When to See a Rheumatologist for Your Back Pain

Model of the lumbosacral spine from the back.
Model of the lumbosacral spine from the back. MedicalRF.com/MedicalRF.com/Getty Images

What is a Rheumatologist?

A rheumatologist is a board certified MD who specializes in diseases of the joints – in other words, arthritis.  While you can go to a rheumatologist for osteoarthritis of the spine, this branch of medicine is particularly noted for its diagnosis and treatment of systemic, autoimmune and inflammatory forms of the disease.

According to the American College of Rheumatology, rheumatologists treat joint diseases in a similar way to orthopedists, but they don’t perform surgery.

About Rheumatic Diseases

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) says that rheumatic diseases affect an estimated 46 million people in the United States.  Rheumatic diseases strike people of both genders and all races and ages.  The NIAMS adds that almost 300,000 children are afflicted with ​rheumatic disease. 

Rheumatic Diseases and the Spine

Not all rheumatic disease affects the spine, but the ones that do can be very difficult to live with.  They are grouped as (and named) spondyloarthropathies, and include inflammatory conditions such as ankylosing spondylitis and axial spondylitis. 

Related:  What is Active Inflammation?

Some types of spondyloarthropathies affect other joints as well.  For example, ankylosing spondylitis usually affects the sacrum and low back the most, but it can also affect hips, shoulders, and knees.  Psoriatic arthritis sometimes affects the spine and sometimes doesn’t, but it almost always affects the ends of fingers and toes.

  (Psoriatic arthritis, as the name suggests, occurs in some people with the skin disorder psoriasis.)  These are just two of a number of possible examples of spondyloarthropathy types that not only damage the spine but likely affect other areas of the body, as well.

Related: Sacroiliitis

When to See A Rheumatologist

Most of the time common muscle aches, pains or injuries are not serious.

  But if your joints hurt and especially if the signs of inflammation (redness, swelling, pain, stiffness, and loss of joint function) don’t subside after a day or two, you may need to see a doctor. 

Usually, the journey to the rheumatologist’s office starts with an appointment with your primary care doctor.  After evaluating you, she can refer you to a rheumatologist if she thinks it’s necessary.  Whether you need a rheumatologist or not, remember that the earlier you see your primary care doctor, the easier it will likely be to heal from or manage your condition.

The American College of Rheumatology (ACR) cautions that autoimmune disorders and rheumatic diseases run in families.  They say if any of your family members (even if they are not in your immediate family) have or had an autoimmune disorder or rheumatic disease, or if your symptoms get much worse over a short period of time, your doctor should refer you to a rheumatologist earlier rather than later.

The ACR also says that if your primary care physician gives you some medication, this can temporarily improve things, but once you stop the symptoms will likely return.

  In this case, you may need to see a rheumatologist. 

Problem is, taking these medications between the time you see your primary care doc and your first appointment with the rheumatologist may make getting an accurate diagnosis more challenging.  The other thing about taking the temporary medication is that for some people, it can make for a delay (or procrastination.)  This delay may result in irreversible damage to your joints.  The same is true, the ACR says, if you don’t get the proper treatment.

Related: Spinal Instability

Sources:

Arthritis and Rheumatic Diseases. NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases. Oct 2014. Accessed Jan 2016.

What is a Rheumatologist? American College of Rheumatology website. Last Updated April 2015. Accessed Jan 2016.

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