The road to recovery from a stroke, brain injury or orthopedic injury can be difficult to navigate — and it’s different for everyone. The goal of physiatry, or physical medicine and rehabilitation (PM&R), is to guide you through recovery and help restore function so you can live your best life.



Joseph Elias, M.D., PM&R specialist with Houston Methodist Physical Medicine & Rehabilitation Associates at Sugar Land, focuses on diagnosing and treating disability related to musculoskeletal and neurological disorders. Patients may be referred to a PM&R specialist for spine pain, joint pain, stroke, spinal cord injury, brain injury, cerebral palsy and other conditions.


PM&R doctors, also called physiatrists, help restore function and get you back to your activities at work and home. “We use nonsurgical treatments and therapies to help reduce pain, improve mobility, increase range of motion, and regain strength in your daily life,” Elias explained.



A physical exam is one of the most important tools in physiatry, and in some cases, imaging, such as an X-ray or MRI, may also be needed. “When a nerve injury is suspected, we may perform an EMG/NCS (electromyogram/nerve conduction study) test to confirm where the nerve injury is and how severe it is,” Elias added.


It’s important to understand the underlying causes of symptoms so they can be addressed by your physiatrist and other specialists. Depending on your situation, you may see other specialists in interventional spine management, neurology, orthopedic surgery or neurosurgery. “Communication with all doctors, therapists and team members involved in your care is the key to success,” Elias said.



Your physiatrist can create a treatment plan that addresses your unique concerns. “Sometimes you may be hurting so badly that you need some acute pain relief before you can tolerate physical therapy (PT) or occupational therapy (OT). In cases like this, we may prescribe nonnarcotic oral or topical medications or perform an injection, such as a steroid injection or a trigger point injection, before starting therapy,” Elias added.


PM&R provides a range of treatments that promote rehabilitation and recovery, including:


Electromyography/nerve conduction studies (EMG/NCS)


Neurological injuries

  • Cerebral palsy
  • Multiple sclerosis
  • Spinal cord injury
  • Stroke and brain injury


Spasticity management

  • Botulinum toxin (Botox®) injections


Spine and musculoskeletal injuries

  • Back and neck
  • Carpal tunnel syndrome
  • Shoulder, hip and knee


Ultrasound-guided peripheral joint injections



Sometimes the most meaningful progress is measured by performing everyday tasks. “For example, your goal might be having the ability to reach into your upper cabinets after a shoulder injury or being able to pick up your grandchild after a back injury. If you’ve had a stroke or other neurological injury, your goal might be to cook a meal for yourself or return to work in a wheelchair,” Elias said.


Experiencing a musculoskeletal or neurological injury can be life changing. “After getting home from the hospital, you may need extra support to help you get back to real life. Having access to PM&R on an outpatient basis provides a link to the care you need to improve function and access equipment to help with mobility and everyday tasks,” Elias said.