Necolle Morgado-Vega, MD, is a physiatrist, which is a doctor who specializes in physical medicine and rehabilitation (PM&R). Physiatrists take the “whole person” into account as they focus on providing nonsurgical solutions for problems with the muscles, joints and nerves. A patient may see a physiatrist as a first step in care or after consulting other specialists.
If Dr. Morgado-Vega could give her patients one piece of advice, it would be this: “Listen to your body.” The doctor, in turn, should take time to listen to what the patient has to say. In medical school, she recalls older, experienced physicians telling students, “Ninety percent of a diagnosis is in the patient history, which involves basically asking patients questions, listening to their answers and processing it.” Dr. Morgado-Vega says, “I think patients have most of the answers, and doctors are there to put that puzzle together and home in on the problem.”
This approach worked well with one patient when it became clear that he wasn’t drinking enough water—dehydration is known to exacerbate musculoskeletal pain. Dr. Morgado-Vega has helped others reduce their pain with such simple solutions as targeted stretches or standing work stations. “You may have something truly organic going on with your back or your shoulder, and we’ll figure that out. But there might be other things that are making it worse than it has to be,” she says.
Dr. Morgado-Vega treats back pain, in addition to problems ranging from arthritis to symptoms that accompany such conditions as multiple sclerosis, spinal cord injuries and traumatic brain injuries. She administers joint and cortisone injections, among other treatments. She often refers patients for physical or occupational therapy, as well as acupuncture and transcutaneous electrical nerve stimulation (TENS), which involves applying electrodes to the skin to administer low-voltage electrical current to relieve pain. When necessary, Dr. Morgado-Vega consults with other types of musculoskeletal, rheumatologic and surgical specialists.
“After an injury, disease, illness, sickness, trauma—whatever the case may be—our goal is to improve their quality of life,” she says.