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Treating an ‘invisible’ illness: When to see a rheumatologist

Paoli Hospital April 5, 2017 Senior Health

Millions of people across the globe—regardless of health status, age and gender—are affected by joint and muscle pain every day. And, in some cases, who they are might surprise you—the young father whose debilitating back pain makes it difficult to pick up his children; the 45-year-old woman whose lupus flare-up has kept her from another weekend with friends.

But to Jennifer Kwan-Morley, MD, a rheumatologist at Paoli Hospital, part of Main Line Health, stories like these are similar to those of patients she sees every day.

“Many of us expect to see people wearing their pain ‘on their sleeve,’ so to speak. In many cases pain does manifest itself through physical symptoms like poor posture or knotted joints as a result of arthritis, but pain can be invisible, too,” she says.

Rheumatologists like Dr. Kwan-Morley are accustomed to seeing patients who suffer from a variety of musculoskeletal conditions and autoimmune diseases, ranging from osteoporosis and more than 50 kinds of arthritis to lupus and gout.

“The conditions that a rheumatologist treats can vary so widely, and there are many people who come to us after years of trying to find the right doctor to address their pain,” explains Dr. Kwan-Morley. “Rheumatic conditions are not always easy to diagnose.”

So, how do you know if a rheumatologist is right for you? Could making an appointment with one be a solution to the joint pain that’s been plaguing you? It depends, says Dr. Kwan-Morley.

If you’re experiencing symptoms like those listed below, it may be time to talk to a rheumatologist or to ask your primary care doctor for a referral:

  • Joint pain that occurs without injury
  • Joint pain with other symptoms like morning stiffness, swollen joints and fever
  • Joint pain that’s accompanied by psoriasis or other rashes
  • Persistent back pain

Symptoms like these are common but, contrary to popular belief, they don’t have to be permanent.

“A rheumatologist’s goal is to minimize pain and discomfort using non-surgical techniques. Our background in internal medicine allows us to help treat pain with a multi-modal approach including physical and occupational therapy, exercise, medications, injections, and lifestyle modifications.” explains Dr. Kwan-Morley.

However, in some cases, surgical care may be necessary. If you’re experiencing joint pain after an injury, your pain gets worse when you’re carrying excess weight or your pain is preventing you from completing everyday activities or interfering with your lifestyle, you may require more advanced treatment and a visit with an orthopaedic surgeon.

If you have joint pain or swelling that lasts for more than a few days to weeks, talk to your primary care doctor. They can conduct a preliminary physical exam to determine what the source might be and, if necessary, may refer you to a rheumatologist for further examination.