A rheumatologist is an internal medicine physician with subspecialized training in rheumatology. This treatment plan can vary from person to person and depends greatly on your individual age, gender, family background, and personal medical history, as well as the amount of musculoskeletal pain and other symptoms that youre experiencing. But if your insurance doesnt require a referral, you can call them and make an appointment on your own. In most cases, patients see a rheumatologist for treatment upon referral from their physician. Now that you know more about what to expect, you and your rheumatologist can focus on what matters: getting well. Rheumatologists diagnose, treat and manage a broad range of conditions, including: Conditions rheumatologists treat include: Orthopaedists and rheumatologists specialize in conditions affecting the joints, bones, muscles, ligaments and tendons. Being prepared and helping your rheumatologist make the most of the time they have with you is key to the best outcome. What are the potential side effects of RA medicines? Whats the Connection Between Rheumatoid Arthritis and Acne? Could I benefit from any clinical trials for new treatments? Follows through with necessary procedure or test requests, prescription refills, new appointment times and referrals to other facilities or services. difficulty using or moving a joint normally. They may do this by opening an individual rheumatology practice, by joining other established rheumatology practitioners, or by working for a hospital which has a rheumatology division, such as Brigham and Womens Hospital in Massachusetts or Detroit Medical Centers Division of Pediatric Rheumatology, located in Michigan. What to expect at your first rheumatologist appointment. After the physical exam, new patients may be asked for blood and urine samples, as well as imaging like X-rays, MRIs or ultrasounds. Dont neglect your emotional state. Necessary cookies are absolutely essential for the website to function properly. Your rheumatologist sees people with symptoms of fatigue or extreme tiredness, joint or back pain all the time. Last medically reviewed on February 4, 2021. Keep a journal of your day-to-day symptoms to share with them. Refers questions to physician/provider and . Rheumatologists are like detectives looking for clues to relieve your pain and treat your condition. All your joints will be looked at and you will be thoroughly examined in areas where problems might exist. You may not get a diagnosis right away, and you should be aware that many autoimmune disorders may take a number of years to fully evolve. Or they might send you to a lab for these tests. Patients also typically see a rheumatologist for support in providing the most appropriate and effective medications for their own unique condition. After the Visit What are your next steps? The rheumatologist will want to know about any prescription or non-prescription medications that you take as well. Your doctor will: Then, theyll ask you to bend, flex, and stretch your joints and muscles. These cookies will be stored in your browser only with your consent. Is this lupus, a similar condition or a combination of overlapping syndromes and how would we know? You must continue to take your medications to be well. The appointment may take up to two hours. During this time, there are steps you can take to prepare. Will I have to take RA drugs for the rest of my life? Treatment recommendations may include medications, referral to physical therapyand/orother specialists, or diagnostic or therapeutic joint/tendon injections. Additionally, the images show any joint damage as well as the degree of inflammation that has already occurred. 681-342-3490, Rheumatology PayScale salary information places this rheumatology specialtys median slightly lower, closer to $205,000. You might not get a definite RA diagnosis on your first visit. Cleveland Clinic 1995-2023. Here are a few examples for which you may be tested: Your doctor may order imaging tests, such as X-ray or CT and MRI scans, to achieve a correct diagnosis or gain more insight into your condition and its progress. A rheumatologist's role is to diagnose, treat and help medically manage patients with arthritis and other similar aliments. Obtaining a RA diagnosis may require several visits on your part, but once the rheumatologist identifies and analyzes your symptoms, he or she can better determine the exact diagnosis and treatment options most suitable for you, the patient. It may not even mean that you have lupus. Doctors must pass the internal medicine or pediatric board examination to subspecialize. Everix D. (2018). (Opioid and opiate pain relievers are associated with a high rate of addiction, so the prescription of these medications for RA is on the decline.). The first thing to realize is that a referral to a rheumatologist is not something to be feared. Like any new relationship, preparing for the first meeting can raise a lot of questions and maybe some nerves, so we asked a few rheumatologists what they would tell new patients to expect. These are excellent treatments for many people with RA, because stopping inflammation can prevent permanent damage to joints. When Im in pain, should I use the joint/muscle or rest it? (Ice? Rheumatologists work with a team of doctors trained in many areas to determine the most appropriate treatment for your individual needs. The doctor will press and feel (palpate) each of the small joints on the hands and feet for presence of pain and tenderness. Your rheumatologist will perform a thorough examination to start. If your child has had X-rays, bring the films to the appointment. Research, including studies on aerobic exercise and resistance exercise, has found that exercise has specific health benefits for people with RA. What kind of other symptoms should I look for? Tests: Your visit will probably also include several tests requiring urine and blood samples, and perhaps imaging exams. If I notice new symptoms or changes to current ones, who should I contact first, you or my primary care physician? Cleveland Clinic is a non-profit academic medical center. RA still has no cure, even though modern therapies can bring relief and prevent further damage. ", Hospital for Special Surgery: "The Doctor-Patient Relationship and Rheumatology Decision-Making: Are You Thinkin' What I'm Thinkin'?" Lupus. The doctor may need to see the patient more than once and possibly a number of times to make an accurate diagnosis. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. A rheumatologist is a physician or pediatrician who is trained in the area of rheumatology. Before your rheumatologist can help you, he or she needs to understand the medical history that brought you to the appointment in the first place. We do not endorse non-Cleveland Clinic products or services. That journey is long and can get very complicated as you add and subtract treatments and as your disease flares up, remits, or develops new traits. For patients with RA, rheumatologists assist with the treatment of its many symptoms, including joint pain, swelling and inflammation, stiffness, and deformities. RA is a complex connective tissue disease, making it difficult to diagnose in its early stages. Your rheumatologist will ask a lot of pointed questions about your symptoms. Once a diagnosis of RA is confirmed, the rheumatologist recommends ongoing medical treatments and monitors the patient regularly. how often you should exercise, and what types of workouts are best and safest for you, whether you should use heat and/or cold, and if so, how often, if you smoke, what methods you can try to help you quit, how to achieve and maintain a healthy weight for your body, if recommended by your doctor, how to get emotional and community support if you need it. Treatments can also stop working. In preparing for your first visit to the rheumatologist, there are some items which are helpful to collect and bring with you. Ultimately, the more prepared you are for this visit, the better your chances at getting an accurate diagnosis in the shortest amount of time and that means the healthiest possible outcome for you! Your rheumatologist may even ask you to rate the pressure on a scale of 1 to 10 or simply say whether it is mildly or extremely painful. Vaccine Guidelines for Individuals with Rheumatic and Musculoskeletal Diseases, Ronnys Story: Fighting Insurance Delays to Keep My Child Healthy. All rights reserved. You were most likely prescribed these medications soon after you were diagnosed, but they might not always work. If you are curious, concerned or even confused, speak up! Its common to think of rheumatologists when it comes to arthritis. (2019). A public awareness campaign from the American College of Rheumatology, 2021 Rheumatic Diseases in America White Paper, What to Expect at Your First Visit with a Rheumatologist. Could it be your RA is cured? Time of day (if applicable) or days when pain was better or worse. What do you plan to do if I dont see any improvement, or if my symptoms get worse? Here are some questions to consider bringing up: Around 90% of people with RA will take methotrexate at some point, according to the advocacy group the Arthritis Foundation. If you would like an appointment, ask your child's primary care provider for a referral. 2005-2023 Healthline Media a Red Ventures Company. What changes to my diet or lifestyle do you suggest? Youll likely see your rheumatologist at a specialized outpatient facility, such as an office which houses other internal medicine providers, or possibly directly within the hospital in their division of rheumatology. Additionally, it can easily be confused with other conditions which have similar symptoms, such as lupus and Lyme disease. A rheumatologist is an internal medicine doctor who specializes in diagnosing and treating inflammatory conditions that affect the joints, tendons, ligaments, bones, and muscles. To use one of these images, please contact us at[emailprotected]for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus. Its generally considered safe for regular use and has manageable side effects. Heat? Cleveland Clinic is a non-profit academic medical center. This is can be frustrating, but it is also important for them evaluate your condition with a fresh set of eyes and ears. DMARDs and biologics do take longer to work. The doctor will want to check your blood and other fluids. You may also want to write things down in a journal (highly recommended) or maybe you may want to bring an advocate to your consultation. If you havent covered these topics yet with your doctor, bring them up at your next appointment: Living with a painful chronic condition can be as hard on your mind as it is on your body. Training starts with a traditional undergraduate bachelors degree followed by a four-year medical school curriculum (a doctor of medicine degree, or MD) or osteopathic education (a doctor of osteopathy degree, or DO). Be sure to share how the pressure makes you feel. Pain, sleeplessness, fatigue, and depression can interfere with your getting regular exercise. It can also be helpful to call your regular care provider for copies of recent lab work, X-rays, etc. AS often affects the joint where the spine and, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Heres what to expect and tips for being prepared. Dont be afraid to ask your rheumatologist lots of questions about your symptoms, your diseases progress, and the medications typically used to treat RA (like NSAIDs, corticosteroids, and disease-modifying antirheumatic drugs). We do not endorse non-Cleveland Clinic products or services. All contents Kaleidoscope Fighting Lupus 2019. Learn the signs of this rare but serious complication of rheumatoid arthritis and how you can manage the symptoms. These details will help your rheumatologist immensely. The answer to both these questions is no. It's common to think of rheumatologists when it comes to arthritis. They also help to refine diagnostic criteria as we continue to learn more about and better understand the various musculoskeletal and autoimmune conditions like RA. They may ask you to move or bend your joints to assess your mobility and levels of pain. The next you can hardly get out of bed. Your rheumatologist will need to know about every medication youre taking: You can write up a list or toss all the bottles in a bag and take them with you. Your appointment may take an hour or more, but it will be well worth the time. Speak up if it hurts too much. and your full medical history. An in-person visit may still be necessary, however, when doctors need to . Expect to have a thorough examination. After medical school, physicians complete a three-year residency with a focus on internal medicine (adult medicine) and/or pediatrics (children and young adults). You can learn more about how we ensure our content is accurate and current by reading our. It is an opportunity to see a specialist who will look at you with a fresh set of eyes and a perspective unlike other healthcare providers you may have seen. Theyre usually linked with a local hospital, so they can work with people admitted there for treatment of rheumatic diseases. Also, always speak with your doctor if youre considering getting pregnant. What kinds of problems run in your family? Some that are similar, yet must be treated differently, are lupus, Lyme disease, and relapse polychondritis. Just be as honest and as patient as you can. Your first rheumatologist visitshouldnt be. You can take some of the sting out of this injustice if you establish why you get flare-ups at least then you have an idea of what to avoid or can be alert to an oncoming flare-up. . It is mandatory to procure user consent prior to running these cookies on your website. Many inflammatory conditions may progress over time, requiring your rheumatologist to reassess your treatment plan. Mayo Clinic rheumatologists have experience treating people with diseases and conditions that affect the body's connective tissue. Ye H, et al. Also, include medications you take to treat other conditions. To prepare for the appointment, find out if any family members currently have rheumatoid arthritis or another autoimmune disorder. However, your doctor may consider lowering the dose of your medication or simplifying your drug combination with careful monitoring. You should also ask any questions you have about the visit and the recommended treatments. While both rheumatologists and orthopaedists help diagnose and treat musculoskeletal conditions, rheumatologists have specialized training in musculoskeletal conditions of an inflammatory and autoimmune etiology. All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. I notice that when patients bring a notebook or journal, they seem to better capture our conversation, explains Dr. Smith. How has it changed over the last few days or weeks? To give your new doctor a head start: Make a timeline. Arthritis may be a symptom of a number of different connective tissue diseases since there are more than 100 types of arthritis. Learn how acne and RA may be. As you prepare for your appointment, try asking yourself the following questions about your symptoms: It is also very important to make note of any medications you take regularly, as well as ones you have tried specifically for your symptoms. If you're like most people, you've probably been disappointed by the lack of style advice that's out there. About Lupus, Autoimmune Diseases, Blog, Featured, General Information, Living with Lupus, The Doctors. When you have RA, going for regular check-ups is a given. Rheumatologists . Rheumatologists look for signs of inflammation like: Your doctor may order X-rays; an MRI scan, which uses powerful magnets and radio waves to make a more detailed picture; or a CT scan, which takes X-rays from several angles and puts them together to get more information. Could I benefit from seeing any other healthcare providers, like a physical therapist, pain management specialist, or nutritionist? Especially because many rheumatologic conditions become more difficult to treat over time and respond best to treatment in the early stages.. As a . Thats not a lot of time when you consider all the issues youll need to discuss. Once you have a proper diagnosis, some of the treatment possibilities include: If you have been struggling with possible symptoms of rheumatoid arthritis but still dont have a diagnosis, we encourage you to ask your primary physician for a referral or call UHC Rheumatology at 681-342-3490 for more information on how to obtain one. Even if you dont develop RA comorbidities such as cardiovascular problems or depression, youll likely take a prescription anti-inflammatory, a corticosteroid, at least one DMARD, and possibly a biologic. If you are experiencing related symptoms, please visit your doctor or call 9-1-1 in an emergency. The treatment is based largely on how far the disease has progressed at the time of diagnosis. 3 tips for your first rheumatologist visit. Since every doctor asks this, it can save you writing time to type up a list and simply attach it to the medical request form. For patients with RA, rheumatologists assist with the treatment of its many symptoms, including joint pain, swelling and inflammation, stiffness, and deformities. Consider keeping notes in advance of your appointment to bring along. Occupational therapists can show you how to ease the strain on your joints during daily activities. But, in reality, what you wear is all about your personal style and how you want to present yourself. Provide feedback. Learn how we can help. Because of time constraints, your doctor might keep the focus of your appointment on medical therapies. They can take notes so you can stay focused on the conversation with your doctor. He then ordered lab work and x-rays. Your family history can be very important to diagnosis of rheumatic disease and will also be assessed. They include: After the initial examination is complete, the rheumatologist may order additional testing and exams to further investigate your unique condition. These frequent touchpoints make it easier to adjust therapies before you experience discomfort. Keep a care journal to write down your own experiences, list your medications, and track symptoms. Where in the body you feel pain (muscles or joints). Spend some time thinking about your symptoms in as much detail as you can. 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