What is rheumatology, who is a Rheumatologist?

Rheumatology is a subspecialty of internal medicine and paediatrics, involved with the diagnosis and therapy of problems arising in the joints and soft tissues, as well as autoimmune diseases, vasculitis, and heritable connective tissue disorders. Clinicians who trained in rheumatology are called rheumatologists.

Rheumatologists diagnose and focus on non-surgical treatment of arthritis and related rheumatic diseases, such as lupus, rheumatoid arthritis, gout, fibromyalgia and other disorders of the joints and connective tissues of the body.

The similest way to understand rheumatology is that it deals with ‘aches and pains’ in the joints, spine, muscles and related tissues that help us move our body (also called musculoskeletal or locomotor system). In vernacular it is called ‘Gathia-Bai’. The specialists who deal with rheumatological (‘Gathia-bai’) diseases are known as Rheumatologists.

One of the major changes in modern rheumatology is the development of new drugs called biologics, or disease modifying agents, which can control severe disease more effectively.

There are more than 200 types of these diseases, including rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, and tendinitis. Some of these are very serious diseases that can be difficult to diagnose and treat. They treat soft tissue problems related to musculoskeletal system sports related soft tissue disorders and the specialty is also interrelated with physiotherapy, physical medicine and rehabilitation of disabled patients. Patient education programs and occupational therapy also go hand in hand with this specialty.

Every arthritis has a different name, different symptoms and signs requiring different types of investigations and treatment. Rheumatologists are specially trained in evaluating and recognising different types of ‘Gathia-Bai’. Once that is done, they categorise the problem into:

(i) Simple mechanical-structural (wear-and-tear or trauma related) problem, the so-called ‘green flag Gathia-Bai’
(ii) Any of the severe systemic immunological diseases affecting many other organs in the body (‘red flag Gathia-Bai’)
(iii) Regional or local musculoskeletal problems (e.g. shoulder pain, elbow pain, wrist pain, ankle-feet pain etc.)

The commonest disease in this category is the disease of aging joints, called osteoarthritis. It mostly affects the knees, low back and the neck in elderly persons (usually above 50 years of age). Such patients are immediately referred to physiotherapists-occupational therapists. Those requiring surgical intervention are then guided to Orthopaedicians in the hospital or to Spinal surgeons for the needful.