With the number of primary and specialty doctors now available, it can be difficult determining the best person to see for psoriatic arthritis (PsA). If you had psoriasis prior to the arthritic component, then you may already have a dermatologist.
However, only a rheumatologist can properly diagnose and treat PsA. Whether you’re new to rheumatology or have reservations about seeing yet another specialist, consider just some of the reasons why a rheumatologist is necessary.
1. A rheumatologist is not the same as a dermatologist
In the treatment of psoriasis, many seek specialized treatment through a dermatologist. This type of doctor treats disorders of the skin, and can help provide treatments for plaque psoriasis and related skin lesions.
While you might still have skin symptoms during a PsA flare-up, a dermatologist doesn’t treat the underlying causes of this type of arthritis. You’ll need treatment from a rheumatologist in addition to skin treatments from a dermatologist. Aside from PsA treatment, a rheumatologist treats other types of related conditions, such as lupus, rheumatoid arthritis (RA), osteoarthritis, chronic back pain, and gout.
2. Rheumatologists offer more accurate diagnoses
Autoimmune diseases like PsA can be difficult to diagnose. If you’re seeing a dermatologist for psoriasis, they might occasionally ask you about joint pain if they suspect PsA. However, a dermatologist can’t properly diagnose this condition. The fact that PsA and RA share similar symptoms can also make diagnosis difficult if you don’t see the right specialist.
Only a rheumatologist can offer the most accurate PsA diagnosis. Aside from a physical exam, a rheumatologist will also conduct a series of blood tests. Perhaps the most crucial blood tests are those that look for rheumatoid factors (RF) and C-reactive proteins. If your RF test is negative, then you likely have PsA. People with RA have positive RF test results.
Other diagnostic tests may involve:
- taking joint fluid samples
- determining the amount of joint inflammation
- determining sedimentation (“sed”) rate to find out the amount of inflammation
- looking at how many joints are affected
3. Having psoriasis doesn’t necessarily mean you’ll get PsA
The American College of Rheumatology estimates that around 15 percent of those with psoriasis eventually develop PsA at some point in their lives. Other studies estimate up to 30 percent can develop arthritis, but not necessarily the psoriatic type.
For people with psoriasis, PsA, or both, this can mean two important reasons to see a rheumatologist. For one, psoriasis that has developed into PsA requires treatment from a rheumatologist to treat the underlying causes of the inflammation that are now affecting your joints. Also, if you have another type of arthritis, such as RA, you’ll need to seek the same type of specialized treatment.
4. Rheumatologists don’t perform surgery
In some forms of arthritis, joint damage can become so extensive that some people need surgery. Surgery is expensive, and the possibility of a doctor suggesting such procedures can turn some people off from seeking specialized care. It’s important to know that rheumatologists don’t perform surgeries. Instead, their focus is to find the right internal care to manage your disease in the long-term. Ultimately, this will help prevent the need for surgery in the future.
5. Rheumatology isn’t necessarily more expensive
While specialty doctors can cost more in terms of co-pays and initial out-of-pocket costs, rheumatologists aren’t necessarily more expensive in the long run. If you’re already seeing a dermatologist, for example, then you’re already seeking specialty care. Needing both types of specialists can be more expensive up front, but you’ll receive better long-term care than trying to get the same type of treatment from a nonspecialist.
Before seeing a rheumatologist, check to make sure the doctor you want to see is in your insurance carrier’s network of providers — this will help save some money. Also, double-check the estimated costs and see if your doctor is willing to work out a payment plan.
The bottom line is that seeing a rheumatologist early before PsA progresses will actually save money from surgery and hospitalizations that can incur from not treating the disease properly.
6. Rheumatology can help prevent disability
With PsA, it can be easy to focus too much on the short-term symptoms, such as pain during flare-ups. However, the long-term implication of the disease is far more imperative. Left untreated, the wear and tear of your joints from PsA-related inflammation can lead to disability. This can make it more challenging to do everyday tasks. And in some cases, permanent assistance may be needed for safety reasons.
It’s true that a rheumatologist’s mission is to provide medical treatment, but one extra benefit is the decreased incidence of permanent disability. Aside from performing tests and prescribing medications, a rheumatologist will offer lifestyle tips to help prevent disability. This can even come in the form of assistive devices, such as reaching aids to put less strain on your joints.
In addition, a rheumatologist may refer you to other services that can reduce the chances of disability. These may include physical therapy, occupational therapy, or an orthopedist.
7. You may need to see a rheumatologist before symptoms show up
Once the symptoms of PsA — like joint pain — begin to show up, this means that the disease has already started to progress. Though mild cases of PsA can still be treated, joint pain can indicate that damage is already being done.
To head off the effects of PsA, you might consider seeing a rheumatologist before you actually start experiencing symptoms. You may consider doing this if you have psoriasis, or if you have a family history of rheumatic diseases or autoimmune conditions.
Read more in Moderate to Severe Psoriatic Arthritis Pain ResourcesEmery, P., & Ash, Z. (2013, September). Psoriatic arthritis. Retrieved from http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis
Murphy, J. (2015, April). What is a rheumatologist? Retrieved from http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist
Psoriatic arthritis. (n.d.). Retrieved from http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/
Tests to confirm the diagnosis. (n.d.). Retrieved from https://www.psoriasis.org/psoriatic-arthritis/diagnosis/tests-to-confirm
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