February 23, 2013
Living With Fibromyalgia: Doctors
Doctors are a part of life when you have any kind of chronic condition. Be it fibromyalgia, diabetes, heart disease, epilepsy… It doesn’t matter. Not only will you be spending more time at the doctor, but more than likely you are going to have more than one doctor treating you. It’s important that you are familiar with, not only the doctor as the person who is treating you, but exactly what each doctor can do for you.
With help from WebMD, here is a list of some of the doctors who specialize in treating fibromyalgia and pain:
- Rheumatologists diagnose and treat arthritis and other diseases of the joints, muscles, and bones. This includes fibromyalgia, rheumatoid arthritis, osteoarthritis, gout, lupus, back pain, osteoporosis, bursitis, and tendinitis.
- Pain specialists are usually board certified anesthesiologists, neurologists, physiatrists, psychiatrists, or oncologists with additional training in pain management. They receive credentials from the American Board of Anesthesiology (ABA) in collaboration with the American Board of Physical Medicine and Rehabilitation (ABPMR) and the American Board of Psychiatry and Neurology (ABP&N). Or they may receive credentials from the American Board of Pain Medicine.
- Neurologists diagnose and treat disorders of the nervous system. This includes treating common pain problems such as headaches, back pain, muscle disorders, fibromyalgia, neuropathy, and reflex sympathetic dystrophy (RSD).
- Orthopaedists specialize in the diagnosis, clinical treatment, and surgical repair of bone injuries. They also treat muscle problems and joint tissues — tendons, ligaments, cartilage.
- Psychologists diagnose and provide therapy for problems associated with pain, perception, depression, and anxiety.
A general practitioner (GP) is probably the person who diagnosed you with fibromyalgia (or any other condition). They are our first line of defense. They treat everything from the common cold to pneumonia, from migraine headaches to minor skin rashes, and everything in between. The definition of a GP is “A physician whose practice is not oriented to a specific medical specialty but instead covers a variety of medical problems in patients of all ages. Also called family doctor.”
Your GP is the one doctor who probably knows the most about your medical history since they are the ones who see you most often. When it comes to treating fibromyalgia, your GP may or may not be the one who treats you. It is something you will need to discuss with them. My GP, although extremely capable, sent me to see a specialist. Yes, she diagnosed me. Knowing how often I had been in to see her in the last year complaining of pain, having run numerous tests already, she knew exactly what I had. But it isn’t her area of expertise. Because she suggested it (and I really trust her judgment), I saw a specialist. However, your GP may be happy to treat you; at least until such time that either you or he/she feels a specialist is needed. In my case, this had been going on for well over a year. It was time to see someone who knew more about it.
The first specialist you are likely to see after your GP is a rheumatologist.
Basically, rheumatologists deal with anything having to do with pain in the muscles, joints and connective tissues. If it helps, this is the doctor that many people with arthritis see. I just saw my new rheumatologist for the first time 2 days ago. After going through the normal questions about my general health, we did a quick physical exam. This included him checking the 18 points generally associated with fibromyalgia. I talked about this in the very first article I wrote about fibromyalgia. He gently touched, poked, and squeezed all of these “tender points.” When he got to my knees (where the worst of my pain is), I almost head butted him as I tried to pull my legs into my body. Does that hurt? Uh, yeah, it does! Then he asked me A LOT of questions. How long had this been going on? Had I had any other tests done? What was I doing to treat it on my own? What medications had my GP given me? Did I exercise? So many questions that I can’t remember them all; but you get the idea. First, he confirmed my diagnosis. If you don’t already have one, this is where you will get a diagnosis. Then, we talked about treatment options. There are so many options, but you and your doctor will figure out just what is best for you. In my case, I got two new medications, changing my diet and a promise from me to keep exercising (even though I really hate how I feel afterwards, in the long term it will help). After your initial visit, you will more than likely need to go back in one to two months for a check-up. They are going to want to see how the medications are doing and to check your overall well-being. They may use a third party testing service such as Millennium Labs drug screening service to check on possible side effects. They may also decide to run some blood tests, as some medications need to be monitored closely. For some people, they may need or want to continue seeing a rheumatologist. Others may choose to have their GP treat them regularly, with only occasional visits to the rheumatologist. If you have severe chronic pain, the rheumatologist may refer you to a pain clinic or specialist.
Neurologists are another specialist who deal with fibromyalgia. Because fibromyalgia is usually accompanied by another disease (arthritis, Lupus, etc), neurologists are often consulted to treat this condition. They deal with the nervous system and fibromyalgia is thought to be a type of nerve problem (although they aren’t sure). Often, if you are already seeing a neurologist for another condition, it is this doctor who will diagnosis and treat your fibromyalgia.
Another possibility is an orthopedist, a doctor that specializes in muscles and joints. They are often consulted for sports injuries and/or broken bones. Again, if you already have an orthopedist that you use, then this may be the choice for you.
And last, but not least, are psychologists. Fibromyalgia is often associated with depression, anxiety and stress. In fact, stress is a known trigger for fibromyalgia. It not only triggers flare ups, it can also be the factor that brings it on in the first place. Psychologists can help you deal with any and all issues that are causing the depression or anxiety, teaching you coping mechanisms. By learning new ways to deal with these, you lessen your stress, thereby lessening your pain. I am a big believer in psychology, but I understand it’s not for everyone. However, I encourage you to at least do a bit of research before deciding not to utilize this type of doctor.
Whichever combination of doctors you choose, be sure you are comfortable with them. You have to be honest with them in order for them to treat you properly. Choose the doctors that will work best for you and your lifestyle. And when you find a good doctor, stick with them! Good doctors are hard to find!
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