Rheumatology refers to a specialty within pediatrics or internal medicine. This field of medicine concerns the joints, ligaments, tendons, connective tissues, and musculoskeletal system disorders. It also focuses on specific autoimmune diseases and their correlative inflammatory conditions.
A rheumatologist is a specialist who diagnoses, assesses, and treats rheumatology-related health anomalies. Rheumatologists are also actively furthering research, discovery, and analysis of procedures and methodologies to treat these disorders. There are multiple subspecialties within rheumatology that rheumatologists and physicians specialize in. They include:
- Autoimmune and inflammatory disorders
- Soft tissue disorders
- Joint-related chronic pain
- Degenerative bone and joint disorders
- Correlative Metabolic disorders
- Pediatric/juvenile arthritic or rheumatic disorders
Education and training of rheumatologists
To practice as a rheumatologist, one must complete 12-13 years of training. This includes four years of a pre-medical undergraduate program, four years of medical school, and three years of medical residency. Candidates can focus on internal medicine, pediatrics, or both during residency.
After completing these requirements, doctors must enroll in a two to three-year rheumatology fellowship to receive specialized education. This fellowship covers modules on diagnosing and treating chronic muscular, skeletal, and autoimmune conditions. Clinical research can also be part of the fellowship.
Once they have completed the fellowship, rheumatologists must clear a certification exam administered by the American Board of Internal Medicine. They must also take recertification tests every ten years and complete medical education classes as and when necessary to uphold their license to practice.
When to see a rheumatologist near you?
Suppose you encounter any of the following symptoms and conditions. In that case, it might be time to see a rheumatologist:
- Swelling of the joints
- Muscle pain
- Joint pain that is unrelated to injuries
- Joint or muscle pain along with fever, rashes, and excessive fatigue
- Prolonged headache and muscle pain when you are over 50
Many of these conditions might be hereditary, so it is vital to share your and your family's medical history when you visit a rheumatologist, especially if you are seeing them for the first time. This is even more pertinent if you have a family history of rheumatic or autoimmune diseases.
Treatment methodologies rheumatologists use
They treat patients using many therapy procedures, stratagems, and medicinal prescriptions. It depends upon the disease's seriousness, degree, and severity. During your first visit, a rheumatologist may ask about your daily routine, physical activity intensity, family history, etc. In addition, the staff may ask you to present medical reports and test results for any previous procedures you may have undergone. A physician may need them to diagnose your condition(s) best and consequently treat you. The different treatment methodologies are:
- Physical therapy (PT): A rheumatologist may recommend physical therapy for various arthritis-related conditions. These are low-impact training sessions administered by a physical or occupational therapist with your rheumatologist. PT benefits patients suffering from chronic pain issues or injuries affecting the joints. These specialized sessions target the weak tendons, ligaments, and joint muscles and work to strengthen them over time. These exercise regimens enable patients to function in their daily lives without pain, improving their living standards.
- Medication prescriptions: In addition to the preceding, a rheumatologist may also prescribe medications alongside other forms of treatment. For inflammatory disorders (such as rheumatoid arthritis), your physician may prescribe you nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin, ibuprofen, naproxen, etc. NSAIDs reduce inflammation in various body parts, including the tendons, ligaments, and other joints. Some of these drugs possess mild analgesic properties, which work to relieve the pain caused by the disease. The dosage for these drugs depends upon the inflammation level and the disease's severity. For minor inflammation, elderly patients, or cases where pain is the primary problem, a mild dose may be sufficient. On the other hand, for cases with increased inflammation or rheumatoid arthritis, higher dosage schedules are required to reduce inflammation.
- Joint injections and aspirations: For patients afflicted with osteoarthritis, rheumatologists may often administer hyaluronic acid joint injections. These are shots administered directly into the afflicted joint every three to five weeks. Hyaluronic acid is a lubricating substance found naturally in the body; Osteoporosis causes the depletion and degradation of this fluid, rendering the joints rickety and painful. Alternatively, rheumatologists also inject corticosteroids into the joint to treat joint disorders. Alternatively, rheumatologists also perform a procedure known as aspiration. This procedure uses a syringe to extract synovial fluid from a patient's joint. This procedure can be performed for multiple reasons. There may be excess synovial fluid present in a patient's joint. On the other hand, rheumatologists may also utilize this process to extract synovial fluid to be observed and tested to diagnose and treat the patient.
- Referrals: Rheumatologists directly coordinate with multiple specialists from across fields. These can include physical therapists, nurses, orthopedists, surgeons, psychotherapists, etc. Depending upon the patient's requirement, a rheumatologist's role can be consultant, manager, advisor, etc. In most cases, healthcare workers and specialists function together to assess, diagnose, treat, and rehabilitate a patient.
What is the difference between a rheumatologist and an orthopedist?
With so much overlap between medical fields and specializations, it can be difficult for patients to determine which type of doctor to consult for their problem. This is especially true for orthopedic and rheumatology physicians who treat joint pain.
Orthopedics deals with health issues involving bones, cartilage, tendons, or ligaments. On the other hand, rheumatology is concerned with inflammatory autoimmune diseases in which the body's immune cells attack healthy cells, causing swelling. Rheumatoid or rheumatic illnesses can manifest both physically and internally.
To make an informed decision, you need to understand the issues covered by these two specialties.
Rheumatoid or rheumatic disease types include the following:
- Rheumatoid arthritis
- Lupus
- Sjogren's syndrome
- Gout
- Scleroderma
- Infectious arthritis
- Polymyalgia rheumatica
Orthopedic disease types include the following:
- Osteoarthritis
- Hip and knee replacements
- Trauma to bones
- Scoliosis
- Plantar fasciitis
- Bursitis
- Dislocated joints
If you experience discomfort, consult your primary care physician (PCP) for a physical examination and to discuss your symptoms. They can schedule X-rays, blood tests, and other screenings to detect problems and perform an initial assessment. At this point, they may prescribe pain relievers.
Your PCP's initial therapies may be effective, and you may not need to pursue further treatment. On the other hand, your primary care physician can send you to an orthopedist or rheumatologist near you if the issue persists.
It is important to note that most disorders classified under these two medical areas are degenerative. Doctors can use medications and exercise to prevent future degeneration. It means that no medication or fitness routine can reverse the original problem.
Also, while rheumatology conditions are treatable by changing one's lifestyle, orthopedic disorders cannot.
Lastly, most rheumatology patients endure severe discomfort in different parts of their bodies, ranging from their fingers to the cartilage between their ribs. On the other hand, for people suffering from orthopedic disorders, the pain might be relieved if the bone is replaced or a fracture is treated.
More about rheumatic or rheumatoid diseases
Rheumatic disease is a broad term that encompasses arthritis and a variety of other illnesses affecting the joints, tendons, muscles, ligaments, bones, and muscles. If not appropriately treated, rheumatic diseases, such as osteoarthritis, can cause severe joint pain due to the degradation of cartilage, the hard but soft tissue that protects a joint.
The most prevalent rheumatic disorders are osteoarthritis, which is the most common kind of arthritis, and rheumatoid arthritis, also known as RA.
Osteoarthritis occurs when the cartilage surrounding joints wears out or becomes damaged, causing bones to rub together as you use the joint.
In rheumatoid arthritis, the immune system weakens your body's healthy cells by attacking them. It can cause inflammation, edema, and pain in multiple joints simultaneously.
The following are a few other rheumatic diseases:
- Fibromyalgia is a rheumatic illness that causes widespread pain, sleep problems, exhaustion, and emotional and mental suffering.
- Childhood or juvenile arthritis affects youngsters, with juvenile rheumatoid arthritis being the most frequent.
- Lupus is a chronic autoimmune illness in which the immune system targets tissues and organs, causing damage throughout the body.
According to some studies, physical activity can assist individuals with arthritis to reduce joint pain and stiffness while improving function, happiness, and quality of life. Strength training is also helpful. Low-impact physical activity like swimming, walking, and biking can help lessen joint pain.
Lupus is an autoimmune condition that causes the immune system to damage the body's tissues and organs. Lupus-related inflammation can impact various body systems, including the skin, kidneys, joints, blood cells, heart, brain, and lungs.
Lupus can be difficult to diagnose initially since its signs and symptoms frequently resemble other diseases. The most characteristic facial rash of lupus spreads over both cheeks like butterfly wings, and it occurs in some but not all instances of the condition.
Some people are predisposed to developing lupus, which can be caused by infections, specific medicines, or even sunlight. While lupus has no cure, certain medications can help manage symptoms.
If you have an unexplained rash, persistent fever, aching, or exhaustion, consult your primary doctor or a rheumatologist.
Finding a qualified rheumatologist near you in San Antonio, Texas
Diseases like rheumatoid arthritis and systemic autoimmune diseases can severely affect a person's quality of life. It is necessary to consult a doctor if you are experiencing chronic pain in your joints. Finding qualified and experienced rheumatologists around you that you can trust can be a task. Thankfully, Zocdoc exists.
Zocdoc offers a consolidated view of quality medical practitioners and rheumatologists in San Antonio and elsewhere. Log into your Zocdoc account and search for rheumatologists or other specialists you need. Our lightning-fast algorithm will provide you with practicing rheumatologists around you in San Antonio.
You can filter through this list based on availability, age, gender, medical qualifications, etc. You can also see the results based on whether your insurance provider covers a medical practitioner. If you can't find your medical insurance plan on Zocdoc, upload a photo of your insurance card. Zocdoc will automatically scan the image and display the most likely plan for you. This feature isn't available for dental or vision insurance cards. If you face any issues while uploading the image, don't hesitate to contact Zocdoc's Service Team for assistance. Additionally, you can check out Zocdoc's Patient Help Center for answers to any further insurance-related queries.
View ratings, read reviews, and so much more before making an informed choice for the betterment of you and your loved ones. Zocdoc comes through for you.
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Arthritis, rheumatology, and rheumatologist statistics in Texas
A nationwide survey by the Centers for Disease Control and Prevention (CDC) in 2015 stated that approximately 19.8% of the adult population in Texas suffered from some form of arthritis. That's every one in five persons, lower than the national average of ~23.4%. This data is further split into a ratio of 23.1:16.1 (women: men), per the same survey by the CDC.
According to a 2015 census by the Texas Demographic Center, the State of Texas had an adult population of about 19.9 million. Of this, close to 3.94 million were diagnosed within the calendar year. This population is supported by around 373 rheumatologists, of which close to 339 are board-certified (all figures FTE and supplied by the American College of Rheumatology's workforce study, 2015). These figures translate to roughly 53,000 susceptible adults (of which ~10,616 are statistically bound to be afflicted with some form of arthritis) for every physician.
Juvenile arthritis is a similarly grave issue in the country, with as many as 294,000 children afflicted across the United States, as reported by the American College of Rheumatology. With about 313 FTE pediatric rheumatology personnel in America, this results in about 940 cases per physician. Currently and for the foreseeable future, the American healthcare industry is severely overwhelmed, with patients rising and certified practitioners decreasing yearly. This is set to put a considerable strain on the industry, with a worst-to-best-case scenario of nearly 38.3% to 1.9% regarding declining rheumatologists in the United States of America. This prediction is for 2015 to 2030 and is supplied by a study conducted by the American College of Rheumatology and verified by multiple other sources.
Sources
WebMD[1]
WebMD[2]
WebMD[3]
WebMD[4]
Cleveland Clinic
Hospital for Special Surgery
Arthritis Foundation[1]
Arthritis Foundation[2]
Johns Hopkins Arthritis Center
Texas Demographic Center
American College of Rheumatology
Centers for Disease Control and Prevention
Healthline
Orthopaedic Associates
Orthopedic Specialists of SW Florida
Mayo Clinic
