Rheumatologists and GP’s

Question: I have yet to know of anyone who gets any joy at a Rheumatologist (if I’m wrong, please feel free to correct me!!!). I got told “oh, it’s just a mechanical problem….”. Thanks. Can I have oil and filter at the same time please?!! When was the last time your garage said “we’ll have to scrap your car because it’s got a flat tyre!”. We have had the discussion before, and I am more sure that people with RSI get sent to a Rheumatologist because the GP’s don’t know where else to send us!

Answer 1: I think you’re right. I think also they don’t know what the problem really is, so it’s a bit of a lottery whether they think a rheumatologist would help or a mechanical person (i.e. Orthopaedic) or a neurologist of course. Then again, in my case I actually thought a rheumatologist might be better in order to explain a few things and eliminate any underlying problems, but my GP wants to send me for a mechanical check up first (even though the x-rays are all clear).

I wish they’d get this protocol sorted out and decide who the real expert should be for a given set of symptoms and likely causes. Because I think we just get passed around and nobody really wants to deal with it. I also wish it was easier both for patients and GPs to have access to a list of who specialises in what – someone referred today to an “upper limb specialist” – what’s one of them? What heading do they come under? Do they do necks and upper backs too? Where do I find my local one? Also it seems that our sorts of problems, especially the diffuse back and shoulder type ones, fall between the specialism and there’s nobody (or few) that really specialise in what may actually be a case of a bit of everything together. At the end of the day that might also be why a lot of us just end up at pain clinics. I’ve been told that’s probably where I’ll end up as they don’t really expect the orthopaedic consultant to find anything that he can really treat. But I have to see someone first before they can refer me to a pain clinic. It all seems crazy: what I probably really want is an expert on muscles (but I’ve never come across a myologist, if there is such a thing, in the NHS), a damn good physio/masseur and occupational therapist who really knows what they’re talking about.

Please by the way, just on a quick net surf – www.rheumatology.org.uk/– British Soc of Rheum – contains many interesting things, not least lots of nice stuff about how much they do and how much they love to help you, how you the patient matters, and how they work as part of a multi-disciplinary team involving occupational therapists, physios, masseurs, podiatrists and other helpful people… Also an overview of the conditions they get involved in. If you believe it they sound jolly useful people to see and do like muscles too, not just swollen joints. Interesting that their brief overview on over-use injuries (which they do treat, apparently) and fibrositis is that they’re best treated with aspirin, exercise and massage – there you go then… And www.boa.ac.uk/ – Brit Orthopaedic Soc – they also seem to be our guys from what they say they do… specialists in muscles and that, they say. OK, I’m confused again. Can’t find a list of specialists yet but already used up my daily computing/non-working allowance – The above sites have lots of links and addresses/phone numbers, including British Institute Musculo Skeletal Medicine – they sound worth a ring for a start in the hunt for a specialist.

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