What do rheumatologists do, and why would you need one? Rheumatologists are specialists who treat diseases that affect your muscles, bones, joints, ligaments, and tendons, according to the American College of Rheumatology (ACR). This includes various forms of arthritis, such as osteoarthritis, rheumatoid arthritis, and psoriatic arthritis. A rheumatologist can also help you deal with tendonitis, osteoporosis, bursitis, and inflammatory back pain. In addition, rheumatologists treat systemic autoimmune diseases such as lupus, Sjogren’s syndrome, and scleroderma, plus pain syndromes like fibromyalgia.

When to See a Rheumatologist and How to Find One

How do you know when the time is right for you to see one? “That’s a difficult question,” says James Udell, MD, a rheumatologist with the Arthritis Group of Philadelphia and Bucks County in Pennsylvania. “It’s easier to know with some other specialties. For example, if you can’t breathe, you see a lung doctor, and if you’re having loose stools, you see a gastroenterologist,” he notes.

But the symptoms people have when they need to see a rheumatologist are often vague. And rheumatic diseases, notes the ACR, can often be challenging to diagnose. “It’s not uncommon for us to see a patient after he or she has seen multiple other doctors,” Dr. Udell says.

As soon as you suspect you have a bone or joint problem, check in with a rheumatologist, suggests Udell. “The earlier we see a patient, the better they will do in the long run.”

Most of us have joint or muscle pain on occasion, but if it doesn’t resolve, your primary care doctor may refer you to a rheumatologist. If you have a family history of autoimmune disorders or rheumatic diseases, the ACR suggests you consider an earlier visit to a rheumatologist. The sooner you are diagnosed, the sooner you can begin treatment and prevent joint damage.

To find a rheumatologist, consult with your primary care doctor, ask your network of friends and family for recommendations, and consider using the ACR’s online searchable database.

How Can Working With a Rheumatologist Help You?

Rheumatologists understand the biology of autoimmune diseases and are well-equipped with information to target and treat them, says Seth D. Ginsberg, cofounder and president of the Global Healthy Living Foundation, an advocacy group for people living with chronic illnesses. A family practitioner may not have the depth of knowledge about some of these syndromes.

The best case scenario is having a primary care practitioner as well as a rheumatologist who both regularly coordinate arthritis care, Ginsberg notes. “As I was growing up, my pediatric rheumatologist used to send a report to my pediatrician after every visit. That made my file, back when they were kept in folders, very thick for both doctors. But it was important to have as much documented as possible,” he says.

What to Look for in a Rheumatologist

How do you find the right rheumatologist for you? These answers from Udell and people living with RA to questions about selecting a rheumatologist will help you find the best specialist for you.

“I looked for a gentle, confident, wise, reassuring bedside manner,” says Ginsberg. “I was interested in someone I could relate to, have a conversation with, and explain my situation to in broader terms than just my aching joints. My wife came with me during the first visit and joined us in the exam room. Her opinion mattered, too,” says Ginsberg.

Udell agrees that one of the first things to consider is the doctor’s personality and how well it meshes with yours, especially if your disease is a serious, chronic one such as rheumatoid arthritis. “That’s because your relationship with the rheumatologist could be a very long one, which is one reason I went into this specialty,” Udell says.

The doctor-patient relationship should be nurtured as time goes on, Udell adds. If there's an issue that the patient and physician don't see eye-to-eye on, for example, they need to discuss it.

Or you might want to be more aggressive about treatment options while your doctor wants to be less aggressive — this is also something you two must discuss, he says.

When You Know You Have the Right Match

Traci Lynn Martin, a neonatal ICU nurse and expedition kayaker from Lee’s Summit, Missouri, found out she had rheumatoid arthritis and went to a few rheumatologists before she found the right chemistry.

“The first person I saw I didn’t like,” Martin says, “because I didn’t feel like he was listening to me. He had a formula with questions and it wasn’t personalized. It was important for me to stay active, to be able to do my triathlons, and long distance kayaking that I had done my whole life.”

Friends referred her to other specialists, but she knew right away when she found the right rheumatologist. “He sits down and doesn’t rush in and out and doesn’t leave the room until I am happy,” Martin says. “I walked out of there so happy after the first visit, I felt like I had someone who was listening to me for the first time since my diagnosis.”

How to Prepare for Your Appointment With a Rheumatologist

“What I would suggest for anyone who is getting ready to see a new doctor is to sit down before you go and write down on a piece of paper why you are going and what you are hoping to accomplish with your visit,” says Martin. “And write down a list of everything that’s going on with you. If you have everything written down when they come into the room, I think the doctors themselves will sit down and be a little bit more patient. It pays to be organized and know what it is you want to talk to your doctor about.”

At your initial appointment, your rheumatologist will perform a thorough physical exam and discuss your symptoms with you; they may also run lab tests. To get the most out of your first appointment with a rheumatologist, in addition to bringing detailed notes of your symptoms, the Cleveland Clinic recommends bringing a list of questions. Common concerns may have to do with pain relief options, medications, and dietary or lifestyle modifications. Also be prepared to listen and take notes, or bring a recording device. You’ll likely be hearing a lot of new information and having a record to go back to can help keep you from getting overwhelmed.

Red Flags to Watch Out for When Choosing a Rheumatologist

Be wary of someone who doesn’t look you in the eye; eye contact is crucial, Ginsberg believes.

If the doctor’s head is buried in your chart or electronic health record during your appointment, that’s a red flag. You want someone who relates to you, not your chart or lab results, he says.

Another major red flag is when doctors, nurses, or other members of the office staff don’t respond to your phone calls.

What to Do if You Struggle With Finding a Rheumatologist

There has been a shortage of rheumatologists in America — as well as many other developed countries — for the last decade or so, says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida.

But that doesn’t mean that you can’t get good treatment from your primary care physician if that’s what your situation requires. “The advancement in the medical community’s understanding about the causes and the treatments of arthritic conditions, as well as the evolution of telemedicine, has allowed primary care physicians to diagnose and treat most common forms of arthritis,” says Ginsberg.

Dr. Domingues also thinks there could be a positive future for telehealth, which is when patients receive health-related services and information via electronic information and telecommunication technologies.

“It will never replace an in-person doctor, but it may be an option for the future. And the American College of Rheumatology has good support groups. CreakyJoints, an advocacy, education, and support group for people living with arthritis and rheumatic disease, also has forums and resources that should be explored,” says Domingues.

Additional reporting by Deborah Shapiro.

How to Choose a Rheumatologist