Physical Medicine and Rehabilitation

For the vast majority of patients, surgery or other treatments are only the beginning of the healing process. Rehabilitation is a critical component in achieving the best possible outcome. To that end, Florida Orthopaedic Institute provides physical medicine and rehabilitation services as part of a comprehensive continuum of care.

The goal of physical medicine and rehabilitation (also known as physiatry or rehabilitation medicine) is to enhance and restore functional ability and quality of life. That said, it is beneficial to those with physical impairments or disabilities affecting the brain, bones, joints, ligaments, muscles, nerves, spinal cord, and tendons.

Physicians who have completed training in this field are referred to as physiatrists. Rather than focus on a medical “cure,” a physiatrist maximizes patients’ independence in activities of daily living and improves their quality of life.

Physiatrists at Florida Orthopaedic are specialists in designing widespread, patient-centered treatment plans. That said, they use cutting-edge as well as time-tested treatments to maximize function and quality of life for patients, who can range in age from infants to seniors. They are integral members of a care team to help patients achieve not only a functional life but to have a quality of life never thought possible.

Regardless of your condition, our health care professionals are with you every step of the way, designing a plan specifically suited to your needs. Our services extend from postsurgical and joint replacement cases to children and adults with spinal cord injuries, head trauma, strokes, multiple sclerosis, cerebral palsy, chronic pain, and amputation. We also offer a wide range of neuromuscular testing.

Pain Management

Florida Orthopaedic Institute’s pain management program is specifically designed to help patients improve function and mobility. Our doctors use a customized treatment plan that addresses the often debilitating effects of chronic pain disorders and that focuses on a multidisciplinary approach to improving your health.

Our board-certified physicians are fellowship trained in electromyography and in the treatment of neuromuscular diseases, with more than 16 years of combined experience. We offer non-operative management of acute and chronic disorders as well as musculoskeletal disorders.

Our physicians also assist patients with work-related injuries, pain management, rehabilitation, evaluation and prescription for therapeutic exercise, orthotics and prosthetics. We also offer interventional pain management via spine, joint and soft tissue injections.

Accredited By The AANEM

Florida Orthopaedic Institute is one of the few facilities in the country accredited by the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). (The AANEM is the only EMG accrediting association in the country.)

The AANEM’s Electrodiagnostic (EDX) Laboratory Accreditation Program recognizes facilities for achieving and maintaining the highest level of quality, performance, and integrity based on professional standards, and is structured to assess, evaluate, and improve patient care. It is the recognized standard for EDX medicine.

The AANEM EDX Accreditation:

• Establishes clinical excellence in EDX medicine.
• Proves a facility’s commitment to providing the highest quality healthcare and a safe environment for patients.
• Provides patients with a credible measure to differentiate the quality of care.

As an accredited facility, Florida Orthopaedic is a center for excellence for EMG testing, helping improve the lives and quality of care of patients with neuromuscular diseases.

Frequently Asked Questions

What is Neuromuscular Medicine?

Neuromuscular medicine has to do with disorders of the peripheral nervous system (PNS) and its connections with the central nervous system. The peripheral nervous system includes the motor and sensory neurons, neuromuscular junctions, peripheral nerves, and muscles. Additionally, care includes physical examination, clinical investigation, diagnosis, management, and counseling. Neuromuscular-trained physicians have knowledge beyond that expected of a general neurologist or physical medicine and rehabilitation physician.

What is Electrodiagnostic Medicine?

Electrodiagnostic medicine is medical sub-specialty and part of neuromuscular medicine. Specially-trained physicians use information from a patient’s history and physical exam, along with test results that analyze electrical impulses between muscles and nerves. These inputs help diagnose, test, and treat neuromuscular, musculoskeletal, and nervous system disorders.

What kind of medical training do doctors who perform EMGs have?

Doctors who perform EMGs go to 4 years of medical school then have 3 or 4 more years of training in a residency program, plus fellowship training. Within this specialized training, it helps the doctor decide which tests to perform based on your symptoms. That said, nerve conduction studies can be performed by trained technologists under a doctor’s supervision.

Why am I being sent to the EMG Lab for tests?

If you have numbness, tingling, pain, weakness, or muscle cramping, our physician will examine you to decide which tests to do. To diagnose your symptoms, these tests may include nerve conduction studies, needle EMGs, and evoked potentials.

What is a Nerve Conduction Study (NCS)?

By applying small electrical shocks to the nerve and recording how the nerve works, Nerve Conduction Studies (NCS) show how well the body’s electrical signals are traveling to a nerve. These small shocks produce a quick, mild, tingling feeling. During the study, your doctor may test several nerves.

What happens during a needle EMG?

For this test, a small, thin needle is inserted into several muscles to see if there are any problems. During the EMG test, your doctor can hear and see how your muscles and nerves are working by the electrical signals made by your muscles, and then uses their medical knowledge to figure out what could be causing the problem. There may be a small amount of pain during the examination, with your doctor only testing the muscles necessary to decide what is wrong.

What is an Evoked Potential test?

These are painless tests that check the nerve pathways through the spinal cord or from the eyes and ears. The signals for these tests can come from small electrical shocks, light pulses, or clicks of sound in the ears, with nerve responses recorded over the scalp and other areas of skin.

How long will these tests take?

Most tests usually last 20 to 90 minutes. You can do any of your normal activities, like eating, driving, and exercising, before the tests. When you go for your test, tell your doctor if you are taking aspirin, blood thinners (like Coumadin®), have a pacemaker, or have hemophilia. Take a bath or shower to remove oil from your skin. Do not use body lotion on the day of the test. If you have myasthenia gravis, ask your EMG doctor if you should take any medications before the test.

There are no lasting side effects, so you also resume your normal activities afterward.

Depending on your symptoms, your physician may recommend more tests such as neuromuscular ultrasound, biopsies, or genetic testing.

OPIOID ALTERNATIVE TREATMENTS

Each year, millions of prescriptions are written for opioids. But these powerful drugs have serious side effects and can lead to addiction.

There are many non-opioid treatments available for pain, including prescription and over-the-counter medicines, as well as non-drug remedies.