Clinical Specialties : Musculoskeletal



Refers to more than 100 different diseases that cause pain, swelling, and limited movement in joints and connective tissues throughout the body. Arthritis is usually chronic and progressive, meaning that it may last a lifetime. Although the specific etiology of various forms of arthritis are still not well understood, a physiatrist can develop an individualized comprehensive medical rehabilitation plan that can help manage any form of arthritis. How the disease progresses also varies depending on the form of arthritis, and the success of the recommended treatment program. The two most prevalent forms of arthritis are:

Osteoarthritis (OA) – In this condition, the arthritis is the degenerative form of joint disease where the cartilage slowly and progressively deteriorates; and may even disappear altogether. Since cartilage is the substance that covers and protects the end of the bones providing a cushioned support, the loss of cartilage thickness in OA leads to pain and loss of movement as bone begins to rub against bone.

Rheumatoid arthritis (RA) – In this type of arthritis, the joint disease is inflammatory and the disease is systemic – i.e. affecting nearly all of the joints and many other organs throughout the body. RA is characterized by the inflammation of membrane lining the joints, which causes pain, warmth, redness, and swelling. The chronic inflammation causes deterioration of the joint that results in chronic pain, swelling, limited movement, and deformity.

Low back pain

Is the most common form of physical disability. An estimated 90 percent of all Americans will suffer from back pain at some point in their lives. Despite recent advances in diagnosis and treatment, low back pain remains the second leading cause of work absenteeism. Studies show that early aggressive treatment of back injuries results in quicker recovery and fewer lost work days. Treatment by physiatrists centers on various combinations of exercises individualized to each particular patient based on their diagnosed problem. Additionally, medical rehabilitation of low back pain may include various medications, and minimally invasive injections or other procedures, and a treatment focus on improving and maximizing function and quality of life as much as relieving pain. Our physiatrists are fellowship trained in treating back problems and aim for a rapid return to life and work for all of our patients.

Neck pain

Treatment for any neck injury is recommended as soon as possible to minimize the danger of further aggravation and chronic pain. There are very broad and general approaches to the treatment of neck pain, but with proper diagnosis, a more problem focused treatment can be initiated. Our physiatrists are expert in developing an individual treatment plan for you that maximizes function and quality of life while striving to minimize the pain. Multiple medical rehabilitative treatment options exist and tailoring treatment to your individual diagnosis and needs allows you to achieve the best outcome possible.

Sports injuries

Sports related injuries usually come in two forms, acute trauma and repetitive overuse injuries. Acute trauma such as strains, sprains, fractures, and dislocations most often occur as the result of a sudden injury on the field of play. Although initial treatment may require a period of rest or even surgery, eventually each injured athlete will require some amount of rehabilitation to return to the desired level of athletic achievement. Physiatrists can help assist in the acute management of most soft tissue trauma and are expert in designing and monitoring the rehabilitation program after the injury has healed. Inadequate rehabilitation is the most common reason injuries re-occur.

Physiatrists are particularly expert in the diagnosis and treatment of repetitive overuse injuries in sports. From tennis elbow, to runner’s knee, to rotator cuff tendonitis, to many other conditions that have a more insidious onset, the physiatrist is trained to recognize the diagnosis, and treat the injury with a variety of non-surgical, medical and rehabilitative options including possible therapies, medications and/or injections that will return most athletes to full function without resorting to surgery. Of course, if surgery is necessary, your physiatrist can recognize that and works in tandem with surgical specialists in the sports medicine field who will assist where necessary. The overall goal is to return each one of our patients to their sport, their job, or their chosen activity at the highest level of function and without risking re-injury.

In addition to treating the primary problem, physiatrists are trained to assess and treat the whole body in the injured athlete and therefore address the biomechanical issues that caused the injury to begin with. By restoring normal flexibility and muscle function and balance, optimal athletic performance can be achieved in addition to restoring the injured body part. Our physiatrists will develop a personal plan to get you back in the game as soon as possible.

From low back pain and herniated discs to carpal tunnel syndrome and tendonitis, physiatrists seek to not only reduce and eliminate chronic pain, but also to prevent its recurrence and assist their patients to achieve optimal function.

Laura Y. Huang, MD
Assistant Professor

Robert W. Irwin, MD
Professor and Interim Chair

Lauren T. Shapiro, MD, MPH
Assistant Professor

Andrew L. Sherman, MD
Professor and Vice Chair

Adriana D. Valbuena-Valecillos, MD
Assistant Professor