Arthritis is a general term for joint pain or joint disease. The condition encompasses over 100 different types, ranging from the common wear-and-tear of osteoarthritis to complex autoimmune disorders like rheumatoid arthritis. Because of this wide variety, no single doctor handles every aspect of the condition, and effective management often requires a coordinated team approach that typically begins with your primary care provider.
Starting with Your Primary Care Provider
The Primary Care Provider (PCP), such as a family doctor or internist, is generally the first point of contact when new joint pain or stiffness appears. They are responsible for the initial assessment of symptoms and ruling out other conditions that might mimic arthritis, such as infections or injuries. This early evaluation involves a physical examination, a detailed medical history, and often includes ordering basic diagnostic tests.
The PCP may request blood work to check for inflammation markers or specific antibodies, and they might order X-rays to assess the joints. Their most important role is recognizing the signs of inflammatory arthritis, which requires timely intervention and a rapid referral to a specialist. While PCPs can manage mild cases of osteoarthritis with pain relievers, they typically defer to a subspecialist for complex diagnosis and long-term disease-modifying treatment plans.
The Specialist for Medical Management
The specialist who provides the most comprehensive diagnosis and non-surgical medical management for arthritis is the Rheumatologist. A rheumatologist is an internal medicine physician with extensive additional training, typically two to three years in a fellowship, focusing on musculoskeletal disease and systemic autoimmune conditions. They are the experts in inflammatory and autoimmune types of arthritis, such as Rheumatoid Arthritis, Psoriatic Arthritis, Lupus, and Gout.
The rheumatologist pinpoints the exact cause of joint pain, which is necessary because different types of arthritis require different treatments. Their diagnostic process combines physical exams with sophisticated laboratory tests for specific autoantibodies, like anti-CCP, and advanced imaging. They are the authority on administering specialized medications, particularly Disease-Modifying Anti-Rheumatic Drugs (DMARDs) and biologics, which target the immune system to slow disease progression and prevent joint damage.
A typical visit involves monitoring disease activity, assessing joint swelling and tenderness, and adjusting the long-term medication strategy to minimize symptoms and side effects. They may also perform procedures like joint aspiration (removing fluid from a swollen joint for analysis) or administering corticosteroid injections directly into the joint to reduce inflammation and pain. For chronic conditions like Rheumatoid Arthritis, ongoing consultations are necessary to manage the disease and prevent complications.
Professionals Focused on Function and Structure
While the rheumatologist manages the disease itself, other specialists address the physical consequences and structural damage that arthritis can cause. When joint damage is severe and non-surgical treatments are no longer effective, an Orthopedic Surgeon is consulted. These specialists focus on the musculoskeletal system and perform surgical interventions, such as joint replacements, joint realignments, or arthroscopy to repair damaged tissue.
Orthopedic surgeons often treat structural forms of arthritis, particularly advanced osteoarthritis where cartilage has deteriorated. They also work closely with rheumatologists when inflammatory arthritis has caused irreversible joint destruction requiring surgery. Their role is structural—to fix or replace the physical joint—while the rheumatologist manages the underlying disease.
Complementing the medical and surgical teams are Physical Therapists (PTs) and Occupational Therapists (OTs), who are essential for maintaining quality of life. A physical therapist develops customized exercise programs to improve joint strength, flexibility, mobility, and endurance. They may use techniques like heat or cold treatments and instruct patients on proper posture and the use of walking aids. Occupational therapists focus on adapting daily life activities to protect joints and conserve energy by teaching joint protection techniques and recommending assistive devices.