Dr. Isaac, Medical Director of the Comprehensive Spine Care Center at Brigham and Women’s Hospital, specializes in the treatment of spine disorders. He is board certified in Internal Medicine, Physical Medicine and Rehabilitation, and Pain Medicine. He graduated from Thomas Jefferson Medical College; completed a combined residency program in Internal Medicine and Physical Medicine and Rehabilitation at Albert Einstein Medical Center and Temple University Hospital and a Spine Fellowship at the University of Pennsylvania.
He specializes in the non-operative management of spine disorders. His treatment focus is on education of the patient regarding their diagnosis, exercise therapy, medications, and minimally invasive injections for the treatment of pain and restoration of function.
Our physiatrists (also known as physical medicine and rehabilitation physicians) specialize in non-surgical care for conditions, particularly neuromuscular disorders, that cause pain and impair normal function. Along with their standard medical training, many physiatrists also pursue additional training in one or more of the following subspecialties: musculoskeletal rehabilitation, pediatrics, spinal cord injury, sports medicine, traumatic brain injury, and pain medicine.
Why Should I See a Physiatrist?
Physiatrists not only have a keen understanding of how the body works and the medical issues at play, but also understand how these medical issues can affect a patient’s mobility, mood, and quality of life. Through their breadth of training, physiatrists aim to rehabilitate the whole person, addressing their physical, emotional, medical, and vocational needs.
Diagnosing Spine Disorders
Along with developing a detailed medical history, and performing standard diagnostic procedures, physiatrists at our Spine Center have particular expertise in using electrodiagnosis. This diagnostic technique, which includes electromyography (EMG) and nerve conduction study, detects areas of nerve and muscle damage by measuring electrical activity in specific areas of the body. EMG helps detect neuromuscular abnormalities by measuring electrical activity in the muscles. A nerve conduction study helps to differentiate a nerve disorder from a muscle disorder.
To develop a complete diagnosis, the spine physiatrist also will evaluate whether a patient has other musculoskeletal and neurological conditions and how that may be contributing to the patient’s primary condition.
Treating Spine Disorders
A physiatrist’s treatment focuses on thoroughly educating patients about their diagnosis and coordinating a multidisciplinary approach to non-operative (conservative) musculoskeletal care. Treatment – focused on restoring function, reducing pain, and improving quality of life – may include one or more of the following:
Explain benefits and role of exercise therapy, and instruct patients about proper exercise techniques and regimen guidelines.
Establish a physical therapy regimen.
Counsel patients about ways to improve their overall health, such as smoking cessation and weight management.
Prescribe and manage a medication regimen, with a focus on non-opiate therapies.
Administer minimally invasive injections to the spine and peripheral joints – using ultrasound guidance – to treat pain and restore function. (These injections also can be used as a diagnostic tool, helping to pinpoint pain sources.)
Refer to psychosocial support.
Refer to alternative therapies, such as medical acupuncture.
In the vast majority of cases, a physiatrist can effectively manage a patient’s spine condition. However, when non-operative measures fail to effectively treat pain and restore function, our physiatrists can refer patients to one of our spine surgeons for further evaluation.