From the Research
A patient should be referred to physiatry instead of physical therapy when they have complex rehabilitation needs that require physician-level medical expertise, such as severe or complicated functional limitations, multiple medical comorbidities, or the need for medical diagnosis and management alongside rehabilitation. This is supported by the most recent and highest quality study, which highlights the importance of physiatrists in treating patients with disabilities or physical impairments affecting the musculoskeletal system, brain, and spinal cord 1.
Key Considerations for Referral to Physiatry
- Severe or complicated functional limitations
- Multiple medical comorbidities affecting rehabilitation
- Need for medical diagnosis and management alongside rehabilitation
- Cases of severe traumatic brain injury, spinal cord injury, complex stroke recovery, multiple trauma, complicated pain syndromes requiring medication management, or when interventional procedures like joint injections or spasticity management are needed
Physiatrists can prescribe medications, order diagnostic tests, perform procedures, and coordinate comprehensive rehabilitation plans, while physical therapists focus on direct hands-on treatment and exercise programs 1. Often, the physiatrist will evaluate the patient first and then coordinate a team that includes physical therapists as part of a comprehensive rehabilitation plan. This approach ensures patients receive appropriate medical oversight while also benefiting from specialized therapeutic interventions.
Benefits of Physiatry Referral
- Accurate diagnoses and treatment plans
- Wide range of modalities to treat pain and augment function, such as management of pain medications, osteopathic manipulative therapy, trigger point injections, intra-articular steroid injections, orthobiologic therapy, and interventional spinal procedures
- Emphasis on the use of the least invasive modality before employing more invasive treatments
- Improved quality of life and functional outcomes for patients with complex rehabilitation needs 1.