Physical medicine and rehabilitation
Rehabilitation; Physical rehab; Physiatry
Physical medicine and rehabilitation is a medical specialty that helps people regain body functions they lost due to medical conditions or injury. This term is often used to describe the whole medical team, not just the doctors.
Rehabilitation can help many body functions, including bowel and bladder problems, chewing and swallowing, problems thinking or reasoning, movement or mobility, speech, and language.
Many injuries or medical conditions can affect your ability to function, including:
- Brain disorders, such as stroke, multiple sclerosis, or cerebral palsy
- Long-term (chronic) pain, including back and neck pain
- Major bone or joint surgery, severe burns, or limb amputation
- Severe arthritis becoming worse over time
- Severe weakness after recovering from a serious illness (such as infection, heart failure or respiratory failure)
- Spinal cord injury or brain injury
Children may need rehabilitation services for:
- Down syndrome or other genetic disorders
- Intellectual disability
- Muscular dystrophy or other neuromuscular disorders
- Sensory deprivation disorder, autism spectrum disorder or developmental disorders
- Speech disorders and language problems
Physical medicine and rehabilitation services also include sports medicine and injury prevention.
WHERE REHABILITATION IS DONE
People can have rehabilitation in many settings. It will often begin while they are still in the hospital, recovering from an illness or injury. Sometimes it begins before someone has planned surgery.
After the person leaves the hospital, treatment may continue at a special inpatient rehabilitation center. A person may be transferred to this type of center if they have significant orthopedic problems, burns, a spinal cord injury or severe brain injury from stroke or trauma.
Rehabilitation often also takes place in a skilled nursing facility or rehabilitation center outside of a hospital.
Many people who are recovering eventually go home. Therapy is then continued at the provider's office or in another setting. You may visit the office of your physical medicine physician and other health professionals. Sometimes, a therapist will make home visits. Family members or other caregivers must also be available to help.
WHAT REHABILITATION DOES
The goal of rehabilitation therapy is to teach people how to take care of themselves as much as possible. The focus is often on daily tasks such as eating, bathing, using the bathroom and moving from a wheelchair to a bed.
Sometimes, the goal is more challenging, such as restoring full function to one or more parts of the body.
Rehabilitation experts use many tests to evaluate a person's problems and monitor their recovery.
A full rehabilitation program and treatment plan may be needed to help with medical, physical, social, emotional, and work-related problems, including:
- Therapy for specific medical problems
- Advice about setting up their home to maximize their function and safety
- Help with wheelchairs, splints and other medical equipment
- Help with financial and social issues
Family and caregivers may also need help adjusting to their loved one's condition and knowing where to find resources in the community.
THE REHABILITATION TEAM
Physical medicine and rehabilitation is a team approach. Team members are doctors, other health professionals, the patient, and their family or caregivers.
Physical medicine and rehabilitation doctors receive 4 or more extra years of training in this type of care after they have finished medical school. They are also called physiatrists.
Other types of doctors that may be members of a rehabilitation team include neurologists, orthopedic surgeons, psychiatrists and primary care doctors.
Other health professionals include occupational therapists, physical therapists, speech and language therapists, social workers, vocational counselors, nurses, psychologists, and dietitians (nutritionists).
David AM. Cardiac rehabilitation. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019.chap 123.
Rondinelli RD, Ranavaya MI. Practical aspects of impairment rating and disability determination. In: Cifu DX, ed. Braddom's Physical Medicine and Rehabilitation. 6th ed. Philadelphia, PA: Elsevier; 2021.chap 5.
Last reviewed on: 12/9/2021
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.