Being a dancer and a medical doctor, her interest in physiatry started with her desire to treat performing artists and athletes, as she can talk their language and understand their psychological makeup and their drive to return to their sports or profession, despite pain and injuries. After completing a four year PM&R residency program at the University of Illinois Hospital in Chicago, she pursued Musculoskeletal and Performing Arts Medicine fellowship program at University of Texas-Houston, under the mentorship of the internationally known physiatrist, dancer and musician, Dr. Rebecca Clearman. With her, she learned the importance of having a holistic approach in the treatment of physical injuries.
Since completion of fellowship, she worked in several group practices. As an associate at Gulf States Rehabilitation, Inc, in New Orleans, she continued to grow in her skills, working closely with several physiatrists, doing inpatient and outpatient rehab and caring for very complex cases in spinal cord, brain injury, post strokes and other neurological and musculoskeletal conditions, including workers’ compensation and motor vehicle injuries.
At Hawaii Orthopedics, Inc in Hilo, she worked closely with orthopedic surgeons, spine surgeons, podiatrists and physical therapy on site, appreciating their different perspectives and exchanging ideas for treatments of chronic pain and musculoskeletal and neurological injuries.
In 2002, Dr. Smigel opened her own private practice in Hilo, and in 2007 she opened her practice in Honolulu. She founded the Hawaii Center for Regenerative Medicine in 2016. Dr. Smigel has a special interest in nonsurgical approaches in the treatment of musculoskeletal injuries and chronic pain. She incorporates traditional medical intervention, evaluating and correcting improper biomechanics with physical therapy, manual therapy, community based exercises such as Pilates and Yoga, prescribing appropriate oral analgesic pain medications, mainstream interventional pain procedures, now cutting edge regenerative procedures, such as prolotherapy, platelet rich plasma, adipose stem cell , perineural injection treatment and prolozone for treating chronic pain. She is trained in both fluoroscopic guided and ultrasound diagnostic and needle guidance for musculoskeletal and nerve hydro dissection. She is the principal investigator and author of three published papers in relation to Dextrose Caudal Epidural. These papers are the first of its kind to show evidence that dextrose is analgesic. She has been invited to address conferences around the world regarding these studies.
Dr. Smigel is an expert in diagnosing neurological conditions with nerve conduction velocity studies and electromyelogram.
She volunteers her time for several medical missions to the Philippines, Honduras and Mexico, and has served as a prolotherapy instructor with the Hackett-Hemwall Patterson Foundation (HHPF) since 2003. She is a Fellow of the American Academy of Physical Medicine and Rehabilitation, the Physiatric Association of Spine, Sports and Occupational Rehabilitation, the American Academy of Orthopedic Medicine and of the American Academy of Electrodiagnostic and Neuromuscular Medicine.