How do Physiatrists diagnose?

A physiatric diagnostic evaluation starts with a detailed patient history, review of records and determination of a patient’s goals. A comprehensive evaluation then occurs through a functional and physical exam. A physiatrist’s most valuable diagnostic tools are his or her head and hands. They do utilize imaging, modalities and laboratory studies as well. In addition, physiatrists may use special techniques such as electrodiagnostic studies or diagnostic blockades.  Electromyography (EMG), nerve conduction velocities (NCV), and other types of electrodiagnostic evaluations can be performed to determine how and where a nerve is damaged as well as severity. These techniques, along with an exceptionally detailed musculoskeletal and neurological examination, help physiatrists to diagnose and quantitate conditions that cause pain, weakness and numbness like carpal tunnel syndrome, peripheral neuropathy and radiculopathy (“pinched nerves”). This in turn helps to best advise a patient as to the optimal medications, procedures or even surgeries that can help to achieve an optimal outcome. Sometimes an understanding of how much pain is being generated from a nerve structure is needed and can be obtained through a through a diagnostic blockade. Some blockades are for both diagnostic and therapeutic purposes.