If your primary care provider or dermatologist suspects you have psoriatic arthritis (PsA), they’ll likely refer you to a rheumatologist. You might think, “Another doctor? That sounds complicated. Why can’t this one treat me?”
Psoriatic arthritis is a chronic autoimmune disease that occurs when the immune system attacks healthy cells and tissue. Although other doctors can treat some PsA symptoms, one specializing in joint, muscle, and bone disorders will be better equipped to make an early diagnosis and prescribe treatments that help slow disease progression and prevent inflammation, pain, and joint damage.
“If you only have skin issues, a good dermatologist should be able to treat you,” one MyPsoriasisTeam member said. “But if you have any issues with joint pain and stiffness, it’s a good idea to see a rheumatologist as well.”
The key is finding the right one.
A rheumatologist is a doctor with specialized training in musculoskeletal, inflammatory, and autoimmune diseases. This area of medicine is called rheumatology. Conditions that rheumatologists treat include psoriatic arthritis, rheumatoid arthritis, osteoarthritis, bursitis, gout, and systemic lupus erythematosus (the most common type of lupus).
For people with psoriatic arthritis, a rheumatologist is often the one who helps them make sense of their symptoms, like joint pain, ligament tenderness, nail pitting, and dactylitis (swelling of the fingers and toes). Since no single test can confirm a psoriatic arthritis diagnosis, rheumatologists often rely on physical exams, family history, symptoms, and their experience in treating people with PsA. They may recommend X-rays or blood tests to rule out other types of arthritis, autoimmune diseases, or skin conditions.
“I was misdiagnosed for many years,” shared one MyPsoriasisTeam member. “When I finally went to a rheumatologist, he immediately knew what was wrong with me. It was psoriatic arthritis.”
After you receive a psoriatic arthritis diagnosis, a rheumatologist plays a vital role on your health care team. In addition to creating your treatment plan, they can prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), corticosteroids, biologics, and other medications or therapies based on your psoriatic arthritis symptoms. Prompt, appropriate treatment can help prevent permanent changes in the joints.
Here are a few ways to find a rheumatologist:
Once you’ve found a rheumatologist in your area, consider these five characteristics to help decide if they’re a good fit for you.
While all rheumatologists can treat psoriatic arthritis, not all do. Some specialize in other types of arthritis or autoimmune conditions. Before making an appointment with a rheumatologist, read reviews and search for comments from people who mention psoriatic arthritis. You can also look online to see if they publish psoriatic arthritis research, attend conferences, or write articles about PsA.
Not finding anything in your search doesn’t mean the rheumatologist lacks experience with PsA — it just means you’ll need to ask at your first appointment. Don’t be shy. Your quality of life and well-being are at stake. If you’re not confident in their answers or expertise, keep looking.
As one MyPsoriasisTeam member advised, “Make sure you have a good rheumatologist. This is very important.”
Have you ever felt rushed during a doctor’s appointment? Have you ever waited weeks to get on your health care provider’s schedule? Both scenarios can be frustrating. The best rheumatologist in the world can’t help if they’re too busy to see you.
Ask the receptionist or office manager how far out they schedule appointments. Also, ask about their protocol for urgent needs. Will they make time for you if you’re in pain or have suddenly worsening symptoms? If they can’t answer those questions or their protocol is to refer people to urgent care or another provider, keep looking.
One MyPsoriasisTeam member said, “I can’t get into a rheumatologist for months. My primary care provider is trying to keep my symptoms under control until then.”
“My rheumatologist is wonderful, but his schedule is ridiculous due to a shortage of rheumatologists in our area,” mentioned another member.
Find a rheumatologist who will make time for you.
Psoriatic arthritis affects approximately 1.5 million people in the United States. About a third of people with psoriasis develop PsA, which can occur at any age and sometimes without psoriasis symptoms. While all those people have PsA in common, there are many factors they don’t share, such as age, gender, activity level, and preexisting health conditions. If your rheumatologist treats you based on how they treat everyone else, it might be time to find a new provider.
“Find a rheumatologist who will listen to your concerns and symptoms and not just rely on blood work,” one MyPsoriasisTeam member said.
“My rheumatologist did an X-ray of each hand and wrist to determine if I have osteoarthritis, psoriatic arthritis, or nerve problems,” shared another.
“Mine is sending me for an MRI,” said a third.
Having a rheumatologist who sees you as an individual and adjusts your treatment plan accordingly can go a long way toward easing symptoms, slowing disease progression, and maintaining your quality of life and mental health.
Patient-doctor communication is essential with any medical condition but especially with a chronic disease like psoriatic arthritis. If your rheumatologist doesn’t call you back, explain things thoroughly, or share test results promptly, consider trying a new one. “Find a good rheumatologist and build a relationship with them,” advised one MyPsoriasisTeam member.
In addition to communicating with you, your rheumatologist should communicate with your primary care provider and other doctors. After a psoriatic arthritis diagnosis, your health care team will likely expand to include more specialists, like physical therapists, occupational therapists, and dermatology specialists, if you also have psoriasis. Everyone should work together to support you.
It’s also important for your rheumatologist to know about all medications you’re taking — not just those for PsA — and discuss them, if necessary, with your other providers. Psoriatic arthritis can exist with a host of other health conditions, including:
Even if your rheumatologist willingly communicates with the rest of your health care team, one MyPsoriasisTeam member recommends taking notes: “Each of us needs to be our own advocate and do as much research as possible. We should also keep a journal of our symptoms and conditions to keep each doctor informed of what is happening.”
When you tell your rheumatologist that your psoriatic arthritis treatment is causing side effects and you would like to try a different medication, you should feel like they’re listening to you and willing to address your concerns. If you tell them that your joint symptoms are worsening or your fingers are more swollen than usual, you should feel like it matters to them. Everyone has a bad day and schedules are sometimes extra busy, but if you consistently feel like your rheumatologist is rushing through your appointment or ignoring your concerns, it’s probably time to find a new one.
“There are health care professionals who blow things off, but there are also wonderful doctors who have great knowledge and care for their patients,” said one MyPsoriasisTeam member. “Don’t give up. Keep looking for a doctor who takes the time to honestly assess and provide the care you need.”
MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 124,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis and psoriatic arthritis.
How did you choose your psoriatic arthritis doctor? Do you have tips for others who are looking for a doctor? Share your experience in the comments below, or start a conversation by posting on your Activities page.