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Common Questions

• What is a physiatrist?

  A Physiatrist is a doctor specializing in nerves, muscles, and bones. We diagnose and treat injuries or illnesses that affect how you move. Our goal is to reduce pain and restore function without surgery. We help patients stay as active as possible at any age. Our training allows us to diagnose and treat conditions throughout a person's lifetime.

• What conditions does a Physiatrist treat?

  A Physiatrist treats a broad range of conditions that affect patients of any age. Some examples of the common things we treat include: back and spine injury, carpal tunnel syndrome, pinched nerves in neck/back/arms/legs, amputee recovery, osteoarthritis and joint pain, whiplash, muscle strain/sprains, and conditions causing muscle spasticity. We also assist with balance and fall prevention, and sports related injuries.

• I was shoveling my driveway and felt a “pop” in my back. Now I have pain in my back and it sometimes goes into my legs. What should I do?

  This may be a problem with a disk bulge or herniation of the disc. If you have any unexplained problems going to the bathroom, you should go immediately to the Emergency Room. If you do not have these problems, you should contact a Physiatrist for an evaluation so a treatment plan can be formed. There are many options available to reduce your pain, and most of the time this will not require surgery.

• I have noticed that sometimes my right hand falls asleep when I drive and occasionally I drop things. What can cause this?

  Symptoms like these along with occasional numbness and tingling may be from a few different sources. One common source is Carpal Tunnel Syndrome. A proper diagnosis is needed for treatment and can be obtained by having a physical examination.  Sometimes nerve and muscle testing is necessary. In the case of Carpal Tunnel, options can be discussed that range from simple to more aggressive treatment.

• I’m 41 years old and have knee pain. Are there any options for me besides surgery?

  Knee pain can come from many different sources. Commonly, arthritis begins to develop as we age and can be a primary cause of knee or other joint pain. There are many non-surgical options available to treat arthritis including medication, exercise and joint fluid replacement therapy. In addition, a non-invasive pulsed electrical stimulation device can be very helpful.  Pain in the knee may come from a different source, and a good physical exam is needed to identify additional causes so appropriate treatment can be utilized.

• I have a condition that causes spasticity, or increased muscle tone. The spasticity is causing me pain/interfering with my daily activities. Are there any treatment options for me?

  Often, spasticity is beneficial for patients to assist with posture and stability, but when it causes pain or interferes with function, reducing the spasticity is important. Treatments from your Physiatrist will include, but are not limited to, medications. One option you and your doctor may decide to use is Botox. Botox may help to reduce the spasticity and make life more manageable.

• I have recently been involved in an accident and I have back pain. What should I do next?

  People often hurt themselves in this way or even on the job. A Physiatrist is a back injury specialist with training in diagnosing and treating these injuries to achieve increased activity and pain reduction. Together, we can achieve better results if proper treatment is begun right after the injury occurs.

• What is the difference between Physical Medicine and Physical Therapy?

  Physical Medicine (Physiatry) Physicians are trained medical doctors who specialize in diagnosing and treating problems related to the musculoskeletal and nervous system. Physical therapy is one of many treatment options that might be prescribed by your Physiatrist, and a physical therapist would administer that treatment.

• A few months ago I developed back pain but lately it has been going down my legs. What should I do?

  There are many reasons why back pain might cause radiation of symptoms into the legs. This might represent a change or a new problem. The symptoms may be coming from the spine, nerves or muscles. You should have this change in symptoms evaluated by a trained back specialist, a Physiatrist, to determine how best to be treated.

• I have arthritis and take Ibuprofen, but lately I’ve had this pain in my left hip. At times it goes into my groin. I’ve also noticed trouble walking. What should I do?

  The pain may represent hip arthritis. Additionally, it may represent radiation of pain from the back, or other mechanical problems with the musculoskeletal system. If the arthritis you have is worsening beyond the point where your anti-inflammatory medicine helps, further treatment, such as a cortisone injection into the joint, might be indicated. In severe cases, hip surgery may eventually be needed.

• I do a lot of sitting at work and this hurts my back. Any suggestions?

  This may be due to the set-up of your workspace. Too often, typical workspace set-ups put people into difficult postures and create bad habits and poor body mechanics. Evaluating the set-up and making good ergonomic alterations may improve this condition. If this is done, and the pain continues, then your back should be evaluated to determine why and where it hurts.

• About 2 months ago I had my first child. Everything went well but I have developed pain into my buttocks, near my tailbone. What could this be from?

  Often, as a woman goes through pregnancy and childbirth, the changes that occur can put stress on the joints where the pelvis and spine come together. These joints are called the Sacro-Iliac joints, or SI Joints. These joints can be stretched during pregnancy or delivery. There is a regimen of easy strengthening exercises that can be prescribed to help stabilize these joints. Additionally, cortisone injections may be helpful to reduce the pain so that the strengthening exercises are more effective.

• I had an amputation of my right leg. My doctor said I am ready to get a new leg. How do I go about doing this?

  At this point, you are ready for a preparatory prosthesis. You should have a consultation with a Physiatrist who will discuss with you your specific needs, and help to design a prosthetic leg. You will then work together with your Physiatrist and a Prosthetist (prosthetic mechanic) to build your new leg and make the necessary adjustments until it is the perfect leg for you.

• I’ve had back pain for years and even had back surgery but I still have pain. Now what?

  The surgery has corrected the original anatomical problem that initially caused your pain. Over the course of time, both before and after the surgery, your body does things to try and naturally "splint" your back to protect it from worsening. This reaction by the body, unfortunately, can cause its own issues, as anytime the body overcompensates for one problem, it can create a second one. Your Physiatrist can help sort out these issues, and prescribe treatments that can help put you back on the course of wellness.

• About 3 weeks ago I was involved in a car accident. I’m now starting to have headaches and some pain across my shoulders. Why is this starting now?

  During car accidents, the muscles of the neck and shoulders tighten up to protect the spine from damage. Sometimes this tightening can cause tiny microscopic tears in the muscle which then causes those muscles to remain tight while it heals. Muscle has the ability to remember this tightness, and wants to stay tight. This then causes progressive tightness which can then create tension headaches. This is not always apparent at the time of the accident, and may occur weeks after the accident.

• I am a diabetic but I also have chronic low back pain. I am now starting to have pain along with tingling down my legs. How do I know what is causing this?

  These symptoms into your legs may indicate further degenerative changes in your spine causing irritation of the nerves. Also, with the diabetes, some of these symptoms may occur due to nerve ending changes in the legs or arms as a result of the diabetes. Diagnosis of this may be done using a Nerve Conduction Study and an Electromyogram, (EMG). Once the diagnosis is found, there are treatment options available.

• My 19 year old daughter is complaining of pain in her upper back, since she started college. What could be causing this?

  Frequently, students who need to carry heavy loads of books do so in a backpack or shoulder bag. Quite often, these bags are not used as they were intended to be worn. People have the tendency to throw the backpack over one shoulder, which unevenly distributes the heavy weight across the spine causing overcompensation and pain. Wearing the backpack evenly as intended should help this situation. If not, additional treatment may be needed.

• I recently helped a friend move some furniture and developed shooting pain into my low back. I went to the ER and had an MRI done and was told nothing was wrong. But why do I still hurt?

  More often than not, back pain is not due to a disk rupture or something that can be explained on MRI. In fact, having a finding on an MRI does not necessarily mean that is what your problem is. Most cases of back pain are mechanical at the level of muscles and joints.  Did you know that 50% of people will have a disk bulge on MRI and do not have pain from it?

• What is sciatic pain due to? What can I do to prevent it?

  Sciatic pain is a generic term for any pain in the area of the leg where the sciatic nerve travels. The sciatic nerve is actually a bundle of smaller nerves that start in different places and end in different places. Sciatic pain or "Sciatica" can come from any one of these areas, or an irritation of the nerve bundle itself. Some examples of where the pain might start from are the spine, pelvis, buttock muscles, or nerve entrapment in the leg. Prevention of this pain is through learning what the exact cause is, and how to avoid aggravation of this area.

• Over the past month, after slipping on some ice, I’ve had back pain. It is worse if I lean back too far and find myself hunched over all the time. Why?

  Slips and falls can cause spasms of the muscles or jamming of the joints of the spine. In some cases small fractures may also occur. Any of these injuries can cause back pain which is made worse when leaning backward. This pain may also be seen leaning forward, twisting, or bending to the sides. Relieving the inflamed area through posture support, medication or cortisone injection can help in the recovery process.

• I’ve had a fusion done on my lower back, but I still have pain. My sister has a TENS unit. Would this help me?

  The pain associated with post-surgical recovery often comes from tight muscles that spasm into a natural "splint" as the body heals. Additionally, pain may come from another place in the back than where surgery was. TENS units work to change your perception of the pain signals. They do not, however, help fix the problem. If your pain is from tight muscles, another stimulator for them may be more appropriate. If the pain is from another location, that source should be found to treat it accurately.

• I’m a paraplegic and I’ve recently moved to the area. Is there anyone that I should be following with?

  Physiatrists are trained to follow the changes a person's body goes through from a spinal cord injury. Whether your injury is new or you are an experienced patient with great knowledge of your injuries, you will need to establish with a physician who understands the problems and issues that arise after spinal cord injury. Establish a relationship early with a Physiatrist you trust so that you and your doctor become familiar with how your body and injury work.

• I’ve had headaches for years and tried all the medications. Do you have any options for me?

  Headaches come in many forms. Although many headaches are called migraines, they in fact may be tension headaches instead. If you find that you have tight neck and shoulder muscles that are painful, these muscles might be the source of your headaches. Muscle relaxation techniques and treatments can help this. You may want to consider the use of Botox to help relax the muscles. Botox is an injection that helps to relax, tight, overactive muscles.

• I’ve been told I have carpal tunnel syndrome. I wear a brace but it doesn’t help. I don’t want surgery. What other options are there?

  There are three main options for treating carpal tunnel. The braces are the most conservative treatment, and many people respond well to this. If you still have symptoms despite bracing your remaining options are surgery or you could have a cortisone injection into the tunnel. Some people notice success from the injections sufficient to avoid surgery, or at least put it off until a later time.

• My wife recently had a stroke and continues to have right sided weakness and her memory isn’t the best. What can be done to help with this?

  If she is not already involved in rehabilitation for these problems, she should begin working with a physical and occupational therapist for the weakness, and a speech and language pathologist or a neuropsychologist for the memory issues. She may also need a prescription for a brace to support her weak side if it helps her to walk. Your Physiatrist will help determine your specific needs.

• I recently had an MRI due to low back pain and pain down my legs. My doctor said I have spinal stenosis. What causes this? What can be done?

  Spinal stenosis can be caused from degenerative changes to the spine, or a specific disk herniation. Stenosis means a "narrowing" of the canal where your nerves run. This can cause compression on the nerves which can lead to numbness, tingling, pain, and even weakness in your legs or arms if the stenosis is in the neck. This can be treated conservatively with physical therapy and traction. You may require an epidural injection, and in some cases this condition may require surgery.