If you’re living with rheumatoid arthritis (RA), your primary care physician can monitor many of your day-to-day healthcare needs. For more comprehensive assessment and treatment, however, you may need to see a rheumatologist.
Rheumatologists are doctors — internists or pediatricians — who receive special training in diagnosing and treating musculoskeletal disease and systemic autoimmune conditions like RA.
Known collectively as rheumatic diseases, these conditions can cause pain, swelling, stiffness, and deformities in your:
- supporting muscles
Becoming a rheumatologist requires completing 4 years of medical school, where they receive training as a medical doctor or osteopath. That’s followed by 3 years as a medical resident specializing in internal medicine, pediatrics, or both.
To complete their formal education, a rheumatologist spends 2 to 3 years in a rheumatology fellowship, learning about chronic musculoskeletal and autoimmune conditions and how to treat them.
Once they’ve completed the fellowship, the rheumatologist must pass a certification exam administered by the American Board of Internal Medicine.
Rheumatologists must take a recertification exam every 10 years. They’re also required to take continuing medical education classes to retain their board certification.
A rheumatologist can treat any of the more than 100 known rheumatic diseases and musculoskeletal conditions and injuries, including:
- rheumatoid arthritis
- musculoskeletal pain disorders
- back pain
- muscle strains
- antiphospholipid syndrome
- other autoimmune disorders
A rheumatologist will gather your complete medical and family history, perform a physical examination, and run certain types of testing.
Rheumatologists commonly test people for the presence of excessive antibody production for suspected autoimmune disorders. To assess musculoskeletal problems, they may order:
- CT scans
- MRI scans
All of this information helps them work with you to develop the right treatment plan for you.
Treatment may include:
- injections into joints or tendons to reduce inflammation
- referral to other specialists, like a physical therapist
Rheumatologists also can talk with you about:
- coping mechanisms for living with conditions like RA
- ways to prevent disability or regain function
- how to improve your quality of life
Muscle and joint pain are not uncommon, but if you have pain that lasts for more than a few days, visit your primary care physician.
Your doctor can evaluate whether you’re experiencing temporary pain from an injury or other inflammatory causes, or if an underlying rheumatic condition may be involved that requires a referral to a rheumatologist.
If the pain you’re experiencing gets worse over a short period of time, that’s a good indicator that you should see a rheumatologist.
Likewise, if your symptoms decrease with initial treatment, like pain medication, but return once the treatment stops, it may be time to seek out a specialist.
You may want to schedule an appointment with a rheumatologist if you:
- experience pain in multiple joints
- have new joint pain that’s not related to a known injury
- have joint or muscle pain accompanied by fever, fatigue, rashes, morning stiffness, or chest pain
- have muscle pain with or without other symptoms
- are over age 50 and have recurring headaches or muscle aches
Many rheumatic conditions are hereditary, so you should also let your doctor and rheumatologist know if you have any family history of autoimmune or rheumatic disease.
If you have persistent joint, bone, or muscle pain, don’t delay seeking treatment. Joint stiffness that lasts more than 30 minutes, especially if it’s worse in the morning after long periods of inactivity, or any joint swelling should also be promptly evaluated by a doctor.
Rheumatic diseases can lead to permanent damage over time if not addressed in a timely manner. Outcomes improve when these conditions are treated earlier, even for chronic and progressive diseases.
Rheumatologists and orthopedists both treat rheumatic diseases, but in different ways.
Generally speaking, rheumatologists treat rheumatic diseases with nonsurgical interventions, whereas orthopedists perform surgeries to improve function and quality of life.
You may want to see an orthopedist if you:
- have joint or musculoskeletal pain related to an injury
- have hip or knee pain that gets worse when you put weight on these joints
- have severe joint pain that interferes with your day-to-day life
- have moderate or advanced arthritis in your hips or knees
- have joint pain that hasn’t responded to previous treatment
- need a joint replacement
A good rule of thumb: Unless you have suffered a traumatic injury that requires surgery, see a rheumatologist before you consult an orthopedist.
Rheumatologists specialize in treating RA and other rheumatic conditions. They receive extensive training and education to assess and treat people with these conditions. They can also offer counseling for how to cope with diseases like RA.
You should see a rheumatologist if you have chronic joint or musculoskeletal pain that does not go away on its own or reoccurs after short-term treatment.
Your primary care physician may refer you to a rheumatologist. People with rheumatic diseases typically see rheumatologists for treatment rather than orthopedists, unless they have an acute injury requiring surgery or a chronic condition that does not respond to nonsurgical treatment.