiatrist." Yet nearly 67 percent of those surveyed said they could benefit from medical care provided by these physicians once the specialty was defined for them. Restoring function without surgery is something most Americans greatly prefer and has obvious advantages including reduced medical complications and less time lost time from work. Rehabilitation physicians specialize in non-surgical management of a full range of conditions including low back, shoulder and neck pain, tendonitis, arthritis, osteoporosis, sports injuries, or more complex conditions such as spinal cord injuries, stroke and cardiac rehabilitation and traumatic brain injuries, using advanced diagnostic techniques and treatment options. The AAPM&R survey indicated that 70% of respondents go to their PCP for information about medical professionals or specialists prior to visiting a specialist.

"Surgery should be a last resort, after we've fully explored whether a condition can be managed effectively with non-invasive treatment," Dr. Martin Lanoff, Assistant Clinical Professor, Rosalind Franklin University of Medicine and Science, North Chicago, IL, told PCPs attending the session. "To improve patient outcomes, we need to raise awareness of rehabilitation physicians. Family physicians can help in their role as counselors and advisors to their patients."

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Dr. Lanoff noted that the AAPM&R has developed educational materials to help PCPs educate patients on rehabilitation physicians and their role in optimizing function. The materials are available through PCP offices and are available for download free at www.aapmr.org.

Nearly two-thirds of American adults say they have suffered from one or more injuries and/or conditions that could be appropriate for treatment by a rehabilitation physician, including an injury or condition requiring extended medical attention (31%), a sports injury (31%), on-the-job injury (24%) or chronic pain (29%). The survey was conducted by L.C. Williams & Associates Research Group.

Rehabilitation physicians attend four years of medical school plus an additional four years of hospital-based residency training as specialists in physical medicine and rehabilitation. Some physicians pursue additional advanced degrees in sub specialties, such as sports medicine or spinal cord injury.

Physiatrists treat a wide range of neurologic and orthopedic conditions. Depending on the disability, rehabilitation physicians use a variety of treatments including biofeedback, pharmacological treatment, injection techniques, physical therapy and exercise. Additionally, rehabilitation physicians educate patients about body mechanics and flexibility and can provide preventative information, for example by recommending runners wear properly constructed running shoes and change their shoes every 300-500 miles.

A patient with neck pain might first be treated with electrical stimulation, mobilization, medication, or even specialized injections to relieve the acute pain. The rehabilitation physician then will work on flexibility and strength to get the patient back to his regular work, sports and leisure activities. Finally, the rehabilitation physician will work with the patient to minimize recurrence of the problem.

For a stroke patient, early rehabilitation and a complete understanding of and commitment to the process is essential. A rehabilitation physician will design an individualized recovery program that might include treating a stroke patient's spasticity (contracted muscles, causing stiffness or tightness of the muscles) with botulinum toxin injections -- it is

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