Column: When to see a rheumatologist for arthritis - wellness webinar scheduled

Arthritis is a common condition most people will struggle with at some point in their life.
The most common type of arthritis is osteoarthritis, or “wear and tear” arthritis, that happens as we age or may occur earlier in areas of prior injury.

Other causes of osteoarthritis include obesity, a family history of osteoarthritis, and joint deformities, such as unequal leg length, bowlegs, or knocked knees. This type of arthritis will usually affect weight bearing joints such as the hips and knees, as well as hands and spine.

The most common symptom of osteoarthritis is pain in the joint, especially with use. You may also experience stiffness, cracking, and a bony enlargement or swelling of the joint.

Management options will often include diet, exercise (including physical therapy), medications to help with pain, medicines injected into the joint itself, or surgery with a joint replacement. These management options are most often discussed with your primary care provider who may then refer you to a physical therapist, physiatrist (physical medicine & rehabilitation specialist), or an orthopedic surgeon.

However, there are less common types of arthritis caused by autoimmune issues, called “inflammatory arthritis,” that include rheumatoid arthritis and psoriatic arthritis.

Rheumatoid arthritis (RA) occurs when the immune system malfunctions and attacks the body. It is a chronic arthritis that most commonly affects the hands, wrists, and feet, and causes inflammation that can destroy and deform the joints. RA may also involve systemic inflammation that can affect your heart, lungs, or eyes.

Psoriatic arthritis occurs in people with psoriasis. It is an inflammatory arthritis that can affect
small joints (fingers and toes), as well as large joints and the spine. It is also caused by a
malfunction of the immune system, where it attacks the skin and the joints.

Management of both rheumatoid and psoriatic arthritis may include many of the same options
as osteoarthritis. However, there are special types of medications used in the treatment of these types of arthritis, called disease modifying agents, or “DMARDs.” These medicines work
on the immune system to decrease pain and inflammation, as well as prevent damage and
deformity to the joints. Such medications are prescribed by a rheumatologist trained in
autoimmune issues, which is why it is important to be aware of the different types of arthritis and know when to see a rheumatologist.

Signs that you may have an inflammatory/autoimmune type of arthritis often include joint pain associated with a red, hot, and swollen joint (without a known injury), morning stiffness of more than one hour, or other concerning systemic symptoms such as fever, weight loss, or fatigue.

Your healthcare team, including your primary care provider, are able to help navigate such symptoms and determine when further testing and/or referral to a rheumatologist is necessary.

- 
Leah Krull, MD is a board-certified Rheumatologist and sees patients alongside Leah Walsh, NP at Barton Rheumatology.

Dr. Krull and Leah Walsh will host a free Wellness Webinar, “Understanding Arthritis & Joint Pain” on Thursday, February 10 at 5 pm. Register in advance at BartonHealth.org/Lecture. For more information about Barton Rheumatology, visit BartonHealth.org/Rheumatology.