What a Physiatrist Does, and Why PM&R; Matters forChronic Pain and Mobility

Juliet Gaisey, MD

Board-Certified Physical Medicine & Rehabilitation Physician

In clinical practice, many patients with chronic pain continue to struggle despite seeing

multiple specialists. While pain is often the presenting complaint, the true issue for many patients is declining mobility, loss of independence, and reduced participation in daily activities. This is where Physical Medicine & Rehabilitation (PM&R;) plays a distinct and essential role.

What Is a Physiatrist?

A physiatrist is a physician trained to diagnose and manage conditions affecting movement, function, and quality of life. PM&R; focuses on restoring physical function rather than treating a single organ system or relying solely on surgical or procedural solutions.

How PM&R; Differs From Other Specialties

Orthopedic surgery focuses on structural pathology and surgical intervention. Pain

management often emphasizes symptom control through medications or procedures.

Physiatry bridges these approaches by prioritizing functional outcomes, how a patient

moves, performs daily tasks, and maintains independence.

Chronic Pain Is a Functional Problem

Chronic pain is closely linked to deconditioning, gait abnormalities, balance impairment, and fear of movement. Imaging findings frequently correlate poorly with pain severity, while functional limitations are stronger predictors of disability.

What Physiatrists Treat

Physiatrists commonly manage chronic spine pain, osteoarthritis, post-injury recovery,

neuropathic pain, balance disorders, obesity-related musculoskeletal pain, and functional decline in aging or medically complex patients.

The PM&R; Treatment Approach

Care typically includes comprehensive functional assessment, coordination with therapy

services, biomechanical evaluation, judicious use of medications or injections, weight and metabolic considerations, and home- or community-based care when appropriate.

Why PM&R; Matters in Value-Based Care

By emphasizing function, PM&R; helps reduce unnecessary procedures, prevent falls,

support independence, and improve long-term outcomes, key goals in value-based

healthcare models.