How Should I Navigate My Insurance
For Medicare recipients and those who have a choice in their insurance, please ask me what insurances are easy to work with and which are not,Dr. Robert Hylland, rheumatologist with Rheumatology Centers of Western Michigan tells SheKnows. When it comes to expensive medications and investigative studies frequently needed for optimal management of the patient with RA, some insurances are impossible to work with, and the patient will suffer because of it.
Do You Need To See An Orthopedic Physician Or A Rheumatologist
Patients should use the guidelines below to help determine if they should choose an orthopedic physician or rheumatologist for their arthritis and joint pain.
Patients might need an orthopedic physician if they have:
- Joint or musculoskeletal pain that began after an injury
- Gradually progressive hip or knee pain that is worse with weight bearing
- Joint pain that is severe and interfering with function
- Moderate or advanced arthritis of the knee or hip
- Previous unsuccessful treatment for joint pain
- Been told by their doctor they might need a joint replacement
Patients might need a rheumatologist if they have:
- Pain involving many joints
- New joint pain not associated with any injury
- Joint or musculoskeletal pain associated with morning stiffness, fever, fatigue, rash or chest pain
- Joint pain that followed a tick bite
- Joint pain associated with back pain
- Joint pain and psoriasis
- Muscular pain with or without any other symptoms
- New headaches or muscle aches and are over the age of 50
- Back pain with or without pain in the legs
- Unexplained, ongoing symptoms such as fever, sweats or weight loss
A patients’ medical needs are important and unique, that is why UMass Memorial Medical Center offers specialty trained physicians that have devoted their education and career to treating specific medical conditions to serve you.
What Are Some Of The Other Methods To Diagnose Osteoarthritis
Besides the appearance of arthritis on X-ray, there are some other tests as well that are performed by the doctors to know better about the patients condition. Before the X-Ray test, the doctor will ask some questions to study your symptoms. The doctors will ask these things to the patient.
- The degree of pain
- How long have you been suffering from this pain?
- What kinds of activities are difficult to perform because of the pain or decreased mobility?
After reviewing the symptoms, the doctor will perform some physical examinations to know about these things:
- See if there is a swelling in the joint, as it could be a sign of excess fluid.
- Check if the muscle is thinning or not
- Check out joint mobility to see if it is normal or not
- Joint tenderness
- The grating sounds while moving the joints, which is called crepitus
- Swelling in the bones
- Joint instability
Some other forms of tests that doctors may include are as follows:
- Blood tests: The blood tests are usually not necessary to diagnose osteoarthritis however, the doctor may ask the patient to test their blood for ruling out other possible diagnoses.
- Joint fluid analysis: The doctor will use the needle for withdrawing the fluid if there is an excess swelling around the joints. The fluid will be used by the doctor to see if the patient has an infection, gout, or some osteoarthritis-related inflammation.
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Why See A Hand Specialist
The reason you should see a hand specialist if you are experiencing arthritis pain in the hands is simple: hand specialists are experts in treating conditions like arthritis pain in the hands. No other physician can give you the expert care that this type of physician offers.
Would you see a heart specialist for your diabetes condition or an endocrinologist if you broke a bone? Of course not! There are a variety of medical doctors specializing in every subfield of medicine possible. Because no single doctor can specialize in every subfield of medicine, patients see specialized doctors for specific needs. Arthritis is an orthopedic condition that affects the musculoskeletal system. Orthopedic physicians are experts in treating all types of musculoskeletal issues. Therefore, you should see an orthopedic physician if you have arthritis.
Further, arthritis can affect any joint in the body. Orthopedic physicians often have specializations in different parts of the body. Hand specialists are orthopedic physicians who have specialized education and experience treating orthopedic issues in the hands and wrists. This makes them experts in this particular subfield of orthopedic care.
They Are Specialists Who Like What They Do
According to a 2018 survey, if rheumatologists had it to do over again, four out of five them would choose to be a doctor and three out of four would choose the same specialty. That satisfaction may be because they can see the impact they make on patients lives and well-being.
If you treat someones high blood pressure and cholesterol, youre helping in the long term to prevent heart disease and stroke, but the patient doesnt feel anything unless they have side effects from the medication. When you treat someone with arthritis and you relieve their pain, they wake up feeling better and normal, and that is the wonderful part about being a physician and a rheumatologist, says Dr. Marchetta.
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Laboratory Tests For Diagnosing Psoriatic Arthritis
Your rheumatologist will likely order a series of laboratory tests, the results of which will help check for other conditions or point to psoriatic arthritis. These studies will examine factors such as the following:
- Complete blood count
- Erythrocyte sedimentation rate and C-reactive protein , which are inflammatory markers that might be elevated in PsA but should not be elevated in wear-and tear osteoarthritis or arthritis
- Rheumatoid factor and anti-cyclic citrillunated peptide , which are antibodies often present in cases of rheumatoid arthritis, but not commonly found in cases of PsA
- Blood urea nitrogen, creatinine, uric acid, and urinalysis
Prepare For The Journey Of Arthritis
Many people who are newly-diagnosed want the quick fix or cure for arthritis. For most people with arthritis, however, there is no cure. There have been significant advances in treatment options over the years, but finding the right course of treatment can be a journey. It is not uncommon to start one course of treatment and have to change several times before you find what works best.
Also, it is important to realize that what brings relief to one person may be totally ineffective for you. There are many things to try, including exercise, so try to be patient as you go through the process of finding what works for you. Even after you have been treated for a period of time, it’s very important that you talk to your healthcare provider about new or persistent symptoms. It may be time to change your treatment if your response is no longer satisfactory.
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Rheumatologists Often Need To Use Touch During Examination
More than many types of physicians, rheumatologists are very hands-on with patients when they assess their condition.
During a visit, we feel the joints, move the joints, touch a rash, look at skin close up, listen to the patients heart, and so much more, Dr. Weselman says.
This is especially the case for a patient coming for a first-time diagnosis, whose workup inevitably involves many up-close actions, she says.
You Should Go See A Podiatrist If:
- You are having difficulty walking or running
- You have consistent pain in your feet and ankles
- You are experiencing pain and discomfort in your toes and toe nails
- You have bothersome skin conditions such as callus, corns, warts, cracking, blisters, scaling, and peeling of the feet/heels.
- You have a painful bunion
- You suspect a strain, sprain, or broken bone
- You have any signs of infection on your feet or legs
- You think you have Athletes feet or other fungal infections
- You are Diabetic
- Diabetes makes you significantly more prone to foot problems. If you have diabetes, you should have a foot exam performed by a foot doctor or podiatrist at least once a year.
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Expect Ups And Downs With Arthritis
Pain is an unwelcome intruder on normal daily activities. Every person diagnosed with arthritis hopes that treatment will quickly gain control over the disease. And not only do people with arthritis hope to gain control of their condition but they hope to maintain that control. The truth is that the usual course of arthritis is fraught with ups and downs. Like many chronic health conditions, it can feel like a roller coaster.
Even with treatment, you should expect both good days and bad days with arthritis. Some people find that the ups and downs, a major part of dealing with arthritis, are the most difficult aspect. If possible, prepare for those ups and downs by building flexibility into your life.
Some people find it helpful to list out ways to adapt to unforeseen circumstances ahead of time, and there are even retreats focused on “resilience training” to help those coping with chronic medical conditions.
Signs That You Need Specialist Care
Arthritis can often be managed under the care of a general physician. However, as the disease advances, the tools needed to properly manage the disease may beyond the scope of your healthcare providers. With ongoing advances in our understanding of arthritis, a primary care doctor is not always able to keep up with new procedures, protocols, and medications.
In such cases, it may be time to bring a new member into your healthcare team. Chief among these is a rheumatologist who specializes in osteoarthritis as well as rheumatoid arthritis and related disease.
Whether or not you need a specialist depends on the stage of your disease and how typical your case may be. The following insights should help you decide.
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Do I Need To See A Doctor About Arthritis Good Question Wed Say That If Joint Pain Is Regularly Affecting Your Quality Of Life Its Time To Be Proactive About Getting The Treatment You Need
Youre fairly certain the joint pain youre experiencing is the result of Osteoarthritis. Now what? Are their effective ways to treat joint degeneration? Do you need to go see a doctor, and if so, how soon should you schedule an appointment?
First, its important to assess your symptoms. Understanding the types of symptoms youre experiencing and gauging their severity will help you determine whether or not its time to see a doctor.
Are you experiencing one or more of the following symptoms?
Pain and tenderness in the joint area
Stiffness and limited range of motion
Swelling of the joint
Ask yourself the following additional questions:
Does my pain increase with movement?
Is the stiffness most noticeable just after rest?
Have my symptoms become gradually worse over time?
Is joint pain affecting my quality of life?
If you have one or more of the symptoms listed and you answered yes to one or more of the questions above, then its time to act. You asked, Do I need to see a doctor about arthritis? and our answer is: YES!
Which Type Of Doctor Should I See For My Rheumatoid Arthritis
Most people with RA are treated by either an internist or a rheumatologist. Who you choose to be your treating physician depends on many factors:
Most people with RA are treated by either an internist or a rheumatologist.
The doctors training and experience
His or her board certification
The proximity of the physicians office to your home
Whether the physician participates in your insurance plan
The doctors reputation in the community
Your ability to build a trusting relationship with the physician
The doctors ability to speak your native language or understand your culture and customs
While many of these issues do not necessarily bear directly on a doctors knowledge or clinical abilities, patients often choose a doctor based on what is most important to them. The issue of which type of doctor a patient with RA should see for treatment has been examined in the medical literature, and differences in care and in the outcomes of patients have been noted.
Tumor necrosis factor
A protein that plays an early and major role in the rheumatic disease process.
The more intensive level of care rendered by rheumatologists may result in improved symptoms and fewer visits to the hospital for patients with RA. Not surprisingly, however, this more intensive management leads to significantly higher costs than the costs for patients who are treated by internists.
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Whats The Difference Between A Rheumatologist And An Orthopedist
Rheumatologists and orthopedists both treat rheumatic diseases, but in different ways.
Generally speaking, rheumatologists treat rheumatic diseases with nonsurgical interventions, whereas orthopedists perform surgeries to improve function and quality of life.
You may want to see an orthopedist if you:
- have joint or musculoskeletal pain related to an injury
- have hip or knee pain that gets worse when you put weight on these joints
- have severe joint pain that interferes with your day-to-day life
- have moderate or advanced arthritis in your hips or knees
- have joint pain that hasnt responded to previous treatment
- need a joint replacement
A good rule of thumb: Unless you have suffered a traumatic injury that requires surgery, see a rheumatologist before you consult an orthopedist.
What Would You Do If You Were In My Shoes
In 42 years Ive never had that question asked. It opens the door for divulging all of the wisdom and teachings I have accumulated in managing Rheumatoid Arthritis for thousands of patients. It signals an openness to change that is so very important for achieving the best results, Dr. Hylland adds. I can share the characteristics of those patients who have the best outcomes and those with the worst. It opens up conversations about diet and dieting, smoking and its troublesome effects on RA, defining realistic expectations, making necessary adjustments in working routines and home activities, explaining my reasoning behind my medication choices and the importance of adequate rest and an optimistic attitude. Such a conversation builds confidence in the relationship between doctor and patient and that confidence is fundamental in obtaining the best results.
If you or someone you love is in the midst of navigating a new diagnosis with Rheumatoid Arthritis, remember your doctors are the a great resource for knowledge if you can, take advantage of what they know and start having these important conversations early to better set yourselves up as a powerful healthcare team.
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It’s Easy To Get The Care You Need
See a Premier Physician Network provider near you.
You want to stay active and avoid pain, right? Then dont delay seeking treatment for joint problems likeosteoarthritis. Your doctor can help you avoid permanent joint damage and other serious health issues.
So, what joint symptoms are a sign for you to call your doctor for an evaluation?
What Causes Osteoarthritis
The most common form of arthritis, osteoarthritis, is associated with injuries, wear-and-tear processes, and genetics. An arthritis joint will demonstrate the narrow bone spaces due to various reasons. The cartilage thins, the formation of cysts within bones, bones spurs seen on the edges, deformity of joints are some of the reasons, which leads to crooked joints.
*All individuals are unique. Your results can and will vary.
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What Are The Symptoms
Psoriatic arthritis can affect any joint in the body and symptoms can vary from person to person. It can develop slowly with mild symptoms, or come on quickly and be severe. The most common symptoms are:
- pain, swelling and stiffness in one or more joints
- pain and stiffness in the buttocks, lower back or neck
- pain in tendons, such as at the back of the heel or sole of the foot
- changes in nails, such as thickening, colour change or separation from the skin
- pain and redness in the eyes.
People Who Are Due For An Infusion Or Injection
Its one thing to delay treatment a few weeks, but if you put off an injection or infusion long term, your disease may worsen, Weselman states. This may not only be painful, but, depending on your condition, it can be life-threatening, such as by damaging the kidneys or heart.
Delaying this care may also be shortsighted, because if your condition worsens you may need a potentially riskier medication. If you have an acute flare and end up needing steroids, which are an immunosuppressant, you havent done any good, she says.
Doctors offices and infusion centers are tasked with following ACR guidance for safely administering these medicines while decreasing potential exposure to the coronavirus. This includes screening patients before they arrive about whether they have symptoms that could indicate COVID-19, spacing chairs in waiting rooms and infusion rooms to allow for physical distancing, and disinfecting all rooms between patient visits.
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