Roger Kasendorf, DO : How Board-Certified Physiatrists Manage Pain From Diagnosis to Relief

Pain can affect nearly every part of daily life, from work and sleep to mobility, exercise, and emotional well-being. While many people associate pain treatment with medication or surgery, comprehensive pain management can involve a much broader approach. Board-certified physiatrists, also known as physical medicine and rehabilitation physicians, specialize in diagnosing and treating conditions that affect movement, function, and quality of life. Their goal is often to identify the underlying cause of pain and develop an individualized treatment plan that supports long-term improvement.

Physiatrists take a whole-person approach to pain management, considering how an injury, medical condition, lifestyle, physical limitations, and daily activities may contribute to symptoms. Depending on the diagnosis, treatment may include rehabilitation, therapeutic exercise, medications, lifestyle changes, behavioral strategies, or carefully selected procedures. This comprehensive approach can help patients work toward better function and meaningful pain relief while minimizing unnecessary interventions.

Understanding the Cause of Pain

The first step in effective pain management is determining what is causing the pain. A board-certified physiatrist reviews the patient's medical history, symptoms, previous treatments, and physical abilities. The physician may evaluate posture, strength, flexibility, range of motion, balance, gait, and neurological function to identify factors contributing to the patient's discomfort.

When appropriate, diagnostic imaging or other tests may be used to provide additional information. The purpose is not simply to identify an abnormality on a scan but to determine whether that finding actually explains the patient's symptoms. A careful diagnosis helps the physiatrist create a treatment plan that addresses the underlying problem rather than focusing only on pain symptoms.

Creating an Individualized Treatment Plan

Pain can affect people differently, even when they have similar diagnoses. For this reason, physiatrists typically develop treatment plans based on the patient's specific condition, goals, lifestyle, and functional needs. A person recovering from a sports injury may have very different rehabilitation goals from someone dealing with long-term back or neck pain.

An individualized plan may combine several treatments instead of relying on one solution. The physiatrist may coordinate rehabilitation, medication management, exercise, education, and other interventions according to the patient's progress. Treatment can also be adjusted over time as symptoms and functional abilities change.

Using Physical Rehabilitation and Therapeutic Exercise

Physical rehabilitation is an important component of many pain management programs. Carefully selected exercises can help improve strength, flexibility, balance, endurance, and movement patterns. A rehabilitation program may also help patients return to activities they previously avoided because of pain or limited mobility.

Physiatrists may work closely with physical therapists and other rehabilitation professionals to establish appropriate goals and exercises. The program generally progresses according to the patient's condition and response to treatment. Learning proper movement techniques and building physical capacity can be particularly valuable for people experiencing recurring musculoskeletal pain.

Considering Medications and Non-Surgical Treatments

Medication may be one part of a comprehensive pain management strategy, but it is not necessarily the only component. Depending on the diagnosis and individual circumstances, a physiatrist may consider different medication options while weighing potential benefits, side effects, interactions, and long-term considerations.

Non-surgical treatments can also play an important role. Depending on the condition, these may include therapeutic exercise, activity modification, physical therapy, heat or cold therapy, and selected interventional procedures. When procedures are appropriate, a physiatrist may use them as part of a broader treatment strategy rather than treating them as a standalone solution.

Addressing Chronic Pain With a Multidisciplinary Approach

Chronic pain can be complex because physical symptoms may interact with sleep, stress, activity levels, mood, work demands, and other aspects of daily life. A comprehensive approach recognizes that successful pain management may require attention to more than the painful body part itself.

Physiatrists may collaborate with physical therapists, occupational therapists, psychologists, other physicians, and additional healthcare professionals when appropriate. This multidisciplinary approach can help address different factors that influence pain and function. Patient education is also important because understanding a condition and learning practical self-management strategies can help people participate more actively in their recovery.

Monitoring Progress and Adjusting Treatment

Pain management is often an ongoing process rather than a single treatment or appointment. Board-certified physiatrists can monitor changes in pain, mobility, strength, activity tolerance, and overall function to determine whether a treatment plan is producing meaningful results. Patient feedback is an important part of this process because improvements in daily function may be just as significant as changes in pain intensity.

If progress is limited, the treatment strategy can be reassessed and modified. The physiatrist may revisit the diagnosis, adjust rehabilitation goals, consider another treatment option, or coordinate additional evaluation when necessary. This flexible approach allows treatment to evolve with the patient's needs and keeps the focus on improving function and quality of life.

Conclusion

Board-certified physiatrists use a comprehensive approach to pain management that goes beyond simply treating symptoms. By combining careful diagnosis, individualized treatment planning, rehabilitation, appropriate medications, non-surgical interventions, education, and ongoing monitoring, they can help patients address pain while working toward improved movement and function.

Every pain condition is different, and the most appropriate treatment depends on the individual's diagnosis, medical history, symptoms, and goals. If pain is interfering with everyday activities or continuing despite previous treatment, discussing the problem with a qualified healthcare professional may be an important step toward finding an appropriate management strategy.