The non-surgical speciality of Physical Medicine and Rehabilitation (or Physiatry) attempts to restore an individual to their highest level of physical, vocational, educational, emotional, social, and spiritual well-being. Problems can vary considerably from simple ligamentous sprains to complex problems with cognitive impairment. With these wide ranging problems come equally wide ranging demographics. Physiatrists diagnose and treat individuals from all age groups, with impairment to virtually any system in the body.
Physiatry consulting is also performed for individuals, lawyers, insurance companies, employers, or others needing independent medical assessments.
Some conditions that can be helped by the expertise of a physiatrist include (but are not limited to):
- acute and chronic pain;
- amputations, both congenital and traumatic;
- arthritis of any form;
- brain injury due to trauma or stroke;
- carpal tunnel syndrome;
- cerebral palsy;
- Duchenne muscular dystrophy;
- low back pain;
- metatarsalgia and foot pain;
- multiple sclerosis;
- poliomyelitis/post-polio syndrome;
- post-MVA (motor vehicle accident) pain;
- post-surgical fibrosis;
- reflex sympathetic dystrophy;
- scoliosis and kyphoscoliosis;
- sports injuries;
- spinal cord injuries;
- work injuries; and
- any other disease or condition that causes a loss in function or ability including those of a neurological, neuromuscular, musculoskeletal or orthopaedic nature. The connecting thread is that these cause functional (or disabling) problems for the affected person.
The treatment recommended by a physiatrist can be equally diverse. However, typical recommendations involve the use of:
- custom prescribed braces;
- medications, including injections;
- custom prescribed orthotics;
- psychology support;
- prosthetics for amputees; and
- customized exercise/therapy to be provided by physiotherapy, occupational therapy, or speech therapy.
Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. An electromyograph detects the electrical potential generated by muscle cells when these cells contract. The cause of muscular weakness, paralysis, involuntary muscle twitching, abnormal levels of muscle enzymes (e.g.: creatine phosphokinase) appearing in blood, can be investigated by means of an EMG. An EMG is an evaluation of electrical activity in resting and contracting muscles.
The procedure is simple, leaves no residual marks, and is usually non-invasive. Two metal disc electrodes are placed on the skin over the muscle to be tested. The electrical activity of the muscle is recorded at rest and during contraction and displayed as electrical waves on an oscilloscope at the same time that the activity is reproduced as sounds over a speaker. During the test, one or both of the electrodes may be repositioned to evaluate different areas on one muscle, or to evaluate different muscles. Needle electrodes may be used to test a smaller, more specific area.
Nerve conduction studies can accompany EMG testing. Performed using the same equipment, these studies are useful in determining if muscular weakness is due to a peripheral nerve or spinal cord disease. During a nerve conduction study, a nerve is stimulated by means of a small electrical shock while a recording device detects the speed of the response through the nerve. The discomfort is minimal and comparable to receiving a shock of static electricity when touching a door knob. Such electrodiagnostic studies can determine the cause of numbness, tingling, or pain from nerve damage.
There are no special preparations required for either an EMG or nerve conduction study. The tests and examinations are preformed by Dr. Reid, and not a technician. The average duration of an EMG is approximately 30-40 minutes. There are typically no restrictions or limitations imposed after having the test.