Center for Musculoskeletal Care expands non-surgical treatment options with physiatrists

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Vivian Shih, MD, is one of the physiatrists at the Center for Musculoskeletal Care. Physiatrists provide holistic care focused on non-surgical treatments for a wide variety of musculoskeletal and neuromuscular conditions.


Your knee has been hurting for months, but you don’t want to see a doctor because you’re afraid you’ll be told you need surgery.

Yet many people with bone, joint, muscle and nerve problems can get better without surgery, which is why physiatrists are central to the patient care model at Yale New Haven Health’s Center for Musculoskeletal Care (CMC).

Physiatrists are physicians who specialize in physical medicine and rehabilitation. They complete advanced training in the prevention, diagnosis and management of musculoskeletal and neuromuscular conditions, including arthritis, tendinitis, muscle sprains, back and neck pain, and balance and walking problems. They prescribe non-surgical treatments such as medications, injections of the joints/soft tissues and spine, physical therapy and adaptive equipment such as braces or orthotics.

“Physiatrists use a holistic approach, treating the whole person versus focusing on a specific problem area on the body,” said CMC physiatrist Vivian Shih, MD. “An injury or chronic condition can affect more than the ability to move. It can affect how people function at work and home, how they feel emotionally and other aspects of their lives.”

Dr. Shih is one of several Yale Medicine physiatrists, who may be the first physicians new CMC patients see if they are experiencing symptoms such as joint or back pain, weakness, numbness or frequent headaches. The physiatrist performs a detailed medical assessment and diagnostic testing and consults with other Yale Medicine specialists in neurology, rheumatology or orthopedics to determine the care plan for each patient. CMC’s multidisciplinary team may also include physical, occupational and speech therapists, nutritionists and social workers.

At CMC, practical, non-surgical treatment options will always be offered first. Physiatrists are skilled in innovative treatments such as image-guided joint and spine injections and platelet-rich plasma therapy that uses a patient’s own blood platelets to speed healing. These procedures are easily performed in the office setting. When needed, physiatrists facilitate a quick referral for specialized treatment or surgery. The physiatrist remains part of the team, overseeing pre- and post-surgical rehabilitation.

The CMC has several locations, all offering diagnostic imaging and rehabilitation. A new musculoskeletal ambulatory surgery center is scheduled to open at YNHH’s Saint Raphael Campus in early 2018.

“We are building a multi-site Center for Musculoskeletal Care in convenient locations, offering advanced diagnostic, treatment and rehabilitation options provided by specialists who are experts in their fields,” said Mary I. O’Connor, MD, director, CMC at Yale School of Medicine and YNHH. “Yale New Haven Health and Yale School of Medicine share a vision to reshape musculoskeletal medicine through advanced research, innovative therapies and a holistic approach to patient care. We focus on helping patients get better without an operation, but if they need surgery, we have expert surgeons. It all comes down to helping people achieve optimal bone, joint and muscle health so they’re able to live their lives to the fullest.”