Rheumatology

Rheumatology is a subspecialty in the practice of both internal medicine and pediatrics.  This means that a doctor must first become either an internal medicine practitioner or a pediatrician and then subspecialize, receive extra education and clinical practice, in the specialty of rheumatology.  A doctor who practices rheumatology will be devoted to diagnosis and treatment of individuals who suffer from rheumatic based diseases.

In years past the diagnosis or terminology of “rheumatism” was used.  Today, it’s mainly used by the public, but is no longer used in medical or technical literature.  The traditional term was used to cover a huge range of medical diagnoses and therefore has come to mean very little.  The major types of rheumatic pain include Ankylosing spondylitis, bursitis or tendinitis, arthritis, rheumatic fever and rheumatic heart disease, lupus, tenosynovitis, capsulitis and neck pain.  Although these all have very little in common in terms of their origins, they do have two commonalities – they cause chronic pain and are difficult to treat.

The term rheumatology originates from a Greek word that means “which flows as a river or stream”.  This may have been in response to the type and degree of pain which an individual will suffer from over the remainder of their life span.  Today, rheumatology is a rapidly advancing medical field, due in part to the technological advancements made in imaging studies and the treatment of immunological disorders.

A rheumatologist, a physician who practices rheumatology, will treat autoimmune diseases, musculoskeletal pain disorders and osteoporosis.  There are at least 100 different types of diseases that fall into these categories, also including rheumatoid arthritis, osteoarthritis, gout and fibromyalgia.  Some of the diseases which are treated are very serious, difficult to diagnose and treat, while others are more simple to identify but still difficult to obtain adequate pain control for the individual.

The first step that should be taken is an evaluation by the primary care physician who can help determine the current status and determine whether or not the care of a rheumatologist is appropriate.  Any musculoskeletal pain that is not severe or disabling may only last a few days.

Many different types of diseases which a rheumatologist would treat are not easily identified in the early stages.  Primary care physicians may refer early in the diagnosis to a rheumatologist in order to give their patient the earliest possible diagnosis and treatment.  It is important to determine the correct diagnosis as early as possible because many of these conditions are progressive.  With the right treatment protocols the progression can be slowed and sometimes even halted.  Other musculoskeletal disorders will only respond best only when treatment is begun in the early stages.

Be prepared to visit your rheumatologists on a consistent basis because many diseases are complex and require consistent evaluation and tweaking of the treatment protocol.  The disease itself may often change or evolve over time so that rheumatologists who are working closely with their patients can design an individualized treatment protocol.

Many times the rheumatologists will work closely with the primary care physician and may only act as a consultant to advise the other physician.  In other situations the rheumatologists will manage the illness and bring together a team of physical therapists, occupational therapists, psychologists and social workers to give their patients the best possible outcome.

Musculoskeletal disorders are often treated with a multidisciplinary team approach because the condition is often chronic and painful.  By using a team the healthcare professionals can help the patients and their families cope with the changes the condition will often cause in their lives.