University Orthopaedic Associates (UOA) is proud to offer interventional physiatry and pain management with Dr. Pavli Demian, Dr. Tony George and Dr. Robert Pannullo. We know you have questions about this service, and we have the answers.

What is Interventional Physiatry?

A physician who specializes in interventional physiatry is almost like an orthopedic surgeon who does not operate. Interventional physiatrists are experts with the musculoskeletal system and its conditions. Interventional physiatry, also known as physical medicine and rehabilitation (PM&R), offers a holistic view of the patient. Interventional physiatrists investigate and treat conditions of the nerves, muscles, tendons, ligaments, bones and cartilage. Many have a special focus on conditions of the spine. The “interventional” part describes the use of various injections for symptom relief.

What is Pain Management?

Pain management is the specialty of evaluating, diagnosing and treating chronic or acute pain. It is generally focused on conservative treatment and minimally-invasive procedures for pain relief. Proper use of medication is an integral part of pain medicine.

What’s the Difference Between Interventional Physiatry and Pain Management?

The two specialties overlap quite a bit but are distinct. Pain management deals with pain of all sorts and all locations, whereas physiatrists are focused on rehabilitation and the musculoskeletal system. Often, both a pain management physician and a physiatrist would be the suitable specialist for a patient’s problem, and other times one or the other may be more suitable. UOA’s Dr. Pannullo has specialized training in both pain management and interventional physiatry, allowing him to cover more ground, treat more patients and be more versatile.

What Kind of Injections Are Used?

Interventional physiatrists use a variety of injections to treat pain and musculoskeletal conditions. These can include:

• Corticosteroids
• Dry needling
• Hyaluronic acid
• Lidocain
• Nerve blocks
• Platelet-rich plasma
• Stem cells

Does a Physiatrist Perform Any Procedure Other Than Injections?

Yes. Physiatrists are trained in a number of diagnostic techniques, including musculoskeletal ultrasound and nerve conduction studies. They can also recommend nonoperative treatment methods such as therapeutic exercise, pain medication and orthotics.

Is Interventional Physiatry Just for the Spine?

No. While many interventional physiatrists focus heavily on the spine, they are equipped to deal with conditions affecting any part of the musculoskeletal system.

What Diagnostic Techniques and Tests Do Interventional Physiatrists Use?

Physiatrists use the following diagnostic methods:

• Electromyelography—to check muscle function
• Musculoskeletal ultrasound—to create an image of a patient’s musculoskeletal system
• Nerve conduction studies—to check for nerve damage

How Do Physiatrists and Orthopedic Surgeons Work Together?

Physiatrists and orthopedic surgeons work very closely together to provide comprehensive treatment. At UOA, Dr. Pannullo will often be a patient’s first stop, especially if that patient has an as-yet undiagnosed source of pain. After evaluating the patient, Dr. Pannullo can decide if a patient can be managed with conservative treatment, or to refer the patient to an appropriate surgical specialty to discuss operative care for his or her condition.

How Do Physiatrists and Physical Therapists Work Together?

Physiatrists are experts in devising a holistic rehabilitation plan, and for many conditions and surgical procedures, physical therapy is an integral part of that plan. Physical therapists conduct and monitor the patient throughout the physical therapy portion of the recovery, while physiatrists keep an eye on the big picture and coordinate any other forms of recovery and rehabilitation a patient may need.

If you are experiencing pain of any kind, request an appointment with our interventional physiatrists. Dr. Demian, Dr. George and Dr. Pannullo can diagnose the source of your pain and recommend a holistic treatment plan that works for you and your circumstances.