Should You See a Rheumatologist for Osteoarthritis?

7 Signs That You Need Specialist Care

Osteoarthritis can often be managed under the care of a general physician. However, if your condition is severe, you might need to see a specialist.

A rheumatologist is a physician who specializes in treating inflammatory diseases and joint diseases, which include 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.

A patient talks with her doctor
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Role of the Primary Care Doctor In Osteoarthritis

Osteoarthritis can range from mild to severe. It often occurs years after an injury, and it is not considered a systemic disease. This means that it doesn't affect other body systems the way some inflammatory conditions—like rheumatoid arthritis do.

Your primary care doctor will make an initial assessment based on your symptoms, medical history, and physical examination. They can order X-rays, blood tests, or any other diagnostic tests needed. Your primary care doctor can also prescribe medications to relieve pain and other symptoms of osteoarthritis.

After test results come back and enough time has passed to evaluate how you are doing on the prescribed medications, your healthcare provider may continue to take care of your condition if you are responding to standard treatment. If not, they may decide to refer you to a rheumatologist, orthopedic surgeon, or a pain management specialist.

Role of the Rheumatologist

After consulting with your primary care doctor, your diagnosis might not be clear-cut or you might not be improving as expected with treatment. In this case, your primary doctor may refer you to a rheumatologist.

A rheumatologist is a physician who specializes in the diagnosis and treatment of rheumatic diseases, a group of disorders characterized by chronic, often intermittent pain affecting the joints or connective tissues.

You may need to a rheumatologist if:

  • Your pain is unrelenting.
  • Your symptoms are persistent or worsening despite treatment.
  • The diagnosis or underlying cause of your pain is not clear.
  • Your symptoms are flaring more frequently or more severely.
  • You are less able to handle tasks you use to be able to manage.
  • You are becoming increasingly homebound.
  • Your condition is lowering your quality of life.

A rheumatologist might determine that you have a different cause of your pain and that it's not osteoarthritis. In this case, your treatment plan will be specific to your condition.

They might do a procedure as part of this diagnosis, such as joint aspiration. And you might need injected pain medication, either done by a rheumatologist or by a pain specialist.

A rheumatologist can also consult on a limited basis to offer guidance about whether your treatment plan is appropriate and optimal for your condition. Then you can return to your primary healthcare provider for regular follow-up appointments.

A rheumatologist does not perform surgery. If surgery is indicated, an orthopedic surgeon would be your best option.

Other Providers Who Manage Osteoarthritis

There is no disease-modifying therapy that reverses osteoarthritis. This disease is a breakdown of a joint, usually due to wear and tear or after an injury. Management includes physical therapy, pain control, and sometimes surgery.

Other providers you might need to see:

  • Your primary care physician or rheumatologist may recommend over-the-counter (OTC) pain medication or prescribe pain treatment.
  • A physical therapist can work with you to direct you on how to do exercises for strength and pain relief.
  • A pain management physician or rheumatologist may treat you with pain therapies, such as injections.
  • A rheumatologist does not perform surgery. If surgery is indicated, an orthopedic surgeon would be your best option.

Before seeing a specialist, you will have to start by checking your health insurance coverage and its requirements. Insurance companies usually require that you see a primary healthcare provider before consulting with any specialist.

A Word From Verywell

A good team of healthcare providers that includes a primary care provider and specialists can work with you and together to ensure that you are getting advanced care for complex problems—as well as medical care that maintains consideration of all of your health problems.

By Carol Eustice
Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis."