Dianostic Tools Physiatrists Use
SMG, NCS, and EP
There are only two specialties that include specific
training in electrodiagnostics as a substantial part of their
curriculum-neurology and PM&R. Only PM&R allows enough training
during residency to allow for board certification in the procedure. Electromyography (EMG) consists of
inserting fine needle electrodes in muscles and observing the recorded motor
unit potentials when the muscles are activated. Nerve conduction studies (NCS)
use electrodes to record motor and sensory responses that are propagated by
electrical stimuli. Evoked potentials (EP) are typically used to measure
sensory responses more proximally in the spinal cord, brainstem, and brain.
These serve adjunctive roles in the diagnosis of various neuromuscular
disorders including compression neuropathies, radiculopathies, peripheral
neuropathies, motor neuron diseases, neuromuscular junction pathologies, and
myopathies.
Spine Intervention
In recent years, the field of physiatry has grown to
incorporate the use of interventional spinal therapeutics to treat the
growing number of patients with chronic debilitating back pain.
Specialized training in image-guided spinal diagnostics and injections
includes the use of epidural, transforaminal, and selective nerve root
blocks. These techniques are being used as a nonsurgical
pain-relieving intervention for our patient population.
Treatments
The physiatrist is specially trained in management of
musculoskeletal disorders and various other entities including pharmacologic
control of spasticity, chronic pain, bowel and bladder management, and
behavioral training in head-injured patients. Invasive techniques such as
injections are options for arthritis, bursitis, tenosynovitis, overuse, and
myofascial pain syndromes
Physical medicine refers to the use of physical
principles and dynamic intervention to decrease pain, improve range of motion,
and maximize musculoskeletal function. Examples of these agents are
listed on Treatment Chart on the next page. |
