RheumatologyWho should I go to if I have backache, a neurologist, orthopaedist or a rheumatologist?
All of the areas focus on this problem. The first question is how long you have the symptoms and how old you are.
The main causes of backache in case of children or young adults are inappropriate posture and scoliosis. The treatment is the simplest in this age; it is the task of the orthopaedist. You have to pay attention to appropriate posture and you should go swimming and take spine exercises. It is recommended to take the exercises in a group with the help of a physiologist, because if you take them in a wrong way they do more harm than good. If you do sport you should ask your doctor if the sport you do makes it better (such as swimming, ballet, or gymnastics) or worsen (such as tennis, ice hockey) scoliosis.
Bechterew’s disease or spondylitis ankylopoetica develops in the age of 20-30 usually in men but sometimes in women too. It has an inflammatory origin, and if is not treated it can cause the total rigidity of the spine. The most common symptom is backache occurring in the middle of the night which can be reduced by moving. It is often associated with ophtalmia (uveitis, iridocyclitis), or inflammatory diseases of the bowels. In the last 5 years the invention of a new method, the biological therapy, was a huge breakthrough in curing this disease. If it is detected in an early state you have a good chance to get better. It is an inheritable disease. You can read more from this disease in the following webpage: www.derékfájáscentrum.hu.
Adults often have backache after a long-time sitting, standing or walking. It is usually caused by the abrasion of the spinal joints, the weakening of the spinal discs. Also contributes the untreated scoliosis which causes these processes. Temporary solution is an analgesic treatment with pills, injection or electricity. Unfortunately the symptoms often return after a while. You should take spine exercises, because the development of strong backbone supporting muscles can prevent operation.
If the pain radiates to the lower limbs and associated with numbness and weakness of the legs it is definitely a disease of the spinal discs (discus hernia, or protrusion). In this case you should go to see an orthopaedist or rheumatologist who decides if it can be treated conservatively (without an operation). If physiotherapy, swimming and taking exercises will not work and there is chance for developing paralysis or problems with perception it is treated by an operation which is done by a neurologist. Unfortunately it is not the final solution in some cases, because scars can develop in the surgical area, and the same disease can develop in the next spinal discs which mean another operation.
In case of elderly people osteoporosis is an other problem besides the abrasion of the joints and spinal disc hernia. It develops without pain the first symptom can be a fracture. In this state the most important task is pain relief and prevention of other fractures.
Nowadays there is a way to detect osteoporosis in its asymptomatic state. The method is called DEXA. It is similar to X-ray and painless. With screening and treatment started in time vertebral collapse can be prevented. The medicine is prescribed by gynaecologist, rheumatologist or endocrinologist after the results of DEXA. You can prevent osteoporosis by consuming 1000 mg calcium per day, consuming food rich in calcium, walking 15 minutes every day, or consuming 1000 NE D3vitamin.
The metastasis of a tumour can cause backache too. It is usually painful in a rested state.
If you do not know what causes your pain you should go to see your doctor.
What does autoimmune disease mean?
There are two kind of autoimmune diseases. There are diseases which affect organs such as autoimmune inflammation of the skin, thyroid gland, brain or eyes. These diseases are treated by the doctor of the appropriate area, because these diseases do not affect the whole body. There are systematic autoimmune diseases which affect more organs at the same time. These diseases are treated by rheumatologists or immunologists.
Systematic autoimmune diseases are for example: SLE (systemic lupus erythematosus), Sjörgen’s syndrome, dermatomyositis, polimyositis, progressive systemic sclerosis, and vasculitis.
These diseases are really varied. If you suffer from these diseases you have to go regularly (in every 3-6 months) to controls.
You may have autoimmune disease if you have fever and you do not know its origin, losing weight, weakness, bluish fingers, dryness of the eyes or the mouth, arthritis, pleurisy, pericarditis, anaemia, accelerated ESR or protein in your urine.
In these cases you should go to see a doctor. Symptoms can occur quickly, and the fast deterioration can lead to death if it is not treated. Nowadays the majority of autoimmune diseases can be treated by medication. If it is detected in the age 20-30 you can live with it together even start a family.
Polyarthritis
It is affect the 1 or 2% of the people. The joints of the hands, the wrists, the knees, the ankles or the toes are painfully swelling. It can be symmetric or unilateral.
Symptoms do not pass away in days; even it can be associated with stiffness of the joints usually after waking up.
Sometimes painkillers do not help. Many diseases can cause these symptoms which should be detected in a rheumatologic examination combined with X-ray and laboratory tests
In some cases the symptoms are caused by purulent tonsils, urinary tract infection, inflammation of the prostate or a disease which cause diarrhoea. It is detected by the screening in some days, and the symptoms pass away after the elimination of the pathogen.
In case of purulent arthritis the phlegm must be removed by a syringe. Immediate treatment is important because the pathogen can spread in the whole body in the bloodstream.
Sometimes the joints are damaged by your own immune system. Then it is treated by the inhibition of the immune system. The most dangerous type is rheumatoid arthritis which corrodes the surfeca of the bones and that often lead the deformation of the joints and the fingers. If it is detected in an early state it can be stopped, and also there are methods to ease the symptoms of its later sates.
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