Have Pain but Don’t Want Surgery? See a Physiatrist Instead

Physiatry Offers a Holistic Approach to Improving Health

By Morgan deBlecourt and Erin Hull
Updated October 04, 2024
A doctor examines a patient's shoulder

If you experience chronic pain from an injury or medical condition, a physiatrist may be able to help you find relief without surgery. Physiatrists are medical doctors who teach you how to safely strengthen muscles, stabilize joints, rehabilitate injuries, and increase your flexibility. According to Carolyn Keeler, DO, a physiatrist at Duke Spine Center in Durham, physiatry treatments aim to reduce sources of pain and improve function. 

By treating your whole body, not just the specific condition or injury, physiatrists aim to improve your overall well-being. Although there are conditions for which you may still need surgery, partnering with a physiatrist is another way to help you reach your health goals. Here, Dr. Keeler provides information you should know if you’re considering visiting a physiatrist.

When should I see a physiatrist?

You may consider a visit to a physiatrist if you experience chronic pain, back pain, or a sports injury; require rehabilitation following a stroke; or have a chronic condition like cerebral palsy

What does a physiatrist do?

According to Dr. Keeler, a physiatrist will concentrate on finding the source of your pain or limitation and will recommend one or more conservative and noninvasive treatments. These include physical and aquatic therapy, manual manipulation, massage, bracing, prosthetics and orthotics, adaptive devices, dry needling and acupuncture, mental health care, and more. Physiatrists also perform image-guided injections and prescribe pain medications, although they prioritize non-opioid options and aim to help people stop taking medications when possible. Preventing future injuries is another hallmark of the specialty.

What should I expect during my physiatry appointment?

During your first visit, a physiatrist will spend time getting to know you and your medical history. They’ll perform a comprehensive physical exam and observe how you walk, bend, and twist. A neuromuscular evaluation will test your strength, sensation, reflexes, and range of motion. If you haven’t already had imaging scans like X-rays or an MRI, your doctor may order them. Once they have a complete picture of your condition, your physiatrist will work with you to create a treatment plan with which you’re comfortable. 

“A lot of people are surprised that they get to help shape their own treatment plan,” Dr. Keeler said. That’s important, because “something like aquatic therapy -- which relieves pain because there’s less pressure on your bones, joints, and muscle -- wouldn’t be a good choice for someone who doesn’t know how to swim or is afraid of water. If something doesn’t work, we’ll try something else. It’s really important for people to know that we don’t give up.”

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