Who is a rheumatologist?
A rheumatologist is a pediatrician or internist focusing on adult internal medicine. They receive specialized training to diagnose and treat autoimmune or rheumatic diseases affecting your joints, muscles, ligaments, tendons, blood vessels, and bones. These illnesses can result in stiffness, discomfort, edema, and deformity. Rheumatologists treat rheumatoid arthritis, persistent back pain, tendinitis, osteoarthritis, gout, lupus, spondyloarthritis, scleroderma, and psoriatic arthritis.
Education and training of a rheumatologist
Aspiring rheumatologists must complete four years of medical school or osteopathic education. After that, they must gain hands-on experience by completing three years of medical residency in internal medicine or pediatrics. Some individuals may choose to finish both.
Rheumatologists can undergo two to three years of training in specialized fields. After training, they must pass a rigorous exam administered by the American Board of Internal Medicine to earn their certification. Rheumatologists are required to retake the certification exam every ten years and maintain specific continuing education hours every year.
Some of the subspecialties in rheumatology include:
- Pediatric or juvenile rheumatic conditions
- Metabolic disorders that affect the bone
- Chronic pain
- Soft tissue diseases
- Non-inflammatory degenerative joint conditions
- Inflammatory and autoimmune conditions
Furthermore, rheumatologists can conduct research or work as partners with government agencies to develop public policies. They can also work in the pharmaceutical industry or as a clinical educator.
Common types of rheumatic diseases
Some of the most common types of rheumatic diseases include the following:
- Fibromyalgia- Fibromyalgia can cause widespread pain and inflammation. It generally occurs when the patient already has another autoimmune disorder. Doctors may recommend antidepressants and other medications that block the nerves that cause pain. Exercise, massage, and acupuncture may also help manage the symptoms.
- Rheumatoid arthritis- Arthritis includes various conditions that affect the joints and cause pain, swelling, and inflammation. Rheumatoid arthritis involves the attack of the immune system on tissues that form the lining of the joints. It can impact any joint in the body. It first develops in the smaller joints of the feet and hands. Rheumatologists may recommend anti-inflammatory medicines to treat the condition. They may also recommend further treatment to subdue the immune system.
- Gout- Results from uric acid buildup in bloodstream, forming needle-like crystals. These crystals settle in the joints causing sudden extreme pain. Gout generally occurs in the big toe area but can also affect other bodily joints. Doctors may prescribe drugs to lower the amount of uric acid present in the blood. Drinking a high amount of water and limiting the intake of alcohol and meat can help reduce gout attacks.
- Psoriatic arthritis- This is an autoimmune disorder linked to psoriasis. Many people may first notice skin symptoms before experiencing joint pain symptoms. In some cases, it may first affect the joints before showing any signs on the skin. Sometimes it may not show any skin symptoms. Other signs of psoriasis arthritis include swollen toes and fingers and pain in ligaments and tendons. Rheumatologists may provide medications to reduce the pain and manage the symptoms. They may recommend prescription drugs to calm down the immune system.
- Lupus- This is a kind of an autoimmune disease that can co-occur in multiple body parts. Its symptoms are the same as arthritis. Additional symptoms include mouth sores, rash, and other disorders. Doctors conduct detailed diagnostic tests to diagnose the condition and recommend appropriate medications to suppress the symptoms.
- Juvenile idiopathic arthritis- Arthritis in children is called juvenile idiopathic arthritis. It mainly occurs when the child's immune system erroneously attacks the tissues in the joints. Depending on the child's age, doctors may recommend steroids or prescription drugs to manage the symptoms and calm the immune system.
- Spondyloarthritis- This is a type of arthritis that occurs in the tendons and ligaments that are attached to the bones. It commonly occurs in the spine area but can also affect your legs and arms. Doctors may recommend anti-inflammatory medications and pain relievers to manage the symptoms and improve joint movement.
Collaboration of rheumatologists with other medical specialists
Musculoskeletal issues are persistent; hence collaboration between a rheumatologist and other specialists is essential. The changes that musculoskeletal disorders bring about in a person's life can be challenging. Healthcare experts help patients and their families cope with these challenges. Ergo, a rheumatologist treats a patient with assistance from other knowledgeable specialists such as nurses, psychologists, physical and occupational therapists, and even social workers.
Other doctors occasionally serve as consultants and help a rheumatologist by advising on a particular diagnosis and course of action. For example, if the rheumatologist finds that the chronic pain faced by the patient has gone beyond what they can treat, they could collaborate with a pain management physician.
What distinguishes a rheumatologist from an orthopedist?
An orthopedist is a certified doctor who treats growth abnormalities and bone damage. Hence, technically, you should see a rheumatologist near you before seeing an orthopedist. An orthopedist would probably be your first resort only if a severe injury requires surgery. Rheumatologists typically treat rheumatic conditions non-surgically. Both rheumatologists and orthopedists treat rheumatic illnesses. However, their method of treatment and management of disease differs significantly.
When should you see a rheumatologist?
You should consult a rheumatologist near you immediately if you experience recurring joint pain, fever, swelling, or skin rashes. Usually, your primary care doctor will alert you when you need to approach a specialist. They might recommend a rheumatologist for tests that illuminate unexplained issues. You should visit a rheumatologist if you have muscle and joint aches that refuse to go away or if your symptoms are worsening quickly.
What should you anticipate on your first appointment with a rheumatologist?
The rheumatologist would ask for any earlier tests at your first visit and may recommend additional ones if required. Imaging investigations (X-ray, ultrasound, CT scan, MRI) or other procedures may also be required.
They would also need your medical history and will conduct a physical examination. It helps to identify signs and symptoms that may provide them with information about the problem's origin. Rheumatic disease diagnosis will also need your family medical history.
Medication, referral to physical or occupational therapy, referral to additional specialists, or joint/tendon injections are just a few of the recommended treatments.
Some rheumatic disorders might be challenging to identify and require multiple consultations with your rheumatologist. Rheumatologists treat recurring diseases or discuss a patient's drugs, coping processes, methods to prevent disabilities or regain function, and ways to enhance their quality of life during follow-up consultations.
What are the different types of treatments provided by rheumatologists?
Rheumatologists generally offer two types of treatments: therapy and medication. The treatment administered may differ on a case-to-case basis depending on the condition and severity. Moreover, rheumatologists develop personalized treatment plans for treating rheumatic diseases. The two types are explained in detail below:
Rheumatologists provide physical or occupational therapy for various conditions. It helps patients to regain strength and function in their joints. It can also help improve an individual’s quality of life and daily activities.
Most medications prescribed by rheumatologists focus on alleviating or managing pain, reducing inflammation, and slowing the progress of rheumatic conditions. It includes corticosteroids, nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs, and joint injections. They may also recommend aspirations where they use a syringe to remove excess joint fluid. It helps to alleviate pain and reduce joint swelling.
Accordingly, rheumatologists may discuss other treatment options depending on the patient’s condition. Surgeries are required in some instances if the pain or damage is severe. However, they will refer you to other specialists for surgical treatments.
Rare rheumatic diseases
Churg-Strauss Syndrome
Churg-Strauss syndrome is a rare condition involving inflammation of blood vessels, which can limit the flow of blood and cause damage to organs and tissues.
The exact cause of this disease is unknown, but it is believed to result from a combination of environmental and genetic factors, such as allergens or certain medications, triggering an overactive immune response. Instead of targeting infections, the immune system attacks healthy tissues, leading to widespread inflammation.
Churg-Strauss syndrome affects people differently. Some experience mild symptoms, while others may face severe, potentially life-threatening complications. The disease typically progresses through three stages, becoming more severe over time. Nearly all people with Churg-Strauss syndrome have asthma, chronic sinusitis, and elevated white blood cell counts, particularly eosinophils.
Additional symptoms may include:
- Loss of appetite and weight loss.
- Joint and muscle pain.
- Abdominal pain and gastrointestinal bleeding.
- Weakness and fatigue.
- Rash and skin sores.
- Pain, numbness, and tingling in the hands and feet.
There is no cure for Churg-Strauss syndrome.
Takayasu’s Arteritis
This is a rare form of vasculitis that causes inflammation of blood vessels, particularly the aorta and its main branches. Inflammation from this condition can lead to narrowed or blocked arteries, or weakened artery walls that may bulge, causing aneurysms or potential tears. It can result in symptoms such as pain in the arms or chest, high blood pressure, and in severe cases, heart failure or stroke.
The exact cause of Takayasu's arteritis is unknown, though it is thought to be an autoimmune condition where the immune system attacks the arteries. Viruses or other infections may play a role in triggering the disease.
Symptoms usually unfold in two stages:
- First Stage: Early symptoms may include a general feeling of unwellness, fatigue, unintended weight loss, muscle and joint pain, mild fever, and night sweats. Some individuals do not experience these early symptoms, and arterial damage may occur over years without noticeable signs.
- Second Stage: As the condition progresses, inflamed arteries narrow, reducing blood and oxygen flow to organs and tissues. Symptoms may include:
- Weakness or pain in the limbs with use.
- Weak pulse, difficulty taking blood pressure, or a difference in blood pressure between arms.
- Lightheadedness, dizziness, or fainting.
- Headaches or vision changes.
- Memory issues or difficulty thinking.
- Chest pain or shortness of breath.
- High blood pressure.
- Diarrhea or blood in the stool.
- Anemia.
There is currently no cure for Takayasu's arteritis.
How can you find a good rheumatologist near you?
You should see a rheumatologist near you immediately if you have persistent joint or musculoskeletal pain that does not go away or come back despite short-term treatment. People with rheumatic problems frequently see rheumatologists rather than orthopedists unless they have a persistent condition that does not improve with nonsurgical treatment or in case of an acute injury that requires surgery.
It may seem challenging to find the right rheumatologist, but Zocdoc has a solution. Zocdoc eliminates the inconveniences of visiting a hospital and waiting an extended period to see a specialist. We link clients with healthcare professionals directly. If you live in Chicago, you can book an online consultation or an in-person appointment by visiting the Zocdoc website and entering your location, condition, insurance company, and plan. You can add medical, dental, and vision insurance plans to your Zocdoc account.
However, when searching for and booking an appointment, you’ll only be able to select one insurance plan at a time. If you have more than one plan, you can include details about your secondary insurance in the notes for the provider during the final booking step.
If your provider uses Zocdoc’s Intake forms, you can also add secondary insurance information while completing those forms online. For more insurance-related information, check out Zocdoc’s insurance page.
The search results would list renowned rheumatologists near you in your area that can be filtered out based on the time of day, gender, spoken languages, hospital affiliation, and several other parameters.
Zocdoc helps you make an informed choice. You can browse each professional's medical education, training, and certifications and verify patient testimonies and background information. When you select your plan from the drop-down box at the top of the page, you will see a list of in-network service providers.. Appointments can be made on Zocdoc on the same day, even early in the morning (before 10 am) or after hours (post 5 pm). The best part is that all appointments on Zocdoc are quick, affordable, and secure!
Statistics on autoimmune conditions in the U.S.
In America, around 50 million people have an autoimmune condition. In the last few decades, these illnesses have become much more common. Almost twice as many women are diagnosed with autoimmune diseases compared to men.
Adults with atopic dermatitis or AD had a higher prevalence of autoimmune disease (7.9%, 95% confidence interval [95% CI] 7.3-8.5%) than adults without AD (5.7%, 95% CI 5.7% -5.8%), and children with AD had a higher prevalence of autoimmune disease (2.0%, 95% CI 1.7%-2.3%) than children without AD (1.0%, 95% CI 0.9% -1.1%). Adult (adjusted chances ratio 1.45, 95% confidence interval (CI) 1.32-1.58) and juvenile (adjusted odds ratio 2.08, 95% CI 1.73-2.50) AD were linked to any autoimmune condition in multivariable logistic regression models that controlled for sociodemographics. For instance, AD was linked to 18 of the 32 adult autoimmune illnesses and 13 of the 24 pediatric autoimmune disorders studied. These conditions included skin, endocrine, gastrointestinal, hematologic, and musculoskeletal issues. The cost of inpatient care for AD patients hospitalized with autoimmune conditions ranges from $2.5 to $50 million in excess annual costs.
Sources
Yale School of Medicine
WebMD [1]
American College of Rheumatology [1]
American College of Rheumatology [2]
Healthline
Comprehensive Center for Women's Medicine
National Library of Medicine
WebMD [2]
WebMD [3]
Cleveland Clinic
MedicalNewsToday
Health
Mayo Clinic News Network
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