A rheumatologist is a medical practitioner who treats rheumatoid diseases, including musculoskeletal disorders, autoimmune diseases, and connective tissue disorders. Rheumatologists have the expertise to treat over 100 types of clinical anomalies, some of which are hereditary.
Systemic autoimmune diseases and musculoskeletal disorders can cause inflammation in various body parts. They can also affect specific vital organs, skin, eyes, muscles, bones, and joints. Rheumatologists can help with all these concerns.
The term "rheuma" originated in the 1st century A.D. Many believed Greek physicians were the first to use this term. It has a similar meaning to the Hippocratic term "catarrhs." Both these terms refer to a substance that flows or "phlegm." However, rheumatology has little to do with the substance flowing from your nose, i.e., "phlegm."
Modern rheumatology has transitioned through various evolutionary phases and progressed into an outpatient specialty with advanced scientific therapies.
How is a rheumatologist different from an orthopedist?
This is a pertinent question as rheumatologists and orthopedics treat issues related to the bones, joints, tendons, muscles, and ligaments. Nevertheless, there are differences in the approach of a rheumatologist and an orthopedicist.
An orthopedist examines congenital conditions and the general wear and tear of the affected area. On the other hand, a rheumatologist considers every possible organ that may be the root cause of physical degeneration. Orthopedists can perform surgeries to treat their patients, while rheumatologists rely on their specialized training in inflammatory musculoskeletal and autoimmune disorders to provide remedial treatment.
What education and training do rheumatologists possess?
A rheumatology aspirant must pursue a four-year medical school education (M.D.) or an osteopathic (D.O.) course following a regulated bachelor's degree. Both courses have a similar curriculum; hence, both types of doctors can treat rheumatoid disorders. However, osteopathic doctors may acquire a holistic mind, body, and spirit perspective.
After becoming an M.D. or D.O., doctors must undergo a three-year residency program in internal medicine or pediatrics. Some may opt for both. After completing their residency, they undertake a two to three-year fellowship and gain extensive training in treating musculoskeletal and autoimmune diseases.
Having completed their fellowship training, these doctors must clear an examination that the American Board of Internal Medicine conducts to become a board-certified rheumatologist. Many may also participate in a voluntary program called Maintenance of Certification, which the American Board of Medical Specialties organizes.
What are the common diseases that rheumatologists treat?
The scope of rheumatoid disorders is extensive; hence, specialists in this field treat various diseases. Some of the most common illnesses that come within the purview of rheumatology are:
1) Inherited disorders, such as:
- Bechet's disease: Also called the Silk Road disease, this recurring blood vessel inflammation can damage your eyes. It can affect the genitals and mouth as well.
- Rheumatic fever: This is a variant of an autoimmune disease that inflames the body's tissues. Acute rheumatic fever can affect the heart and joints.
- Sarcoidosis: The most commonly affected organs in this inflammatory condition are the lungs and lymph nodes. They can trigger a sudden loss of weight or energy and may even lead to fever or shortness of breath.
- Systemic lupus erythematosus (SLE): SLE is a lifelong autoimmune disorder that can cause severe pain, swelling, fever, and rashes. The heart, lungs, brain, kidneys, and skin are most likely affected by lupus.
- Osteoporosis: The literal meaning of osteoporosis is porous bones. With depleted bone mass, one risks unexpected fractures from the minutest of injuries.
- Psoriatic arthritis: This autoimmune disease causes pain, swelling, and morning stiffness. Oligoarticular, polyarticular, and spondylitis are the most common forms of psoriatic arthritis.
2) Rheumatoid diseases affecting the joint, such as:
- Ankylosing Spondylitis (AS): AS is a type of chronic arthritis that causes lower back pain. Intermittent hip pain and a stiff back are the initial symptoms that may later spread to the spine and pelvis area.
- Bursitis: A bursa is a tiny sac cushioning the area between bone and muscles or tendons. It is typically filled with fluid. An individual has more than 150 bursae in their body. Bursitis happens when a bursa gets inflamed due to excessive stress. It differs from arthritis in that it is generally short-term, as opposed to the long-term impact of arthritis.
- Gout: It is a painful form of arthritis that causes inflammation, mainly in the foot's big toe. Gout can also impact other joints like the elbow, wrists, ankle, knee, or feet.
- Osteoarthritis: One of the most commonly occurring types of arthritis, it damages the tendons and ligaments, mainly in the knee.
- Rheumatoid arthritis: This autoimmune arthritis causes pain in fingers, hands, ankles, knees, and feet.
Tests and procedures conducted by rheumatologists
Rheumatologists perform various examinations and procedures to diagnose different types of rheumatic conditions. These include the following:
- Physical examinations: Rheumatologists perform a comprehensive physical examination to identify a patient's physical condition. After that, they may use it to track the effects of the current treatment regimen. During the examination, they will ask the patient to move in specific ways, like stretching, bending, or flexing. This will help them analyze the areas where patients experience pain and assess its range of motion, function, and intensity of inflammation.
- Diagnostic tests: Rheumatologists can also order specific lab tests, such as muscle biopsies, skin biopsies, joint fluid, and blood tests. Muscle and skin biopsies can help diagnose and identify diseases like polymyositis, vasculitis, lupus, or psoriatic arthritis. Rheumatologists use joint fluid tests to check for uric acids and diagnose gout. Accordingly, blood tests can help identify markers of inflammation like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and rheumatoid factor (R.F.). They can also help check for genetic markers for diseases like reactive arthritis and spondylitis.
- Imaging tests: Rheumatologists or primary care doctors can use different imaging tests to check and assess damage levels in your joints and other tissues. These tests may include a C.T. scan, MRI, ultrasound, or X-ray.
Based on your diagnosis, rheumatologists may recommend the following treatments:
- Medications: Rheumatologists can prescribe various disease-modifying drugs (DMARDs) to help slow the progress of rheumatic conditions or lower immune system activity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help relieve pain and reduce joint inflammation. Some examples include aspirin, meloxicam, naproxen, and ibuprofen.
- Aspirations and joint injections: Rheumatologists can also help treat rheumatic conditions with aspirations or joint injections. Aspiration involves removing fluid from the joints to help reduce swelling, while joint injections deliver medication directly into the impacted joint to decrease inflammation and relieve pain.
- Occupational and physical therapy: Rheumatologists may also prescribe occupational or physical therapy as a treatment. You may have to visit an occupational or physical therapist in such cases. Occupational therapists teach you ways to make daily activities more accessible and safer. They may also use assistive devices like jar openers and splints. On the other hand, physical therapists will teach you specific exercises and other techniques to improve strength, reduce pain, and increase joint movements.
The first step to check for rheumatoid arthritis (R.A.) is a physical examination that assesses for any physical symptoms from head to toe, including the eyes, mouth, and skin. Rheumatologists frequently search for signs of inflammation, such as swelling, warmth, redness, nodules (skin growths), and rashes. They then check the patient's heart, lungs, and bowel movements while recording their pulse. Lastly, they press on the patient's joints to check for soreness.
The doctor will then request the patient to flex, bend, and stretch. This examination part could hurt a little, but the doctor must observe how the patient moves. The patients must let the doctor know if the pain is unbearable. Additionally, the physician will examine their blood and other bodily fluids. While the patient is at the office, the doctor might use a needle to draw blood or joint fluid, or they could refer them to a lab instead to get a blood or fluid sample. Additionally, doctors may order X-rays, an MRI, or a C.T. scan to take pictures of the patient's joints and understand the condition better. The rheumatologist will study the results of the various tests and decide what to do next.
Doctors typically work with patients to establish treatment objectives. Short-term goals or objectives might include reducing inflammatory blood markers and improving quality of life. Medications may also be part of the treatment plan. The rheumatologist may recommend methotrexate, a disease-modifying antirheumatic medication (DMARD). These medications slow down the immune system to prevent it from attacking the joints, resulting in less pain and inflammation.
Additionally, the doctor could advise the patient to take over-the-counter painkillers or prescribe low-dose corticosteroids to reduce swelling. A patient may require more potent drugs known as biologic response modifiers if their R.A. has progressed further. The rheumatologist will then work with the patient to find the ideal combination of medications.
A rheumatologist could also advise consulting with a physical or occupational therapist in certain specific cases. Physical therapists can teach patients exercises to help them move and strengthen their joints, and occupational therapists can teach patients how to lower the stress on their joints through routine tasks.
Including weight management and exercise in the treatment plan is ideal. The joints need movements to prevent stiffness and build up the surrounding muscles. Losing weight can relieve joint stress and minimize pain in overweight patients.
Reasons to see a rheumatologist near you
Rheumatologists are qualified to treat autoimmune and inflammatory conditions affecting the joints and muscles. They can also attend to complex connective tissue diseases involving the skin, which may affect supporting structures like ligaments and tendons.
They are also experts in treating complex inherited diseases, and such conditions often have symptoms like joint and muscle pain or swelling. These may not necessarily occur due to rheumatic disease and can happen to anyone. However, due to the general difficulty of diagnosing rheumatoid conditions, it is advisable to visit a specialist if you have persistent symptoms.
A rheumatologist can help you distinguish non-inflammatory joint pain, more likely caused by osteoarthritis, from joint pain accompanied by other systemic symptoms that may indicate an inflammatory, autoimmune condition. Further, some rheumatic issues also respond best to early treatment, so it's better to consult a specialist as promptly as possible.
You may visit a rheumatologist near you for the following reasons:
- If you have a family history of rheumatic disease
- Suppose you cannot find an underlying cause or treatment for your joint pain. Often, rheumatic conditions may be misdiagnosed. In such cases, a rheumatologist can help you determine the correct cause of joint pain and swelling.
- Suppose your primary care doctor has ordered specific blood tests that indicate the presence of a rheumatic condition. They generally refer patients testing positive for blood tests like antibodies (ANA) and rheumatoid factor (R.F.) to a rheumatologist.
- If you are experiencing extreme or unexplained muscle weakness or fatigue that is not getting resolved or has worsened over a short period
- Suppose you frequently experience episodes of joint pains and swelling accompanied by fever, fatigue, skin rash, lesions on the skin, morning stiffness, or chest pain. In that case, this may be a sign of a rheumatic condition. For example, conditions like lupus may often cause inflammation of the lining of the heart or lungs, leading to chest pain.
- If you experience pain in multiple joints that is not due to an injury
- If you are over 50 years old and have recurring headaches and muscle aches
- If you are facing a loss of mobility in one or more joints
- Suppose you are observing significant hair loss. It may be a sign of alopecia.
- If you are experiencing dry eyes, eye irritation, and a dry mouth (symptoms of Sjogren's syndrome)
- If you notice small, painless bumps beneath the skin, also called rheumatic nodules, that may feel firm or doughy. (This may show up in patients who have severe rheumatoid arthritis).
How do I find top-rated rheumatologists near me in Orlando, FL?
Quite often, symptoms of rheumatic disorders are mild in the initial stages. This can make one complacent in seeking proper medical care from the outset. However, many diseases can aggravate serious health issues if not treated properly.
We at Zocdoc can help you connect with the best rheumatologists in Orlando, Florida, who are experts in handling various rheumatic problems. Enter your search query based on the specialty, location, insurance carrier/plan, and preferred appointment date. You can also get automated filtered results of providers within your insurance network by updating your Zocdoc account's insurance information. Alternatively, you can visit the Zocdoc app to upload a picture of your health plan card. It will help provide filtered results without manually choosing your insurance plan. Check out Zocdoc's patient help center for more insurance-related FAQs.
You can filter your search by provider's gender, language spoken, practice, and other options. Zocdoc will display a list of providers with dedicated profiles based on your search criteria.
Each doctor's profile gives insight into their specializations, qualifications, expertise, languages spoken, licensure, and testimonials from satisfied patients. You can browse through our listings to ensure that you choose the medical practitioner who best fits your requirements. You can then proceed with a hassle-free appointment scheduling process through our platform. For your convenience, you can book either virtual or in-person appointments with a rheumatologist near you.
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A statistical insight into rheumatic disorders in Florida and the United States
Nearly 54 million people in the U.S. get osteoporosis, with women being four times more likely to get affected. Post 50 years, one in every two women and one in every four men are prone to osteoporosis. Another 30% or so have a low bone density condition called osteopenia that puts them at risk for osteoporosis.
The Workforce Study 2015 by the American College of Rheumatology revealed that the Southeast region, including Orlando, Florida, has about 698 adult and 25 child rheumatologists. The adult-physician ratio was around 60,087.0, while the same for children was about 48,3714.7.
According to the Rheumatic Diseases in America Report Card 2019 by the American College of Rheumatology, there were around 5,595 adult rheumatologists in the U.S. By 2030, the demand-supply gap will grow to about 4,729.
Sources
WebMD[1]
WebMD[2]
WebMD[3]
WebMD[4]
American College of Rheumatology
News Medical Life Sciences
Hospital for Special Surgery
Cleveland Clinic
Houston Methodist
Yale School of Medicine
Healthline
MedicalNewsToday
