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How is a physiatrist different from a neurologist? - Dr Mehta

The human body is made up of a multitude of complex systems. These complex systems must be able to interact adequately to work and maintain the body's homeostasis. Physiatrists and neurologists are both medical doctors that work on these complex systems and they share some similarities in their functions but also differ in their areas of expertise. So, how is a physiatrist different from a neurologist? I am frequently asked this question and thought this would be a great question to address in this post.

Both neurologists and physiatrists treat movement, swallowing, speaking, or breathing issues. Further, individuals with neurological disorders may also have issues with mood, memory, sensory problems, or learning which are addressed with both specialties. Both specialists work with patients of all ages and backgrounds. They both often offer treatment on an inpatient (i.e., inside hospital 24/7 care) and outpatient (i.e., outside hospital care) basis. While the neurologists are more concerned with the primary disease process in the nervous system, physiatrists are more concerned with the effects of the disease process on other body systems such as muscle and bone, and improving overall everyday functioning such as dexterity and mobility.

Neurologic Issues - Treatment, Recovery & Rehabilitation

Neurologists work to treat conditions and diseases that are linked to the nervous system. The nervous system includes the central nervous system, the brain, and nerves in the feet, hands, and other various areas of the body. Neurological disorders typically involve diseases or injuries that occur within the central nervous system. The central nervous system contains all of the nerves that work to control the mechanisms within the body. Neurologists provide acute and longterm medical treatments including the following: Brain tumors, Lou Gehrig's disease (i.e., ALS), Meningitis, Cerebral Palsy, Multiple Sclerosis, Muscular Dystrophy, Parkinson's disease, Spina Bifida, Peripheral Neuropathy, Neuromusclar Diseases, Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI), and Stroke.

Physiatrists

Physiatrists, also known as physical medicine and rehabilitation physicians, are physicians that focus on physical mobility and agility. Physiatrists treat a vast variety of medical conditions that affect the bones, joints, nerves, brain, spinal cord, muscles, ligaments, and tendons. Physiatrists use more of a whole body approach and focus on the connections in between nerves and muscles and tendons and bones. Compared with neurologists, physiatrists' focus is on the disability caused by an impairment due to the medical condition. They have a wide area of expertise that aids them in the treatment of conditions that are disabling and may affect a person across the lifespan. Physiatrists work to diagnose and provide treatment to individuals who have conditions due to disabling illnesses, diseases, or traumatic injuries. Physiatrists typically work with patients whose physical abilities have been affected by injury, disease, or chronic medical conditions. Physiatrists are able to aid these patients in restoring and maintaining their mobility and range of motion.

Physiatrists primary goal is to treat the patient as a whole and not focus on treating just the problem area. Physiatrists typically create plans for patients to regain their dexterity or mobility and other areas of function then refer the patient to an occupational, physical or speech therapist to administer and manage the daily program of therapy they prescribe. Physiatrists generally work collaboratively with other providers such as physical, occupational, speech therapists and rehabilitation psychologists as a part of a treatment team. The teams that physiatrists generally work with can include other medical providers. They collaborate with a team of medical professionals in order to optimize patient care. Further, physiatrists often collaborate with other primary care physicians such as orthopedic surgeons, neurologists, and general practitioners. These treatment teams work to help patients recover from the after effects and injuries incurred from their illnesses or trauma. Physiatrists are able to conduct the following procedures: Procedures guided by ultrasound, Nerve/EMG conduction studies, Injections to joints, Blocks and abalation, Nerve stimulation, Prolotherapy, Muscle and nerve biopsy, Prosthetic and orthotic services, Consultation regarding medicolegal issues, Alternative medicine such as acupuncture, Treatment for spasticiy (e.g., botulinum and phenol injections, and intrathecal baclofen pump trial implants), Assessment for impairment or disability

Education and Training

Neurologists and physiatrists educational and training backgrounds are somewhat similar. Both physiatrists and neurologists must obtain a medical degree. During this time, students decide on a specialty and begin taking the appropriate courses for their specialty area. After successfully completing medical school, both physiatrists and neurologists complete a one year internship in a general clinical setting. After completing their general internship, physiatrists and neurologists must complete a three year residency specific to their field of specialty. Both specialists complete a total of 4 years spent in training after medical school. Further, if either physiatrists or neurologists would like to further specialize in their expertise, they may choose to attend additional training through fellowships.

Differences and Similarities of Neurologists and Physiatrists

Physiatrists and Neurologists both focus on different parts of the body, with one focusing on the brain and nervous system and the other focusing on connections between them and the connections between muscles and bones. It may seem as though these physicians have nothing in common, but they do have some similarities. Physiatrists often work together with neurologists to create a treatment plan for individuals with neurological disorders in order to help them regain and maintain their mobility.

Sravani Mehta, MD practices medicine in Nashville, TN at Brain & Stroke Care. focuses on Brain Health in Aging, Brain Injury & Stroke.

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