Uncertain Who to See? A Rheumatologist Can Help with Your Fibromyalgia
Can a rheumatologist help with fibromyalgia?
If you are looking to get fibromyalgia diagnosed and treated, a rheumatologist who specializes in such conditions can help. This article explains how.
Characterized by widespread pain and tenderness, fibromyalgia can often be misunderstood and confused with other conditions. Before you dive in, you might like to check out our general information to demystify fibromyalgia symptoms and diagnosis first.
What does a rheumatologist do?
Rheumatologists are doctors trained in rheumatic diseases, which affect joints, bones, muscles and other connective tissues. This includes problems such as musculoskeletal pain, rheumatoid arthritis, osteoporosis, osteoarthritis, gout, lupus and other auto-immune diseases. This specialty takes many years of study after graduating from medical school (usually around four years general medical and another three years of specialized training).
Fibromyalgia doesn’t always happen on its own, so a rheumatologist can help to ensure fibromyalgia symptoms are not masking another condition.
An initial appointment with the rheumatologist will involve questions about your pain and history. They will want to know where in your body you feel pain most strongly, how severe it is, how long it lasts and so forth. They may conduct a physical examination and request blood tests, urine tests and/or scans such as an X-ray or ultrasound.
While fibromyalgia can be diagnosed from your symptoms alone, this does not exclude that you might have a rheumatic disease as well – it is not uncommon to have both. For more tips on how to get the most from this initial appointment, keep reading!
How can a rheumatologist help with my pain?
A rheumatologist can help to design a program to manage your pain and maximize your quality of life, but this often happens in collaboration with other members of your healthcare team. Remember, fibromyalgia is a complex condition and everyone experiences it differently. For this reason, a comprehensive management plan might be needed, involving a multi-pronged approach that includes support for managing physical and psychological symptoms.
While a rheumatologist may be helpful in the early days of diagnosis and early treatment, in the long term, you may need many people with a range of specializations and skills in your team. Here at MoreGoodDays®, we are happy to talk about ways we can support you with science-backed information and one-to-one support.
Finding a rheumatologist
There are a few ways you can locate a rheumatologist: your GP may be able to suggest one, you can ask on online forums, or when in doubt, try Google. Ask if they are familiar with fibromyalgia diagnosis and treatment, which should be listed on their website. In Australia, check the Find a rheumatologist page via the Australian Rheumatology Association. In the US, try the American College of Rheumatology Find a rheumatologist page.
Hang on a minute, what about a neurologist? Yes, fibromyalgia can have symptoms relating to the nervous system which are the realm of a neurologist. We know that fibromyalgia is really complex and a range of factors contribute to an overactive nervous system sending pain messages even when there is no clear tissue damage. Like a rheumatologist, a neurologist may be able to help with diagnosis but are not necessary for your long-term care.
Top tips for an effective rheumatologist appointment
Like any new relationship, it can be a bit scary, somewhat awkward when you walk into an appointment for the first time. Whether you are seeing your GP, a rheumatologist, neurologist or other pain specialist, here are some things you can do to make the most of the interaction.
Before you go in
Before you see a specialist get prepared and have a good understanding of your symptoms (the nitty gritty of what, where, etc.). Of course you know this – you've been living with the condition – but bring a written outline of your symptoms and history (maybe use online apps and tools such as My Health Story) because appointments are time-pressured and it may happen on a day you’re experiencing brain fog or even feeling emotional (re-hashing your story can do that).
You may want to write down your short and long-term goals, any questions you have and your expectations for the session. For example, are you just wanting a confirmation of diagnosis or ideas and suggestions for treatment or to begin an ongoing treatment or pain-management relationship?
You can treat this appointment like an interview because you want to know they are a good fit for you. This way, you’ll avoid disappointment (Brené Brown's definition of disappointment is unmet expectations). Don't forget, every patient has rights around the way they are treated (these can normally be found on the doctor's website) so it may help to be familiar with these in advance.
When you’re in there
Telling your story, especially if you’ve had a long and challenging relationship with symptoms, can be emotional and even trigger symptoms, so be gentle and kind to yourself.
While you are in the waiting room, take some deep breaths to help you feel clear and present so you can listen and interact in an engaging and constructive way. Attend with a sense of optimism and reality. It is unlikely this doctor will magically eradicate your pain but if you both bring a solutions-focused mindset, you can work together on enhancing your health and wellbeing. Don’t stress if you forget something, just ask about the possibility of checking in some time afterwards or perhaps bringing a support person who knows your history as a second pair of ears and eyes.
Afterwards
If you end up having an on-going therapeutic relationship with this clinician, keep the communication lines open, be willing to be flexible and change the plans to adapt to your changing needs and aim for fostering an open, collaborative and supporting relationship. There may be times when you'll need to whip out the "Sorry, but this just isn't going to work out" – the dreaded breakup conversation is always hard. You may get a sense that a specialist is not the right fit for you and this could present in a range of ways:
- Feeling like you are not being believed/heard. You can pick this up from the way they respond to your story, the eye contact, the follow-up questions and level of interest/empathy.
- Someone who wants to take over and control your health journey (you might get the feeling of a distinct power imbalance and that they are not open to the possibility of collaboration).
- A lack of time/effort to investigate the extent of your symptoms or go through the many options, alternatives and side effects so you can make an informed decision.
- Go with your gut (sometimes just that icky feeling of intuition can be enough).
We’d love your feedback! Did you find this helpful? If you have an experience you’d like to share or want some more information, we’re here to help! Come join the conversation over at our Living well with fibromyalgia Facebook Community.
This article is a part of a 3-article series. For more information check out:
