Who Are Rheumatologists?
Rheumatologists are doctors that specialise in the diagnosis and treatment of patients with health conditions that affect the joints, tendons, ligaments, bones, and muscles. When a person starts to notice they are experiencing persistent pain or stiffness in their joints, their GP will usually refer them to a rheumatologist for further help.
You may guess from the title, rheumatologist, that this type of doctor will specialise in issues such as rheumatism, but in fact, they will help people with a wide range of inflammatory musculoskeletal health conditions.
Rheumatologists are professionally trained doctors and go through the same training as any other medical doctor, but they go onto undertake more specialist training and gain extra qualifications to increase their knowledge and understanding of the conditions that affect the joints.
All of us have suffered from musculoskeletal pains that would last for a couple of days or a few hours. But what if the pain in your neck, muscles, or back persists and increases in severity over the next few days? Well, seeing the doctor might be the right thing to do in such a situation. Since identifying the rheumatic diseases in early stages is not easy, you need specialised training and skills to diagnose these diseases.
Rheumatic diseases can lead to more complex conditions if the diagnosis is not made at the right time – that’s when rheumatologists come into play. Rheumatologists are well-trained experts in the practice of diagnosing rheumatic diseases. The job of these medical professionals is to study and evaluate your signs and symptoms to come up with the right treatment plan. They are well-aware of the urgency of finding the right solution as further delay in treatment could worsen the condition while damaging your wellbeing.
The job of rheumatologists:
Rheumatologists diagnose and treat mainly inflammatory conditions of the joints, muscles, bones and blood vessels. These include autoimmune conditions such as rheumatoid arthritis, psoriatic arthritis, gout, Lupus, Vasculitis and Ankylosing Spondylitis. Also, non-inflammatory conditions such as osteoarthritis, osteoporosis, chronic back pain, fibromyalgia and carpal tunnel syndrome are diagnosed and treated by a rheumatologist.
Rheumatologists have an excellent understanding of the immune system and also general medicine which, most people say, makes them the best diagnosticians in the whole of the medical field. Their treatments can be complex and often involve controlling an overactive immune system. Rheumatologists have a good grasp of managing difficult to control pain as well for conditions such as fibromyalgia.
These medical professionals are trained to engineer proper treatment plans tailored to current conditions and diseases. Most of these doctors work in outpatient clinics, which are generally associated with a local hospital. In most cases, people visit rheumatologists when a primary care doctor refers to them.
The question is, when is the right time to visit a rheumatologist? Everyone experiences severe joint and muscular pain from time to time. However, if the pain prolongs, then further evaluation and diagnosis is required. Quite often, medication mitigates or improves the signs and symptoms of the rheumatic disease making it more difficult for the doctors to carry out the right diagnosis. The primary job of the rheumatologist is to evaluate the previous diagnosis and test reports to assess the presence of musculoskeletal abnormalities. Here’s what a rheumatologist treats and when it is right to see one:
1. Treatment of more than 120 diseases:
Besides rheumatoid arthritis, rheumatologists also treat a multitude of inflammatory and autoimmune diseases. Conditions that limit the function of your muscles, joints, and bones are also looked after by these medical professionals. Additionally, these medical professionals also treat chronic pain in a localised joint or muscular area. Diseases such as osteoporosis, fibromyalgia, and other similar conditions are treated by rheumatologists.
2. Medical investigators:
Patients are often referred to a rheumatologist after your primary care physician is unable to figure out what’s wrong with your condition. Rheumatologists are trained to deal with strange and rare diseases. Diseases which show no specifically conspicuous signs and symptoms. The job of rheumatologists is challenging as they have to consider every systematic aspect, not just a particular organ or body part. Most rheumatologists have to find out the right pattern in the signs and symptoms to put together the right solution and treatment plan.
3. Doctors for a lifetime:
Once your rheumatologist has made the right diagnosis, they have to acquire the right lab work and reports for prescribing the right medication and dosage. The doctor also keeps a check on drug intake to see the impact of the medication on the severity of the detected disease. Follow-ups are the backbone of entire rheumatic disease treatment. Where some might require few follow-ups, others have to ensure a more regular visit. Follow-ups are scheduled as per the severity of the disease and dependent on control of the symptoms.
Specialisms within rheumatology
A rheumatologist can decide to narrow their focus and specialise in specific rheumatic conditions, or they can choose to diagnose and treat a wider range of conditions within rheumatology. So if a doctor has a deep interest in one aspect of rheumatology, such as autoimmune and inflammatory conditions, for example, they can become a specialist in that field.
There is a wide range of conditions that come under the rheumatology umbrella, and these can include:
- Autoimmune and inflammatory conditions
- Chronic pain
- Metabolic disorders that affect the bone
- Non-inflammatory degenerative joint conditions
- Pediatric or juvenile rheumatic conditions
- Soft tissue diseases
What conditions do rheumatologists diagnose and treat?
Rheumatologists can help you when you are experiencing repeated or persistent pains, inflammation, burning sensations, tenderness and stiffness in your joints. You may be referred by your GP to a rheumatologist, or if you suspect you have a joint condition, you can book a private consultation with a rheumatologist to get a quicker and more in-depth diagnosis.
The conditions rheumatologists diagnose and treat include:
- Ankylosing spondylitis
- Bursitis
- Dermatomyositis
- Giant cell arteritis
- Gout
- Idiopathic juvenile arthritis
- Inflammatory arthritis of the knees, hips, or shoulders
- Osteoarthritis
- Osteoporosis
- Polymyalgia rheumatica
- Psoriatic arthritis
- Reactive arthropathies
- Rheumatoid arthritis
- Sarcoidosis
- Scleroderma
- Sjogren’s syndrome
- Systemic lupus erythematosus (lupus)
- Tendinitis
What happens at a consultation?
Your rheumatologist will look at your medical records to check for any already diagnosed underlying health conditions that could be the cause of your symptoms. They will ask about your family history to see if there are issues that may run in your family.
They will carry out a thorough physical examination and perform other tests, such as blood tests, x-rays, scans etc. to help diagnose and rule out any other causes.
At your visit, you will be asked to bend, stretch and flex the areas of concern so the rheumatologist can assess your condition, range of motion and joint functionality.
Your rheumatologist will use the data gathered from your results to diagnose your condition and will discuss your treatment options so you can be fully informed of your treatment plan, what it involves and what results you can expect to see.
If you have any questions that you would like to ask Dr Bhadauria or his specialist team, do not hesitate to get in touch with us.
How is a rheumatologist trained?
In the UK, rheumatologists undergo standard medical training, qualifying as doctors. They receive specialised training and education to enable them to diagnose and manage chronic inflammatory conditions such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus and fibromyalgia and more.
To train as a rheumatologist, you first need to attend medical school for a five-year undergraduate degree in medicine. Once graduated, you will join a paid two-year foundation programme where you’ll work in six placements in different settings.
Following the foundation programme, you can undertake paid speciality training to become a rheumatologist, which will take a minimum of seven years. Many rheumatologists will choose to develop a sub-speciality in paediatric rheumatology, metabolic bone disease, or autoimmune multi-system connective tissue diseases.
5 Reasons Why a Patient Should See a Rheumatologist
Bodily pain and inflammation can have many different causes. You may have an underlying undiagnosed autoimmune disease that could be complex and difficult to diagnose, especially when your symptoms could be mistaken for something else.
Early diagnosis and treatment by a fully qualified and experienced rheumatologist can often be the key to solving your health issues and result in a positive outcome.
Rheumatologists undergo long and dedicated training to enable them to correctly diagnose and treat inflammatory conditions, such as rheumatoid arthritis and other diseases that GPs often misdiagnose.
Outside of formal training at medical school, a rheumatologist undergoes seven additional years of training and education that makes them experts at diagnosing and treating a range of musculoskeletal diseases and systemic autoimmune conditions, which are often referred to as rheumatic diseases.
Here are five reasons why you should consider consulting a rheumatologist if you have unexplained joint pain and swelling that isn’t resolved with time or over-the-counter medication or your symptoms are worsening.
1: If you are getting repeated episodes of joint pain and swelling that are unexplained, accompanied by skin rash or fever, you should book a consultation with a rheumatologist. An early diagnosis can help to limit, slow down or avoid permanent damage to joints and organs.
2: If you have undergone tests that indicate an inflammatory condition, you can get more insight from a rheumatologist about your results. Your consultant will access more comprehensive diagnostic tests that are unavailable to other medical professionals.
3: You can get a fully personalised treatment plan from your rheumatologist based on your laboratory test results, diagnosis and medical history.
4: Patients that still experience frequent symptoms despite being put on medication for a health condition may have an underlying rheumatic disease that has been missed. An evaluation from a trained rheumatologist will be able to eliminate all other possibilities and uncover the underlying cause.
5: Many inflammatory conditions that can be properly diagnosed and treated by a rheumatologist include rheumatoid arthritis, lupus, scleroderma, and spondyloarthritis. You can often get a quicker and more precise diagnosis and access to effective treatment by booking a private consultation with a rheumatologist rather than wait around for weeks for your GP to refer you for further testing.
Article by Dr. Naveen Bhadauria
