Osteoarthritis (OA) is the most common form of arthritis, affecting millions of people worldwide. It is a degenerative joint condition where the protective cartilage within the joints breaks down over time. This process causes pain, stiffness, and loss of mobility, most frequently impacting the hands, knees, hips, and spine. While many people manage symptoms with their primary care physician, consulting a specialist is often necessary to develop a comprehensive treatment strategy. This need for specialized, non-surgical management brings the role of the rheumatologist into focus for patients with chronic joint pain.
The Specialized Role of the Rheumatologist
A rheumatologist is an internal medicine physician trained in diseases of the musculoskeletal system, including joints, muscles, and bones. While known for treating systemic autoimmune conditions like rheumatoid arthritis, their expertise extends to the non-surgical management of joint disorders, including osteoarthritis. Rheumatologists are uniquely positioned to assess the complexity of a patient’s joint pain within the context of their overall health.
They offer a holistic, non-operative perspective, ensuring conservative care is exhausted before considering surgical intervention. Their value in OA management lies in their deep understanding of joint biology and disease progression. They help patients manage pain and improve function over the long term.
Differentiating Osteoarthritis from Inflammatory Conditions
One important function a rheumatologist performs is establishing an accurate diagnosis for joint pain. Osteoarthritis is a mechanical and degenerative problem, causing pain that typically worsens with activity and improves with rest. The underlying issue is the loss of cartilage, which may be visualized on X-rays as a narrowing of the joint space.
Conversely, inflammatory forms of arthritis, such as Rheumatoid Arthritis (RA) or Psoriatic Arthritis, are autoimmune diseases where the immune system mistakenly attacks the joints. These conditions are systemic, affecting the entire body, and often cause morning stiffness lasting longer than 30 minutes, along with fatigue. A rheumatologist uses blood tests to check for inflammatory markers and specific antibodies. This diagnostic clarity is paramount, as the treatment for an autoimmune disease is vastly different from the management of a degenerative one.
Non-Surgical Treatment and Management Strategies
For patients with confirmed osteoarthritis, the rheumatologist designs a comprehensive treatment plan centered on non-surgical interventions. This plan begins with advanced medication management, moving beyond over-the-counter options to prescription-strength non-steroidal anti-inflammatory drugs (NSAIDs) or other pain-relieving medications. The goal of this pharmacologic approach is to control pain and reduce localized inflammation that may contribute to symptoms.
Injections are a key tool to provide targeted relief directly to the affected joint. Corticosteroid injections quickly reduce pain and inflammation within the joint capsule, offering short-term relief that can last for several months. Another option is viscosupplementation, which involves injecting hyaluronic acid—a naturally occurring substance in joint fluid—into the joint. This procedure aims to improve lubrication and shock absorption.
Beyond drug-based treatments, the rheumatologist coordinates multidisciplinary care. They recommend and refer patients to physical and occupational therapists who develop personalized exercise plans to strengthen muscles supporting the joint. They also provide guidance on lifestyle modifications, such as weight management, which reduces the mechanical stress on weight-bearing joints like the knees and hips. This combined approach of medication, targeted injections, and coordinated therapy is essential for slowing disease progression and maximizing joint function.