FAQ

Rheumatology

A rheumatologist is a doctor that specializes in the diagnosis and treatment of arthritis, musculoskeletal conditions, and other autoimmune diseases.

Rheumatologists complete nearly 10 years of schooling to specialize in rheumatic diseases and autoimmune disorders. Some conditions a rheumatologist may diagnose or treat include:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Psoriatic arthritis
  • Sjögren’s disease
  • Tendonitis
  • Osteoporosis
  • Fibromyalgia
  • Lupus
  • Scleroderma
  • Gout
  • Polymyositis
  • Vasculitis

Autoimmune disorders occur when your body’s immune system mistakenly attacks healthy tissue. The cause of these conditions is unknown, but they are commonly passed through genetics. As your immune system attacks healthy tissue in the body, it causes inflammation in the affected area (usually the joints). Common autoimmune disorders include:

  • Rheumatoid arthritis
  • Psoriasis/ psoriatic arthritis
  • Lupus
  • Sjögren’s disease
  • Multiple sclerosis (MS)
  • Type 1 diabetes

Each of these conditions affects different areas of the body and results in diverse symptoms. Most autoimmune diseases cause physical pain, inflammation, fatigue, and swelling in the affected area. Many of these conditions are chronic, meaning that they persist throughout a lifetime. There is no cure for many of these conditions, but they can be managed and treated with help from a rheumatologist and other specialists.

Inflammatory diseases are conditions that are characterized by symptoms caused by your immune system’s response to bacteria, viruses, or toxins. When these offenders are detected by your immune system, it will release certain cells to attack the foreign organism. This process can result in pain, swelling, tenderness, redness, and other adverse effects.

Common inflammatory diseases include:

  • Arthritis
  • Fibromyalgia
  • Vasculitis (inflammation of the blood vessels)
  • Scleroderma
  • Osteoporosis
  • Inflammatory bowel disease
  • Crohn’s disease
  • Asthma

There are hundreds of different types of inflammatory diseases, each with diverse symptoms and treatment requirements. If you are experiencing the symptoms of inflammation, it is recommended that you speak to a rheumatologist - a doctor that specializes in the treatment of inflammatory and autoimmune disorders.

Your primary care provider may recommend that you see a rheumatology specialist if they suspect that you have an autoimmune disorder or a complex musculoskeletal condition that requires specialized treatment.

Additionally, if you have a family history of arthritis or other autoimmune disorders, you may want to ask your primary care provider about a recommendation for a rheumatologist. Genetics - conditions being passed down through your family - is the biggest risk factor for the development of these disorders.

Undiagnosed and untreated autoimmune disorders can lead to significant joint damage. Early detection of an autoimmune disorder can help avoid worsening symptoms, such as joint pain and mobility loss. If you are experiencing any of the symptoms detailed above, or if you have a family history of these disorders, talk to your primary care provider about a recommendation for a rheumatologist.

A rheumatologist will talk to you about your medical history, family history of autoimmune disorders, and what symptoms you are experiencing before conducting a physical examination. Physical exams are crucial in helping providers detect symptoms or signs of conditions such as lupus or rheumatoid arthritis.

Autoimmune conditions can be hard to diagnose in their early stages, so the rheumatologist may order follow-up testing to better determine the cause of your symptoms. These diagnostic tests include:

  • X-ray scans
  • Blood tests
  • CT scans
  • Ultrasound tests
  • MRI scans

Once the rheumatologist has examined your test results, they will work with you to create a treatment plan that can help you manage your symptoms. If surgery is needed, they may recommend an orthopedic surgeon to correct any musculoskeletal damage causing you pain.

No. Rheumatologists can perform diagnostic tests and physical examinations to diagnose autoimmune conditions and musculoskeletal problems, but they are not surgeons. These specialists are able to prescribe medication, administer steroid injections, and refer you to other specialists if needed.

If after your examination your rheumatologist determines that you may benefit from surgery, they will refer you to an orthopedic surgeon - a specialist in surgery of the bones, joints, ligaments, tendons, and muscles.

Arthritis is a condition in which one or more of your joints become inflamed. According to the CDC, 23% of adults (more than 54 million people) deal with some form of arthritis. Arthritis most commonly affects people over the age of 65 but has also been found in children, teenagers, and younger adults. The most common symptoms of arthritis are stiffness and pain in the joints, symptoms that may worsen with age. In addition, arthritis may cause redness, swelling, and loss of mobility in the affected joints.

The two most common types of arthritis are:

- Osteoarthritis: Normal wear and tear on a joint’s cartilage can cause osteoarthritis. Cartilage cushions the ends of bones in a joint, allowing for frictionless movement and shock absorption. After years of use and damage, this cartilage breaks down, and the bones in a joint grind directly on one another. This can limit mobility and cause significant pain.

- Rheumatoid arthritis (RA): Rheumatoid arthritis is an autoimmune disorder in which the body’s immune system attacks the soft tissue in the joints. As this tissue is destroyed, the joints become damaged. In addition to joint pain, rheumatoid arthritis may also cause fatigue, fever, and a loss of appetite.

There are over 100 types of arthritis, each with different causes, symptoms, and treatments. Just as there are many forms of arthritis, there is also a wide range of treatment options available to help reduce symptoms of arthritis and improve your quality of life. Specific medication and treatment will depend upon your age, the type of arthritis you have, and your medical history.

Most symptoms of arthritis are felt in the joints. Depending on the area affected by cartilage deterioration, you might experience knee pain or back pain, for instance.

Common symptoms of arthritic conditions include:

  • Pain
  • Swelling
  • Stiffness
  • Redness in the affected area
  • Loss of motion

The severity of these symptoms may depend on how the condition has progressed, whether it has been caused by injury and other factors.

Osteoarthritis is caused by routine wear and tear on your cartilage over time. This breakdown causes the cushion between bones to deteriorate. As it does so, bones begin to grind directly on one another, causing joint pain, stiffness, and tenderness. Simultaneously, the connective tissue that holds muscle to the bone may break down which can lead to additional joint pain and swelling.

Rheumatoid arthritis is classified as a rheumatic disease - a form of autoimmune disease - that specifically attacks joints, bones, muscles, and organs. Autoimmune disorders occur when your body mistakenly attacks healthy tissue in the body, causing the deterioration of the tissue listed above. There is no specific cause of rheumatoid arthritis, although there are several risk factors that may increase your likelihood of developing the condition.

Treatment of arthritis is focused on restoring the use of damaged joints and pain management. The forms of treatment for arthritis are detailed below.

Medication

Your doctor may prescribe various medications depending on the type of arthritis you have. Common types of medication used to treat arthritis include:

- Painkillers: Painkillers will not help treat the inflammation caused by arthritis, but can help reduce pain and discomfort. Acetaminophen is an effective over-the-counter option for pain relief.

- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, like ibuprofen (Advil, Motrin IB) or naproxen (Aleve) can reduce both pain and inflammation caused by arthritis. Some NSAIDs come in the form of topical creams or gels, which can be applied directly to the affected area.

- Immunosuppressants: Immunosuppressants, such as corticosteroids, suppress the immune system and reduce inflammation caused by arthritis. These drugs are especially beneficial in the treatment of rheumatoid arthritis, as they slow the immune system’s attack on soft joint tissue.

Self-care

There are several simple ways you can help minimize the symptoms of arthritis. These methods will not cure arthritis, but they may help manage pain and mobility problems:

- Weight loss: Losing weight will relieve the load on your weight-bearing joints. This may help you move more freely and prevent future joint injuries.

- Exercise: Regular exercise can aid in the flexibility of your joints. Because the buoyancy of water lowers stress on weight-bearing joints, swimming and water aerobics may be suitable options.

- Physical therapy: PT can help strengthen muscles around an affected joint while helping address balance and mobility problems.

- Assistance equipment: Canes, shoe inserts, walkers, and specialized toilet seats, and can help preserve your joints during daily activities.

Surgery

If medicine and other treatments haven’t helped, surgery may help to relieve the symptoms of arthritis. Surgical procedures will repair, replace (known as joint replacement), or fuse damaged joints to restore range of motion and reduce discomfort. These procedures are commonly performed by orthopedic surgeons, doctors who specialize in the musculoskeletal system.

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