The human body is comprised of several complex systems, some well-understood and others still mysterious. All of them have to work, and interact properly, to achieve optimal health. That's why physicians in various disciplines, from family doctors to the most unusual specialists, interact in surprising ways. Physiatrists and neurologists provide a striking example of that interaction. Despite the differences in their areas of practice, the two specialties have several things in common.
Neurologists treat most diseases or conditions related to your nervous system. That includes your brain, your central nervous system and the nerves in your hands, feet or other areas. Neurologists also treat the blood vessels in your brain, where a swollen or burst vein can be debilitating or fatal. Strokes, chronic headaches, epilepsy, and problems with perception and reasoning are all part of a neurologist's practice. Neurologists refer patients to a neurological surgeon to correct some conditions, such as weakened blood vessels, that don't lend themselves to medical treatment. Some neurologists -- called interventional neurologists -- perform similar procedures by inserting miniature instruments through a tube in the patient's vein.
Physiatrists are also trained physicians, but their focus is very different from a neurologist's. Physiatrists are doctors of physical medicine, and their focus is on proper physical mobility and agility. They work with patients whose physical health has been affected by disease, injury or chronic medical conditions, and help them restore or maintain their strength and range of motion as much as possible. Physiatrists often collaborate with other physicians, helping their patients recover from treatments or illnesses. Once the physiatrist has created a plan of treatment, a physical therapist often takes over the day-to-day program of therapy.
Compare and Contrast
On the surface, it would seem that neurology and physiatry couldn't be more different. One focuses on the brain and nerves, the other on muscles and joints. Yet there are some key areas of overlap. Both neurologists and physiatrists may specialize in pain management, which can have physical or neurological causes. Some physiatrists specialize in treating victims of spinal cord injuries, which is also part of a neurologist's scope of practice. Neurologists also treat many neuromuscular conditions, such as multiple sclerosis or Parkinson's disease, that are caused by the nervous system but cause physical disabilities. A physiatrist might coordinate the same patient's physical therapy.
Up to a point, neurologists and physiatrists are trained similarly. Like other doctors, they begin their careers with a premedical undergraduate degree, then move on to medical school. Medical school takes another four years, usually divided into two years of classroom and laboratory instruction, then two years in clinical rotations. Students who've already decided on a specialty can take suitable electives, or additional clinical time in their chosen field. After graduation, future physiatrists or neurologists spend one year in a general internship and then three in an approved residency program. Additional training fellowships are available for doctors in either field, if they want to specialize further.
- Washington University School of Medicine in St. Louis: Neurology
- Washington University School of Medicine in St. Louis: Physical Medicine
- American Academy of Neurology: Working With Your Doctor
- American Academy of Physical Medicine and Rehabilitation: What Does a Physiatrist Do?
- American Academy of Physical Medicine and Rehabilitation: What Diseases Does a Physiatrist Treat?
Fred Decker is a trained chef and certified food-safety trainer. Decker wrote for the Saint John, New Brunswick Telegraph-Journal, and has been published in Canada's Hospitality and Foodservice magazine. He's held positions selling computers, insurance and mutual funds, and was educated at Memorial University of Newfoundland and the Northern Alberta Institute of Technology.