Osteoarthritis - rheumatologist

[maxaroni]

First of all, I have zero idea what sorts of issues that rheumatologist treat, except rheumatoid arthritis. I have osteoarthritis and not sure what to do. I have recently had a hip replacement due to arthritis. I know my knees have arthritis as do my feet. I have arthritis in some of my fingers to the point of deformity. My c-spine and lumbar spine are arthritic, as well as stenosis. My PCP has only prescribed anti inflammatories. I have seen orthopedic doctors and have had cortisone shots in my knees. I don't want to live on anti inflammatory meds. Do rheumatologists treat osteoarthritis? Any ideas of what they would do?

 

[PrincessShmoo]

First of all, I have zero idea what sorts of issues that rheumatologist treat, except rheumatoid arthritis. I have osteoarthritis and not sure what to do. I have recently had a hip replacement due to arthritis. I know my knees have arthritis as do my feet. I have arthritis in some of my fingers to the point of deformity. My c-spine and lumbar spine are arthritic, as well as stenosis. My PCP has only prescribed anti inflammatories. I have seen orthopedic doctors and have had cortisone shots in my knees. I don't want to live on anti inflammatory meds. Do rheumatologists treat osteoarthritis? Any ideas of what they would do?

What is a Rheumatologist?
A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles, and bones causing pain, swelling, stiffness, and deformity.

Rheumatologists treat joint disease similar to orthopedists but do not perform surgeries. Common diseases treated by rheumatologists include osteoarthritis, gout, rheumatoid arthritis, chronic back pain, tendinitis, and lupus.
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist

 

[MaryLovesPoohBear]

My rheumatoid doctor doesn't treat osteoarthritis. But he does treat RA, Lupus, Sarcoidosis and other auto-inflammatory diseases.

My otho does treat my osteoarthritis. But he treats it with anti inflammatory meds and physical therapy.

 

[maxaroni]

What is a Rheumatologist?
A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles, and bones causing pain, swelling, stiffness, and deformity.

Rheumatologists treat joint disease similar to orthopedists but do not perform surgeries. Common diseases treated by rheumatologists include osteoarthritis, gout, rheumatoid arthritis, chronic back pain, tendinitis, and lupus.
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist

Thanks for that. I actually should have said that I know what a rheumatologist is by googling and reading. However, do not know anyone that goes to a rheumatologist and have no "first hand" knowledge if people actually go to one for OA. I guess part of my frustration in all of this is that I just don't know if I should go down this road of another doctor and find out that the treatment is anti inflammoatories, with or without PT.

 

[minkydog]

I have osteoarthritis in my knees and psoriatic arthritis in my feet & hands. My rheumatologist primarily treats the PsA. All 10 of my fingers have deformities, from mild to severe. Surprisingly, I have little pain. Just stiffness and poor grip strength. My feet get tired easily and I have deformity of the right great toe joint, making it hard to find shoes that fit without inflaming that joint. I have exactly 3 pairs of sandals and one pair of close-toed shoes.

 

[maxaroni]

My rheumatoid doctor doesn't treat osteoarthritis. But he does treat RA, Lupus, Sarcoidosis and other auto-inflammatory diseases.

My otho does treat my osteoarthritis. But he treats it with anti inflammatory meds and physical therapy.

I am about to start PT, once again. Not sure if it will really help, or not. I went a number of years ago for my c-spine and it didn't do much and nothing long lasting. I hate anti inflammatory meds and don't want to live on them.

 

[MaryLovesPoohBear]

I am about to start PT, once again. Not sure if it will really help, or not. I went a number of years ago for my c-spine and it didn't do much and nothing long lasting. I hate anti inflammatory meds and don't want to live on them.

The thing about physical therapy is that it is life long. Or at least it seems to be.

Yes, you only go a few times to work with someone, but they give you exercises to do, and for something chronic, you do them pretty much forever.

When my knees start to hurt, I remember to go back to basics with therapy exercises. The goal is to strengthen the muscles around the knee, therefore taking pressure off of the knee. It works, as long as I work it.

 

[maxaroni]

I have osteoarthritis in my knees and psoriatic arthritis in my feet & hands. My rheumatologist primarily treats the PsA. All 10 of my fingers have deformities, from mild to severe. Surprisingly, I have little pain. Just stiffness and poor grip strength. My feet get tired easily and I have deformity of the right great toe joint, making it hard to find shoes that fit without inflaming that joint. I have exactly 3 pairs of sandals and one pair of close-toed shoes.

@minkydog haven't seen you in awhile but have followed your health, as well as your DH's. Hope things are going as well as they can for you.

My fingers come and go with pain but yes, the grip is not like it was. My knees have had injections, my right knee is partial bone on bone but not near replacement. My back is a disaster between stenosis and OA. My feet get tired easily but also have plantar fasciitis, as well as Achilles tendinitis. Just not sure what, if anything, I can do for this. Oh, I am stiff, not flexible and my ROM with my back and neck is not good.

 

[maxaroni]

The thing about physical therapy is that it is life long. Or at least it seems to be.

Yes, you only go a few times to work with someone, but they give you exercises to do, and for something chronic, you do them pretty much forever.

When my knees start to hurt, I remember to go back to basics with therapy exercises. The goal is to strengthen the muscles around the knee, therefore taking pressure off of the knee. It works, as long as I work it.

That's what I thought. I probably need to wrap my head around that, lifelong commitment. Part of my problem with anti inflammatories is that my mom had kidney failure and anti inflammatories go through the kidneys. Thanks for your insight.

 

[leebee]

I have osteoarthritis in my knees and psoriatic arthritis in my feet & hands. My rheumatologist primarily treats the PsA. All 10 of my fingers have deformities, from mild to severe. Surprisingly, I have little pain. Just stiffness and poor grip strength. My feet get tired easily and I have deformity of the right great toe joint, making it hard to find shoes that fit without inflaming that joint. I have exactly 3 pairs of sandals and one pair of close-toed shoes.

Hey, @minkydog, good to see you again! I've wondered how you all are doing!

My husband has osteoarthritis in his right knee and sees an orthopedist. He managed it with PT, until he had a high tibial osteotomy to change the way his tibia and femur strike, so he'd be bearing weight on the areas of the joint that still have cartilage. This was done to put off a knee replacement for about 10 years. Unfortunately the surgical site became severely infected and he almost lost his leg. Now he has a terribly deformed leg, gastrocnemeous flap reconstruction, and STILL has arthritis in the knee, and it's still painful to walk on. Sigh. No idea of what is next or if anyone can help him.

 

[powellrj]

I have lost faith in rheumatologist. I have seen several over the past few years. The last one told me people go to see him so they don't get in the shape I'm in. Ok, thanks I guess.

 

[MrsDuck]

I regularly see my rheumatologist but that's because I have RA. I'd think rheumys are more targeted to people with autoimmune diseases.

BUT, I'd call a local rheumatologist and ask if their doctors would see you. I'd make it very clear you do not have an autoimmune disease. If they feel you are not a patient for their practice, I'd ask if they recommend any other doctors who could treat you.

Just in my experience: a rheumatologist will put you on anti-inflammatory drugs. You say that isn't something you want so I'd recommend exploring holistic options: acupuncture, physical therapy, massage, diet changes. All contribute to lessening my RA symptoms (I am still on drugs, though, for my RA - a necessity in my book).

 

[sksjasams]

Yes, rheumatologists can treat osteoarthritis. My primary care doctor sent me to one after the treatments she tried did not help. I saw him for a while and he tried different injections and meds, but eventually told me I didn't need to come back because there was nothing more he could do.

 

[Wishing on a star]

I can see osteoarthritis in the knee and hip replacements....
But the other swelling and joint deformity issues sound like rheumatoid to me.

Ii would wonder if I were correctly diagnosed.
IMHO, any of these kid of joint issues would warrant a thorough eval with a good reputable rheumatologist.
I would pursue that right away.

I think the blood tests and other tests are better and more accurate than they once were.
I do know that some autoimmune issues are very hard to diagnose by blood tests alone.

I am so very sorry that you are dealing with this pain!!!
I hope that you can find more treatment and relief.

 

[MaryLovesPoohBear]

Although it can be very difficult to diagnose RA, and certainly someone would want to rule out RA first. OA also can cause deformity. Especially as we age.

 

[maxaroni]

So far, 2 doctors have said that the deformity in my fingers would not be RA, as it isn't in the correct joint? I have had a whole boat load of blood work done and all is okay. I have been told that if you have OA in one joint, most probably it's elsewhere.

X-rays have shown my feet to be arthritic, c-spine and lumbar spine. I also have stenosis, which doesn't help, either.

With all of that being said, I have thought about RA more than once.

I don't even find that the anti inflammatories are overly helpful. At least, not helpful enough to warrant the risk of taking them. The doctor gave me a 2 week sample of Duexis (800 mg ibuprofen w/famantodine (sp?) for the stomach. He understands how I feel about nsaids but thought it was worth a try, putting a parameter on it.

 

[MaryLovesPoohBear]

Other than the causes of RA and OA being different, what they do is different.

RA causes system wide symptoms, including fatigue and fever. OA is only in the joints, degeneration of the cartilage.

OP, what type of treatment are you looking for?

 

[maxaroni]

@MaryLovesPoohBear You know, I just don't know what I am looking for. I am not one to take any type of pain meds, unless it's absolutely necessary. I didn't take anything for my bad hip until the very end and then, it didn't do anything as the hip was destroyed/collapsed. I think my main question was that I know very little about rheumatologists and thought of that route, not sure what I want. I don't want to go from doctor to doctor, if it really is going to be PT and anti inflammatories anyway. I am not sure that I want anti inflammatories for the next 20 years, or whatever. I will take them short term but not for a chronic condition. I know my doctor follows my kidney function (fine now) with my yearly blood work. However, knowing they can cause kidney issues,scares me to no end after seeing my mom go into kidney failure. Granted she had other issues, but I am pretty afraid of them for long term.

I am glad I raised the question as you are all giving me insight and something to think about.

 

[Pea-n-Me]

Osteoarthritis is tough to live with and tough to treat. My mother is almost 92 and suffers with severe OA, and I've been on that journey with her for over twenty years. We've tried a variety of medications with her but most made her feel sick. Currently she manages with minimal amounts of Motrin spaced throughout the day, and her kidney function, thankfully, is like that of a twenty year old. She is otherwise healthy, too. I don't know how old you are, but here's the thing. From an evolution standpoint, humans were not meant to live as long as we now live. The older the bones get, the more they're subject to inflammation and other problems. Even younger people with certain genetics can have problems, too. It's good that you had your hip repaired now (and had no problems, yikes with leebee's poor husband) as it's harder as you get older, and there may even come a time when you're ineligible for surgery. My mother never wanted to have MRIs and surgeries and that was her choice, but now she wishes she considered it more back when she could've.

I'm not going to go off to Google but there are some basic things you can do. Keep your weight within normal range, as it minimizes the pressure on your bones and joints. Make sure you get enough calcium in your diet. Eat healthily and get enough sleep. Remain as physically active as possible - as a pp mentioned, it's important to keep the muscles strong around the bones. Keep your mind active as well, as chronic pain can cause depression and that can exacerbate pain symptoms. Heating pads, hot water bottles, and/or cold packs can help alleviate pain, as can some of the complementary therapies a pp mentioned. (Have you ever tried Reiki?) Talk to your doctor about medications, supplements, and/or creams that can help. Consider getting walking aids if you have to, such as a cane, walker or wheelchair. (Check out www.goldviolin.com) The last things you want to do is not go places because you can't get around, or worse yet, fall. I would say it's worth a visit to a good rheumatologist for a "consult" if you wanted to try seeing one, but oftentimes primary care physicians are the doctors who can help the most, IME.

 

[MaryLovesPoohBear]

@MaryLovesPoohBear You know, I just don't know what I am looking for. I am not one to take any type of pain meds, unless it's absolutely necessary. I didn't take anything for my bad hip until the very end and then, it didn't do anything as the hip was destroyed/collapsed. I think my main question was that I know very little about rheumatologists and thought of that route, not sure what I want. I don't want to go from doctor to doctor, if it really is going to be PT and anti inflammatories anyway. I am not sure that I want anti inflammatories for the next 20 years, or whatever. I will take them short term but not for a chronic condition. I know my doctor follows my kidney function (fine now) with my yearly blood work. However, knowing they can cause kidney issues,scares me to no end after seeing my mom go into kidney failure. Granted she had other issues, but I am pretty afraid of them for long term.

I am glad I raised the question as you are all giving me insight and something to think about.

I understand.

I am sorry to say that NSAIDs are probably going to be your answer. That with therapy. And the things that the previous poster mentioned.

Like you I wish I didn't have to take NSAIDs. But my liver and kidneys are checked every six months. So if something happens to them, we will know pretty quickly.

I have found that working with my hands will help the stiffness and pain from RA. I've gone back to knitting. And adult coloring. Not only does it move my hands around, it also distracts me from the feeling that I have.