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Doctors and pharmacists

Rehabilitation physician

A doctor who specialises in function rather than diagnosis, and who often owns the problems that fall between other specialists.

A rehabilitation physician works on what you can do and what is making that harder. Stiffness, spasticity, pain, positioning, equipment prescription and sometimes botulinum toxin for saliva or spasticity. Not every system routes ALS/MND care through one, but where they exist they are frequently the doctor who takes on symptoms nobody else has claimed.

How you reach this person, and who pays, depends on where you live. Set your country in Location and Compass will show what applies there.

What they can help with

  • Stiffness and spasticity, including medication and injections
  • Pain that comes from posture, positioning or immobility rather than from nerves
  • Prescribing and signing off complex equipment in some systems
  • Coordinating therapy goals across physiotherapy and occupational therapy
  • Botulinum toxin for saliva or for focal spasticity, where that is offered

When you might meet them

  • When stiffness or cramps are not controlled by what you have already tried
  • When pain has become a daily issue
  • When several therapists are involved and nobody is joining it up
  • When complex seating or equipment needs medical sign-off

Things you could ask about

  • Is this pain something we can treat, or something we manage?
  • What are the options for stiffness beyond what I am already taking?
  • Are you the person who signs off my equipment, or is that someone else?

About this entry

Not everyone meets all of these people, and nobody here is compulsory. Who does a particular job differs between countries and between services, so treat this as a way to understand who is who rather than a description of the team you should have.

Based on NICE MND guideline, MND Association muscle weakness and pain.