Rheumatology

Rheumatology is an area of medicine involved with the investigation, diagnosis and treatment of a wide range of musculoskeletal (MSK) conditions. A doctor who specialises in this field is a Consultant Rheumatologist.

Your musculoskeletal system is made up of joints, muscles, ligament and bones. It is such an important part of your body and its ability to function that any problem within it can have a significant effect on your health, vitality and quality of life.

Rheumatic problems are often long-term (chronic), and many people who visit our Consultant Rheumatologists will have been in pain for a long time.

Rheumatic conditions can cause many symptoms, but common ones include:

• Neck or back pain
• Sciatica – back pain that radiates down one leg
• Shoulder pain – caused by, for example, frozen shoulder or rotator cuff sprains or tears
• Joint pain – this could be in one joint or many joints, often with swelling, heat or redness
• Fatigue
• Rashes – for example due to psoriasis or lupus
• Eye complaints like redness (caused by uveitis) or dry eyes
• Weakness – due to inflammatory conditions of muscle
• Diarrhoea – caused by associated inflammatory bowel conditions

Conditions that may cause these symptoms include:

• Arthritis – rheumatoid, psoriatic, colitic, gout and pseudogout, osteoarthritis
• Ankylosing spondylitis and related inflammatory spinal conditions
• Autoimmune diseases and connective tissue diseases - such as Lupus and Scleroderma
• Polymyalgia Rheumatica - stiffness and inflammation in muscles, often worse when waking up
• Soft tissue problems - such as Tennis Elbow or Carpal Tunnel Syndrome
• Osteoporosis
• Fibromyalgia - pain all over the body and generalised sensitivity

If you have one or more of these symptoms or conditions, it is sensible to see a Rheumatologist for expert help.

The Consultant Rheumatologists at The Blackheath Hospital in London provide comprehensive investigation of rheumatic condition and symptoms. They would be delighted to meet with you and help you to get the most appropriate support for your specific condition as soon as possible.

Many of the diseases that affect the joints and muscles can often be managed successfully without surgery.

Where a rheumatic condition involves inflammation, various medicines are available to help reduce swelling.

If you have pain that is not being controlled, your consultant may prescribe stronger painkillers if appropriate.

Steroid injections can be very helpful for a number of rheumatic conditions as they have pain-relieving and anti-inflammatory properties. If these are effective at managing your symptoms they can be repeated at certain intervals. Depending on where your pain is, the injection might be given by your Rheumatologist or by a Radiologist using ultrasound guidance for precision.

Surgery is not often needed but may be helpful in some cases where symptoms are particularly severe. Where damage to the joint is extensive (such as in advanced rheumatoid arthritis for example), joint replacement surgery may be advised to replace the damaged joint with a prosthetic one. If surgery would be a suitable treatment option, your consultant will refer you to one of the Orthopaedic Surgeons at the hospital for expert help.

Whatever joint or muscle problems you have, whether your symptoms are relatively mild or more severe, the Rheumatology team at The Blackheath Hospital will make sure you receive treatment tailored to your specific requirements as soon as possible.

When you come to The Blackheath Hospital in London for your initial Rheumatology consultation, your consultant will take a medical history and talk with you about your symptoms in detail. They will want to know:

• What symptoms do you have?
• How long have you had these symptoms?
• If you are in pain, can you describe it?
• Have you already received any treatment, like prescribed medication?
• Does anything (food, drink, tiredness, stress, time of day) make your symptoms worse or better?

They will carry out a physical examination to determine the current range of movement in the affected joint(s) and to determine where exactly you are feeling any pain or stiffness.

It may be that the cause of your symptoms can be diagnosed within your first consultation, and treatment will often be able to begin right away with either a prescription or a steroid injection.

In other cases, further investigation may be needed. Blood tests can be a helpful diagnostic tool for many rheumatic issues, and you may also be referred for X-ray, ultrasound or an MRI scan, all of which are available on-site.

Your consultant will explain the results of any tests with you and will use them to tailor a treatment plan with you.

If your symptoms are more severe and surgery is required, this will be fully discussed with you. In these situations, your consultant will work closely with the Orthopaedic Surgeons on your behalf to make sure that you receive the most appropriate help as quickly as possible.

Rheumatic conditions may flare-up for no obvious reason, or you may have new symptoms. Regular follow-up with your consultant means that treatment can be adjusted when needed to ensure you keep benefitting from the best possible relief of symptoms.

Most people who visit our Rheumatologists are local to London, although it is very easy to travel to us from further afield should you wish.

You can self-refer. People are often referred by their GP, a consultant in another speciality like orthopaedics, endocrinology or cardiology, from occupational health or their private medical insurance provider.

We treat private medical insurance and self-pay patients.

When you visit a Consultant Rheumatologist at Blackheath Hospital you will benefit from:

• Expert assessment ASAP – A number of joint and muscle conditions are best treated at the earliest possible stage. If you have symptoms that are worrying you, it is easy to book an appointment with a consultant. Earlier assessment and diagnosis means you will be able to benefit from tailored treatment sooner.
• Consultant-led care – Rheumatology requires a holistic approach, with treatment tailored to your specific condition and what will be best for you. Your consultant will oversee every aspect of your care and work closely with you to help manage your symptoms as well as possible.
• A multidisciplinary approach – Our Consultant Rheumatologists work extremely closely with specialists in other areas, such as Orthopaedic and Neurology consultants and are supported by a dedicated team of Radiographers, Anaesthetists, and Nurses. With fast, simple access to this multidisciplinary team, you will always see the most appropriate medical professional for your specific needs.
• Recommended by patients! – In an independent survey, 97.9% of our patients said they were likely or extremely likely to recommend us to their friends and family.
• Convenient appointments – Rheumatology appointments are available throughout the week and are easy to book online or by telephone. We can also offer remote consultations by telephone or video call if required.

If you have any concerns about symptoms relating to joint or muscle pain, book your appointment online with one of our Rheumatology specialists to get clarity about the best way forward.