When To See The Rheumatologist

When To See The Rheumatologist

At times it may be necessary for a person with long-term (chronic) back pain to see a rheumatologist​. Often it is because the person has back pain along with other symptoms, that may mean a rheumatologic condition. 

What Is A Rheumatologist? 

A rheumatologist​ is sometimes known as an arthritis specialist​. They do manage many types of arthritis or conditions affecting the joints. However, they also manage autoimmune conditions, including rheumatic diseases.

What Is A Rheumatologic Condition? 

A rheumatologic condition affects the musculoskeletal system. This means it may involve the bones, joints, cartilage, muscles, tendons, and ligaments in any part of the body, including the back.

These conditions are both autoimmune ​and inflammatory. ​The immune system usually protects the body by means of an inflammatory response - ​for example, when you have an infection or injury. However, in autoimmune conditions​ the same inflammation that protects the body, attacks and damages it.

Autoimmune conditions are often systemic​ - they may cause problems throughout the body. In addition to the bones, muscles, and other structures, a person with a rheumatic condition may have problems with their skin, nervous system, body organs, and etc.

Which Rheumatologic Conditions Cause Back Pain? 

As you know, there are many causes of back pain. Only some of them are rheumatologic.

The symptoms of rheumatologic conditions are different from one person to the next and often change over time in one individual.

The symptoms include:

  • Pain, swelling; stiffness, especially in the morning

  • Trouble with movement

  • Possible deformity

Symptoms may also include fever, tiredness, weight loss, trouble with eyesight, and headaches.

Ankylosing spondylitis (AS) is one rheumatologic conditions that most often affects the joints of the back and hips. A person often has severe pain and stiffness and over time some of the bones of the back may fuse together. This results in the inability to move that area of the back. AK may also cause problems in other parts of the body like the eyes, skin, and bowel

What To Expect When Seeing A Rheumatologist

The rheumatologist will talk with you about your medical and family history and current symptoms. If you’ve had imaging tests or lab work for your back pain, the rheumatologist will review the images and test results.

They will do a thorough physical exam that includes checking your back, as well as each of your joints for pain, swelling, and deformity.

Since you have back pain, it is likely that you will have X-rays or other imaging of your back, as well as other areas of your body. Lab tests include those that help to identify autoimmune disease and those that check for the presence of inflammation.

It may take some time to determine a diagnosis. Treatment depends on the diagnosis (or probable diagnosis). It usually includes prescription medicines, as well as therapeutic exercise, physical (PT) and occupational therapy (OT), lifestyle changes, and, at times, surgery. The goal is to decrease pain, improve function, and prevent deformity.

For More Information

Arthritis Foundation. Retrieved 8-16-2022 from https://www.arthritis.org/.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (2020). Ankylosing Spondylitis​. Retrieved 8-16-2022 from https://www.niams.nih.gov/health-topics/ankylosing-spondylitis/advanced.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (2017). Arthritis and Rheumatic Diseases​. Retrieved 8-16-2022 from https://www.niams.nih.gov/health-topics/arthritis-rheumatic-diseases.