When to see a rheumatologist?

Have you been experiencing  joint pain , swelling in your joints, stiffness on waking and dark-colored patches on your face? If the answer is yes, these symptoms are worth observing. When persistent, they are able to point out when to see a rheumatologist.

Rheumatology is a medical specialty that mainly takes care of connective tissues, that is, muscles, tendons, bones and ligaments. These professionals are qualified to make the diagnosis and guide each patient in the treatment and living with the problem presented.

To understand more about this area of ​​medical practice and its fronts, as well as to know in detail some of the main rheumatic diseases, follow our post until the end. Good reading!

What is the role of the rheumatologist?

Contrary to common sense, joint pain can appear at different ages. Although they are more common among  women  and the elderly, they also affect men, children and young people.

But it is not just the chronic pain in the joints that rheumatologists take care of: generally, patients in this specialty have chronic conditions, difficult to reach a diagnosis, and keep jumping from doctor to doctor without ever having an answer to the pain they feel nonstop.

Some of the conditions treated by rheumatologists are:

  • inflammatory conditions in connective tissue;
  • spondyloarthropathies, which are inflammatory diseases of the spine joint;
  • systemic vasculitis, which is inflammation of the vessel wall and which can cause headaches;
  • degenerative joint diseases;
  • osteometabolic diseases, related to the imbalance between deposition of bone minerals and their degradation;
  • arthropathies and arthritis, which manifest with stiffness and pain in the joints;
  • extra-articular rheumatisms, which are sometimes generalized pains and which do not seem to follow the common clinical correlation.

In this sense, the role of the rheumatologist is, above all, to improve the quality of life of the patient, in an attempt to reduce pain and correct problems that are reversible.

How to identify the good rheumatologist?

As you already know, rheumatologists treat chronic diseases that are often of unknown cause – idiopathic – or are autoimmune. This is the case, for example, of Systemic Lupus Erythematosus: an autoimmune inflammatory disease, in which the body itself produces antibodies that act against its own structures in multiple organs and tissues, such as the skin, which is left with dark spots.

Some of these diseases can be difficult to control and require an integrated and quite complex approach. A research  recently has shown, for example, that emotional factors and stress response can act as a trigger for autoimmune diseases. 

That is, the individual has a pathological genetic alteration that is “read” due to an emotional stimulus. It is also known that the presence of an immune disease is, in itself, a risk factor for the development of more autoimmune diseases.

Another rheumatic disease directly linked to the central nervous system and emotions is fibromyalgia. Although its cause is not entirely clear, lower levels of serotonin – the health hormone – are detected in people with this condition. In addition,  hormonal imbalances , tension and stress seem to be involved in its origin.

These examples help us to understand why the good rheumatologist should consider the patient as a biopsychosocial being, that is, he must take into account the influence of his beliefs, profession, family, social context and mental health in his health condition. Understanding this context can give many tips about the patient’s condition and how to approach it.

In addition, the good specialist should develop a multiprofessional treatment plan that dialogues with other specialties, in order to “attack” all the necessary fronts of a rheumatological disease.

In this sense, the support of  psychologists  is fundamental in solving emotional issues that act as a trigger for diseases, and also in developing strategies to deal with pain.

The  nutrition , in turn, has shown interesting ways to modulate inflammatory diseases through food, while medical specialties such as endocrinology and orthopedics, are also being allied in the treatment of pharmacological and surgical, respectively.

Rheumatologist or orthopedist?

Considering that both specialties deal with pain and dysfunction that can impact muscles and bones, it is normal for you to have doubts about which doctor to look for. Two key questions, however, can help solve this problem:

  • Did the pain or swelling appear after a trauma, sprain or fall? If so, the ideal is to look for an orthopedist;
  • Are the symptoms chronic and accompany pain, heat, redness and stiffness of movement? If so, a rheumatologist is best.

Remember that the  orthopedist  is more recommended in cases of trauma and mechanical problems, often related to the practice of sports. After all, its assignment is to solve musculoskeletal complications. However, in some cases, the two professionals can work together on physical rehabilitation, a relevant option for multidisciplinary treatment.

What are the most common rheumatic diseases?

Now that you know when to look for a rheumatologist, know some of the main ailments treated by this specialty.

Rheumatoid arthritis

Considered a chronic inflammatory disease, there is an attack of the patient’s immune system against their own tissues, especially the articular tissues, responsible for pain and impairment of these structures. Hands, elbows, wrists, feet, knees and spine tend to be the most affected areas of the body.

Today,  data  indicate that about two million Brazilians have rheumatoid arthritis. Although its causes are unknown, it is known that it is more common among women and patients over 40 years old, with a high prevalence among those aged 50 to 70 years.

The symptoms, however, are quite noticeable, ranging from swelling in the joints to weight loss, malaise and joint stiffness in the early hours of the morning after waking up.

Arthrosis

Arthrosis is a very common chronic disease that causes joint pain and results from an erosion in the cartilage that protects the ends of the bones. In this way, the bones start to rub, producing creaks to the movement.

In this disease, the most common complaints of patients are  l ombalgias , and pain of the knees, hips and hands. Numbness, tingling and formation of calcified nodules can also occur.

When treating it, its progression tends to be smoothed, which relieves and increases the capacity of joint mobility.

Fibromyalgia

Those who live with fibromyalgia may have a symptomatic picture of great suffering. Not surprisingly, this disease causes muscle pain and weakness throughout the body, conditions worsened in the face of stress,  depression  and anxiety.

Stiffness, loss of strength, loss of sensation, sleep disturbance, memory disorders and fatigue are quite common in this disease. In these patients, who represent between  0.2 and 6.6%  of the general population, there are changes in the way the body interprets brain and skin receptor stimuli.

The many pains, although difficult, can be controlled with treatment, which should seek to associate medications – antidepressants, anxiolytics and muscle relaxants – with the regular practice of moderate physical activities and  good eating habits . Thus, a life with well-being is resumed. Psychological support is also essential in this health condition.

Osteoporosis

Especially after advancing age, some patients may experience great bone loss, in which these structures become brittle and fragile.

In these cases, even though the condition may be that of a  silent illness , there is a high rate of falls and fractures, which can leave sequelae and pain when rehabilitation is not complete.

The  osteoporosis  is much more common in women, especially after menopause, when there is a decrease in estrogen levels. It is said, then, that it occurs in circumstances in which there is no adequate renewal of bone mass, whether due to low consumption of calcium, vitamin D or other hereditary factors.

Drop

Also known as gouty arthritis, this rheumatic disease is related to the increase in uric acid in the bloodstream. This acid forms crystals that precipitate and deposit on the joints, causing pain, swelling and redness.

The inflammatory condition can be monitored and treated by a rheumatologist, and the feet are very common.

In more severe cases, in which the disease has already evolved to a chronic level, the specialist also indicates changes in habits related to the practice of  physical activities  and the improvement of eating patterns, especially.

Rheumatic fever

Rheumatic fever is an autoimmune disease that develops mainly in school-age children and adolescents after a throat infection by group A beta-hemolytic streptococcus bacteria. The microorganism itself is not uncommon, and many people come into contact with him without developing any major problems.

It happens that the organism of some individuals, due to a genetic predisposition, when assembling a response against the bacterium, confuses parts of it with parts of the body itself, initiating an auto-attack.

Symptoms such as joint pain, nodules under the skin, impaired heart valves   and uncontrolled movements of the limbs are noteworthy, and indicate when to see a rheumatologist.

Ankylosing spondylitis

More common in men, the disease is chronic and inflammatory. Its main manifestations are severe pain in the knees, hips and spine. Not by chance, they directly impact the joints of the axial skeleton, responsible for supporting the body.

For the patient to live well with this condition, appropriate medications and physiotherapy sessions are indicated, which tend to improve the range of motion of the affected joints and, consequently, alleviate their discomfort.

Why is it important to see a rheumatologist?

Nobody likes to live with pain, especially when it directly impacts their quality of life and well-being, right?

Therefore, when presenting some of the symptoms previously reported frequently, it is important to seek medical advice and assistance in order to obtain a diagnosis. A great alternative is to find support from a  private medical clinic.

In this type of service, in addition to the consultation, the doctor usually orders tests such as rheumatoid factor, uric acid, X-rays of the hands, antinucleus factor (ANA) and bone densitometry, in addition to blood evaluations. Rheumatological exams are sometimes very specific and only the rheumatologist will be able to indicate the correct analysis.

The exact time when to see a rheumatologist may not be very obvious and lead to an exhausting journey, going through various specialties and unnecessary exams. Now you already have some clues that will assist in this choice, putting an end to the pains that reduce the quality of life. It is worth remembering that monitoring in this specialty is essential to prevent the progression of some diseases and, many times, it needs to be done for the rest of life. So choose your doctor carefully.

 

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