-- Question: My name is Cindy, and I've had back pain for 12 years. I get frequent muscle spasms from the pain. I'd like to go to a specialist to give me a program to strengthen my back muscles, but I don't know the difference between a physiatrist, a physical therapist, and a trainer. Who do you recommend I go to, and what qualifications should they have so I can be sure that I'm not going to hurt myself following their recommendations?
Answer: Hi, Cindy. This is an important issue because we're all confused about who to see for what problem.
A physiatrist is a physician who specializes in physical medicine and rehabilitation. They have the most extensive training in these types of problems -- rehabilitation for chronic pain syndromes and other structural difficulties like amputations, stroke, spinal cord injuries.
A physical therapist has gone through a very specific training program -- understanding body mechanics, the different functions of the body, how the muscles, joints, ligaments all come together to help us do what we need to do at a physical level.
And a trainer can have a variety of credentials or experiences dealing with physical fitness, long-distance training, and also addressing some of the problems that patients with chronic pain experience.
When it comes to selecting the right person, it's important to have first a diagnosis of what the problem is. That, most likely, is going to be delivered by a physician who specializes in your problem. At that point, your physician can help figure out who else should be involved to carry out the treatment plan. It may be a trainer, might be a physical therapist, or it might be the physician themself.
The important thing is to know the credentials of the person that you're seeing, understand their experience or expertise in working with these types of problems that you have, and then asking them to explain the treatment that they're proposing. If they cannot give it to you in a simple, coherent rationale, then you should be wary, and think about going to someone else who might be able to give you a treatment that is better for you.