General practice

Getting a diagnosis

 

If you have any pain, stiffness or swelling in your joints, it is important that you visit a GP as soon as possible.  When you visit your GP be ready to give a full description of any pain, stiffness or other problems.  You will be working together with your GP to manage your condition so don’t be afraid to ask questions.  Consider making a list before the appointment so that you don’t forget anything or take a family member/friend with you.

It is possible that your GP will be able to diagnose you right away, but, in some instances, they may need to refer you to a rheumatologist or orthopaedic surgeon at your local hospital.  A diagnosis will be made on the basis of your
symptoms, a physical examination and medical tests (if necessary).

 

Osteoarthritis (OA)

 

The majority of patients who are 45 or above receive a diagnosis of OA without the need for tests (clinical osteoarthritis).  This diagnosis is based on their age, whether there is joint pain with activity and when and for how long they experience stiffness in the joints.  However, GPs must be aware of other possible diagnoses and this, in some cases, may require further investigations such as blood tests or X rays.

If you are diagnosed with OA, your GP will be your main contact for managing your condition.  They may also refer you to a physiotherapist for advice on keeping your joints mobile.  If your arthritis is severe, the GP can refer you to a rheumatologist, orthopaedic surgeon or pain specialist.

For more information on osteoarthritis, please see “About Arthritis – Osteoarthritis”

 

Rheumatoid Arthritis (RA)

 

Rheumatoid arthritis is usually managed by rheumatology specialists.  However GPs may be involved in the initial diagnosis and will continue to support you with any ongoing management.

 

To aid a diagnosis of RA, your GP will:

  • Examine your joints and skin, and test your muscle strength
  • Carry out blood tests looking for inflammation
  • Do X-rays to find early signs of damage to joints and bones

 

If your GP is suspicious that you have RA, you will be referred to a rheumatology specialist.  Your GP may consider prescribing you medications to help reduced the symptoms of pain and stiffness, although these do not necessarily supress the disease.  A rheumatology specialist would discuss management options with you, which may include medication, alongside other therapies such as physiotherapy and occupational therapy.

For more information on rheumatoid arthritis, please see “About arthritis – Rheumatoid Arthritis”

 

There are many other conditions that can effect your joints, and the soft tissues that support them.  For more information on these, please see under “About Arthritis”.  This list is in no-way exhaustive, so if you do have any concerns regarding your health, you should discuss this with your GP.

 

Help with long-term pain

 

GPs are very well trained in exploring all aspects of medical problems, including both physical and emotional parts, and usually know how to treat problems related to pain. Your GP should know how to correctly understand what symptoms mean and whether they’re caused by ‘new’ pain or a flare-up of long-term pain. They’ll know when to react, for example by ordering further tests.

 

GPs can  work with you to draw up a plan, which is important with long-term conditions. Living well despite pain is a skill which takes time to master. Your GP will be crucial to how you deal with long-term pain, so it’s important that you try to build a relationship where you can, speak openly and be listened to, ask questions and trust the advice you’re given. Ask them to make the information clearer if you’re worried or unsure.

 

What types of treatment can my GP prescribe?

 

In addition to simple painkillers, GPs often prescribe non-steroidal anti-inflammatory drugs (NSAIDs), steroids or on rare occasions, opiate based pain relief. Occasionally medicines that aren’t traditionally used to treat pain can be prescribed, for example anti-seizure medication like gabapentin, which was originally developed to treat epilepsy, can be effective for neuropathic pain. Anti-depressants are also commonly used to treat long-term pain, whether you have depression or not.  Your GP is well placed to discuss these issues with you.

 

Who can GPs refer me to?

 

GPs are good at knowing where to refer you to if you need other treatments. They can help you get access to other medical professionals and the following services:

 

  • Exercise to maintain fitness and general health
  • Occupational therapy to help with daily living and functionality
  • Psychology to help optimise coping strategies and living well
  • Physiotherapy for specific musculoskeletal problems
  • Other specialities and doctors for second opinions.