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Back pain: why consult a rheumatologist?

Back pain: why consult a rheumatologist?

If your back pain is considered to be inflammatory, your doctor may refer you to a rheumatologist who is a specialist in autoimmune conditions (a common cause of pain in the inflammatory origin, happens when the body is attacking itself and its own healthy tissue), and several other disorders that affect the joints, bones and muscles. He can organize diagnostic tests and initiate it into a treatment, depending on the cause of his back pain.

What is a rheumatologist (1)

The rheumatologist's role is to diagnose, treat and manage people with diseases clinically rheumatic diseases. These health problems affect the joints, muscles, bones and sometimes other internal organs (for example, kidneys, lungs, blood vessels, brain). As these diseases can be very complex, they need the care of a specialist. And only rheumatologists are experts in this field of medicine.

The rheumatologist interacts with the patient and his family and can work in partnership with other health professionals. It gives information about health and teaches the patient, the family and the community to live with a chronic (long-term) rheumatic disease. Topics that may include medicines, disability prevention or rehabilitation techniques, and ways to improve quality of life.

What diseases does the rheumatologist treat? (2)

The term rheumatism, though consecrated, is not which is adequate to denote a large number of different diseases that have in common the involvement of the musculoskeletal system, ie, bones, cartilage, periarticular structures (located near the joints, tendons, ligaments, fascia, etc.) and / or muscles. In addition, many patients with rheumatic diseases may have no complaints of joint, bone, or involvement of periarticular tissues, but rather of diverse organs, such as kidneys, heart, lungs, skin etc.

The causes, treatments, and consequences of various rheumatic diseases can be very different. For this reason, it is important to know which disease of each patient rather than simply classify as having a rheumatic disease. For the terms "rheumatism" or "rheumatic disease" mean nothing in reality because they are not diagnostic. The doctor should seek to identify the disease of each patient. And the early diagnosis is of paramount importance for a good evolution of the disease, avoiding complications that can incapacitate the patient definitively. Therefore, the specialist's search is essential.

Rheumatic diseases can only be classified according to the mechanisms of injury or preferential localization of the disease in:

1. Diffuse connective tissue diseases

Diseases that occur with inflammation of the connective tissue and which are related to disorders of the immune system, which react against a cell, tissue or other antigen from the body itself.

  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Systemic sclerosis
  • Inflammatory muscular disease (polymyositis and dermatomyositis)
  • Sjögren's syndrome
  • Polychondritereifive
  • Mixed connective tissue disease (Sharp's disease)
  • Antiphospholipid antibody syndrome.

2. Systemic Vasculitis

  • Takayasu's Arteritis
  • Wegener's Granulomatosis
  • Temporal Arteritis
  • Behçet's Disease

3. Spondyloarthropathies

Inflammatory disease of the spine, which may or may not cause arthritis in peripheral joints and inflammation in other organs such as the eye.

  • Ankylosing spondylitis
  • Reiter's syndrome
  • Psoriasis spondylarthropathy
  • Spondyloarthropathy of inflammatory bowel diseases
  • Reactive spondyloarthropathies



  • Osteomalacia
  • Paget's disease
  • Hyperparathyroidism
  • 5. Joint degenerative diseases

Degenerative diseases affecting the joints

Primary osteoarthrosis

  • Secondary osteoarthrosis (secondary to acromegaly, fractures, malformation of the joint and bones, etc.)
  • 6. Microcrystalline arthropathies

Joint diseases caused by microcrystals


  • Chondrocalcinosis
  • Hydroxyapatite arthritis
  • Arthritis by other microcrystals
  • 7. Reactive arthritis

Rheumatic diseases associated with infectious processes

Infectious arthritis (infection within the joint)

  • Osteomyelitis (infection in the bone)
  • Reactive arthritis (arthritis secondary to an infectious process located elsewhere Chlamydia , viruses, amyiditis and etc.)
  • Rheumatic fever
  • Lyme disease
  • 8. Extra-articular rheumatism

Diseases that affect structures close to the joints but do not affect the joint itself.


  • Myofascial pain
  • Tendinitis (shoulder, extensors and flexors of the fingers, etc.)
  • Bursitis (shoulder, trochanter etc.)
  • Calcaneal spurs
  • Plantar fasciitis
  • Epicondylitis.
  • 9. Intermittent arthritis

Mediterranean family fever

  • Palindromic rheumatism
  • Intermittent hydrostromis
  • 10. Arthropathies secondary to other non-rheumatic diseases

Osteoarticular complaints that may occur in the course of other diseases.

Diabetes mellitus

  • Hypothyroidism
  • Hyperthermia
  • Tumors (bony, articular, peri-articular tissues)

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