Physical Medicine and Rehabilitation
Physical medicine and rehabilitation (PM&R), or physiatry, is a branch of medicine dealing with functional restoration of a person affected by physical disability. A physician who has completed training in this field is referred to as a physiatrist [fɪz’aiətrɪst]. In order to be a physiatrist in the United States, one must complete four years of medical school, one year of internship and three years of residency. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients).
Physical medicine and rehabilitation involves the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement & activities modification, adaptive equipments and assistive device, orthotics (braces), prosthesis, and experiential training approaches.
Advanced Integrative Rehabilitation Medicine
Integrative Rehabilitation Medicine is a newly developed field that combines both Integrative Medicine and Rehabilitation Medicine. Dr. Sniezek is a pioneer in this field and has over 30 years experience combining traditional and complementary methods, such as Medical Acupuncture, Osteopathy and Chiropractic methods.
Physical Medicine & Rehabilitation physicians may also perform Electrodiagnostics which are used to provide nervous system functional information for diagnose and / or prognosis for various neuromuscular disorders. The common electrodiagnostic test performed by physiatrist are nerve conduction velocity study (NCV) and needle electromyography (EMG). Nerve conduction velocity study involves electrical stimulation to peripheral nerves and the nerves’ responses are measured such as onset latency, amplitude and conduction velocity. Needle electromyography requires needle electrode insertion into the examined muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials such as fibrillation potential or positive sharp wave detected by EMG needle indicates the presence of muscle fibers that lost the nerve supply.
Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskletal pain syndromes such as low back pain, fibromyalgia and traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through multidisciplinary approach involving psychologists, physical therapists, occupational therapists, and interventional procedures when indicated. In addition to the previous methodology, stroke is often treated with the help of a speech therapist and recreational therapist when possible.
In many cases, a primary interest of the Rehabilitation Specialist is the ability of a person to function optimally within the limitations placed upon them by a disease process for which there may be no known cure. The emphasis is on optimization of function and the quality of life for those who may not be able to achieve full restoration. A team approach to chronic conditions is emphasized, using transdisciplinary team meetings to coordinate care of the patients.
Dr. Sniezek completed his training in Physical Medicine and Rehabilitation at the George Washington University Medical Center in Washington, DC.