Orthopaedists vs. Rheumatologists: Which to See for Joint Pain?

If you are one of the millions of Americans experiencing the unpleasant effects of joint pain, you know how difficult it can be just to undertake common, everyday tasks, such as climbing steps, bending down or doing laundry.

But there is no reason to ignore the problem. Read on to learn about which specialist you should see for your joint pain.

Which specialist do you see to treat your joint pain?

In diagnosing pain, the first step would be to do your research and visit your primary physician, as he or she can give a basic diagnosis and refer you to a specialist for a closer look.

The two most common physicians who treat joint pain are orthopaedists and rheumatologists.

“Orthopedic surgeons deal more with osteoarthritis and any trauma to the body,” said Dr. Craig Israelite, orthopaedic surgeon, Co-Director of Knee Service and Assistant Professor of Clinical Orthopaedic Surgery at Penn Medicine.

“Rheumatologists, on the other hand, are experts in the non-surgical treatment of the inflammatory and systemic forms of arthritis. They utilize a whole host of medications that can help with symptoms and even modify the progression of the disease.”

Israelite added that rheumatologists also treat many other non-arthritic diseases, such as lupus, fibromyalgia and sjogrens syndrome, to name just a few.

The rheumatologist will continue to monitor your condition and progression following the use of medications and other non-surgical treatments. However, if symptoms continue to persist, the rheumatologist will often refer you to an orthopaedic surgeon to see if you are a candidate for surgery, usually the last option when no other treatments alleviate the problem.

Would a patient ever need to see both types of specialists?

“There is some overlap, but usually after a failure of medical management, the orthopaedic surgeon will need to intervene by reducing the mechanical joint irritation if symptoms persist,” Israelite explained. “Unfortunately, once the cartilage is damaged, this becomes more of a mechanical problem and almost always ends with a visit to the orthopaedist, who is a surgical specialist, when non-surgical treatment fails.”

Review the following two lists of conditions to determine which specialist would best suit your needs.

Visit an orthopaedist if you have experienced:

• Joint or musculoskeletal pain following an injury
• Hip or knee pain that gradually increases when bearing weight
• Severe joint pain interfering with typical functioning
• Moderate or advanced arthritis in the hips or knees
• Previous unsuccessful treatment of joint pain
• A needed joint replacement

See a rheumatologist if you have experienced:

• Pain involving multiple joints
• New joint pain not associated with an injury
• Joint or musculoskeletal pain associated with fever, fatigue, rash, morning stiffness or chest pain
• Joint pain following a tick bite
• Joint pain coinciding with back pain
• Joint pain with psoriasis
• Muscular pain with or without any other symptoms
• Recurring headaches or muscle aches (and you are over 50)
• Back pain with or without leg pain
• Ongoing symptoms, such as unexplained fever, sweating or weight loss

Penn Medicine’s brand-new, state-of-the-art Musculoskeletal Center—which conveniently brings together multiple medical specialties—is a team of doctors, nurses and physical therapists who take a whole-body approach to diagnosing and treating joints, muscles, and bones. Seek medical care at Penn’s Musculoskeletal Center for advanced treatment in orthopaedics, physical medicine and rehabilitation, pain medicine and rheumatology. Visit www.PennMedicine.org/MSK, or call 215-615-2576.