What's next for PM&R?

[The JockDoc]

I know that emgs, nerve conduction studies and joint/spinal injections are relatively common procedures in physiatry right now. But what's next? I'd like to know from some of the attendings what new technologies or new procedures are being researched for this field.

For example: Will there be more in the way of the kind of injections are done? Could some of these injections be "interventional", as in aiding tissue repair or growth? Are there any new pieces of diagnostic technology coming out? There isn't any pm&r research being done at my school so im a bit out of the loop.

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[Taus]

Not exactly a brand new thing....but the use of musculoskeletal ultrasound for diagnostic and therapeutic purposes is on the rise

 

[axm397]

lots of stuff...

- stem cell or growth factors for disc regeneration, spinal cord and brain regeneration/reorganization
- MSK/nerve ultrasound and US guided interventions (already being done)
- transcranial magnetic stimulation for stroke and brain injury
- peripheral nerve and brain stimulators (already being done)
- nutritional interventions
- fMRIs - all the applications of that
- "bionic" prosthetic devices (already being done and getting better)
- percutaneous procedures for the spine


just off the top of my head - feel free to add

 

[PMR 4 MSK]

Getting other doctors to recognize that we exist and getting patients to understand what we do.

 

[VoiceofReason]

lots of stuff...

- stem cell or growth factors for disc regeneration, spinal cord and brain regeneration/reorganization
- MSK/nerve ultrasound and US guided interventions (already being done)
- transcranial magnetic stimulation for stroke and brain injury
- peripheral nerve and brain stimulators (already being done)
- nutritional interventions
- fMRIs - all the applications of that
- "bionic" prosthetic devices (already being done and getting better)
- percutaneous procedures for the spine


just off the top of my head - feel free to add

just to be clear, are these procedures being done autonomously by physiatrists or is supervision by a surgeon required?

And along those lines whats to stop other specialties from just doing these procedures without referring to physiatrists? just curious

 

[Disciple]

None of the procedures listed require a surgeon except deep brain/motor cortex stimulation.

 

[Ludicolo]

just to be clear, are these procedures being done autonomously by physiatrists or is supervision by a surgeon required?

And along those lines whats to stop other specialties from just doing these procedures without referring to physiatrists? just curious

As disciple said, most of these are non-invasive/minimally invasive. Well within the scope of a competent, well-trained physiatrist.

Nothing is stopping other fields from doing these procedures. As long as someone knows their limitations, what's the big deal? Surgeons can do percutaneous spine procedures if they choose. Neurologists, neurophysiologists, even psychiatrists can do transcranial magnetic stim. Rheumatologists helped develop MSK ultrasound. Ortho and rehab are looking at new things like platelet rich plasma injections for MSK problems. Our scope overlaps with many fields - ortho, neuro, anesthesia, etc. Turf battles are tiring. It doesn't matter which field is better at a given procedure. What matters is the individual performing it.