Rheumatologist- Who sees them? And for what?

A rheumatologist is physician who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.

What special training does a Rheumatologist need?

A rheumatologist must complete four years of medical or osteopathic education followed by three years of residency training in either internal medicine or pediatrics. Some rheumatologists are trained in both. After residency, they must enroll in a rheumatology fellowship for two to three years to learn about chronic musculoskeletal and autoimmune conditions and their treatment.

What diseases do they treat?

Examples of diseases that may be treated by a rheumatologist include rheumatoid arthritis (RA), osteoarthritis (OA), systemic lupus erythematosus (SLE), vasculitis, Sjogren’s syndrome, gout, scleroderma, antiphospholipid syndrome (APS), myositis, sarcoidosis, polymyalgia rheumatica (PMR), and temporal arteritis (or giant cell arteritis). There is many other diseases that they take care of.

Questions that might be asked.

Seeing a rheumatologists for the first time will take some time for your first appointment.  Plan on bringing all your medications to the appointment.  Also, there will be a list of questions that they will be asking to try to find out more about the reason for your visit.  Below is a list of questioning that I’ve found through many websites that the doctor will be asking.  Prepare for these is the best thing and have a timeline as to when things started and how long its been going on for. Read the following and maybe even print this out to be more prepared.

  • What are your symptoms?
  • How often do you have symptoms? (All the time, daily, weekly, every now and then?)
  • What makes you feel better? (Exercise, rest, medicine?)
  • What makes you feel worse? (Lack of activity, not enough sleep, stress, eating a certain kind of food?)
  • What activities cause pain? (Walking, bending, reaching, sitting for too long?)
  • Where on your body is the pain?
  • How bad is the pain?
  • Which words best describe your pain? (Dull, sharp, stabbing, throbbing, burning, aching, cramping, radiating?)
  • How does the pain make you feel? (Tired, upset, sick?)
  • Does it stop you from doing things you enjoy?(Gardening, shopping, taking care of children, having sex?)
  • Are there symptoms other than joint, muscle, or bone pain that seem to be linked? (Rashes, itching, dry mouth or eyes, fevers, infections

What else to expect?

When seeing the rheumatoloigist for RA, expect to have a physical exam so the doctor can check you from head to toe, including your eyes, mouth, and skin. He’ll look for signs of inflammation, like swelling, warmth, redness, nodules (growths under the skin), and rashes. He’ll take your pulse and listen to your heart, lungs, and bowels. Next, the doctor will press on your joints to see if they’re sore. He’ll ask you to bend, flex, and stretch your joints and muscles. The rheumatologist will compare the joints on one side of your body to the other, because RA or any arthritis often affects both sides. This part of the exam may cause some pain, but it’s important for the doctor to see you move. Speak up if it hurts too much. He may use a needle to take blood or joint fluid while you’re in the office or send you to a lab for these tests. The results may show signs of infection, inflammation, or other problems. X-rays, MRIs, and ultrasound images give your doctor a picture of damage to your joints.  All this is very helpful and a must to get a correct diagnosis.

Once all this is done, and a diagnosis has been made, the doctor will then start you on a path for helping you deal with RA or whatever the diagnosis is.  There may be medications that are adding to your daily arsenal.  But all this is to help with what you have.

Make sure to ask questions!

Ask any questions you have about the visit and the recommended treatments. It’s natural to wonder about things like:

  • How long will it take for me to start to feel better?
  • What can I do to sleep through the night?
  • I don’t like to take medicine. What are my other options?
  • Will I have to take RA drugs for the rest of my life?
  • Where can I find resources to help me learn more about living with the disease?
  • How can I find a support group?

By the end of this first visit, your new rheumatologist will know a lot about you and your RA. And you will have a new, valuable partner on your health care team.

Hopefully this will all help get you through your first visit with a rheumatologist. Remember the doctor is there to help you and get you through this so take advantage of this appointment and learn all that you can for you care.  You deserve to have the best treatment out there but be an advocate for yourself and your health.


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