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Rheumatology

Expert assessment and treatment for your joint and muscle pains

Rheumatology is 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.

Our musculoskeletal system is made up of numerous joints, muscles, ligaments and bones. It plays such an important role in our ability to use our body that even a seemingly small problem anywhere in it can have a significant impact on our health, vitality and quality of life.

Rheumatic problems are usually long-term (chronic). Many of the people who come to us for help have been struggling with their pain for a long time and will often have seen a number of different doctors in other fields for help.

When you visit BMI Bath Clinic, fast access to a leading Consultant Rheumatologist means you will receive best-in-class assessment, diagnosis and treatment for your rheumatic condition and symptoms. Our Rheumatology team would be delighted to help you benefit from the most appropriate support for your specific condition, sooner.

People will usually be referred (or self-refer) to a Consultant Rheumatologist because they have certain symptoms that are not currently being controlled or managed successfully.

Some rheumatic conditions (such as lupus or the connective tissue diseases) are rare and are best treated by an expert who subspecialises in that particular condition. For that reason, we always recommend that people who want to self-refer look at our consultant profiles to see who the expert is for their particular condition.

Common reasons people visit us for help are:

  • Neck or back pain
  • Sciatica – pain in leg or arm
  • Shoulder pain – caused by, for example, frozen shoulder
  • Joint pain – this may be in only one joint or in a number of joints
  • Extreme tiredness / fatigue
  • Rashes – for example due to psoriasis or lupus
  • Eye complaints – such as redness (caused by uveitis) or dry eyes
  • Weakness – due to inflammatory conditions affecting the muscles
  • Diarrhoea – caused by associated inflammatory bowel conditions
  • Previous fracture still causing pain or other symptoms, despite treatment

Conditions that can cause these symptoms include:

  • Arthritis – rheumatoid, osteoarthritis, psoriatic, colitic, gout, pseudogout,
  • 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 Carpal Tunnel Syndrome, Golfer’s Elbow and Tennis Elbow
  • Osteoporosis – causes bones to become weaker and more brittle, much more likely to break
  • Fibromyalgia – causes pain all over the body and generalised sensitivity

If you have one or more of these symptoms or conditions, it can be sensible to see a rheumatologist. We can easily arrange an appointment for you at BMI Bath Clinic, in our stunning hospital location just outside the historic city of Bath.

It’s important to know that quite a few rheumatic conditions cannot currently be cured. However, symptoms can often be managed with appropriate treatment.

There is no ‘on size fits all’ treatment for rheumatic conditions, and treatment is always best when carefully calibrated to the individual. The value of seeing an experienced Consultant Rheumatologist is in benefitting from a bespoke treatment plan which may not be available as easily or quickly through other routes.

Due to the extensive nature of the musculoskeletal system, and the many varied conditions that can affect it, a rheumatologist takes a holistic approach to treatment, looking at every aspect of your health, fitness and lifestyle to help tailor treatment to your specific needs.

Symptoms for many conditions may flare up periodically, or new ones might appear. By closely monitoring the results of any treatment, your consultant can make changes when needed to provide you with the best possible ongoing relief of symptoms. Treatment is always very much a collaboration between you and your consultant, and its important you let them know if your symptoms change.

Many diseases that affect the joints and muscles can often be managed well without the need for surgery.

Physiotherapy

Treatment might involve physical therapy to help strengthen muscles and increase flexibility and mobility in painful joints. Our superb on-site physiotherapy team work closely with the Rheumatology team to provide the necessary guidance and support for this.

Painkillers

Where a rheumatic condition is caused by inflammation, various medicines are available to help reduce swelling and to relieve pain. If your pain is not being suitably managed with over-the-counter medication, your consultant may prescribe stronger painkillers when appropriate. Strength and frequency of medication can be adjusted as needed to get the right balance of symptom relief vs. risk of side effects.

Steroid injections

Steroid injections are a common treatment for rheumatic conditions, offering both anti-inflammatory and pain-relieving benefits. If these help to relieve your symptoms they can be repeated periodically. Depending on the exact source of your pain, these injections may be given by your rheumatologist in clinic or by a radiologist under ultrasound guidance to help ensure precision.

Advanced therapies

Around one third of people who suffer with a rheumatic condition will end up on advanced therapies to manage their symptoms. Following a careful assessment and discussion with your consultant, and if appropriate for your condition, you may be able to access advanced therapies that are rationed in the NHS due to cost. Your consultant works extremely closely with specialists in other fields, like Dermatology and Gastroenterology, when required. This close collaboration ensures you receive the best treatment for your condition, from the most appropriate specialist.

Surgery

If conservative treatment options are not able to manage your symptoms, surgery may be an option. It’s important to know that surgery is not often needed, but it can be helpful for those with particularly severe symptoms, such as those caused by advanced rheumatoid arthritis. Where damage to a joint is extensive, joint replacement surgery may be advised. This operation replaces the damaged joint with an artificial implant to restore pain-free movement. If this would be appropriate treatment for you, your consultant will refer you to one of the excellent orthopaedic surgeons at the hospital.

If you have severe Crohn’s Disease, surgery may be advised to remove part of the bowel. In this case, you would be referred to a General Surgeon or Colorectal Surgeon at the hospital.

Whatever symptoms or condition you are struggling with, the highly experienced Rheumatology team at BMI Bath Clinic will ensure you receive the most effective, evidence-based treatment for your specific needs at all times.

Many conditions affecting the musculoskeletal system will have similar symptoms, which often makes diagnosis a bit more challenging. (This also explains why many people with a rheumatic condition may have previously received treatment from somebody else that was not as effective as anticipated or hoped for.)

When you come to BMI Bath Clinic for your initial consultation, your rheumatologist will be looking to determine the precise cause of your symptoms. They will take a medical history and ask you to describe your symptoms in detail. They may ask you questions like:

  • What are your symptoms?
  • When did they start?
  • Can you describe your pain?
  • What (if any) treatments have you tried so far?
  • Does anything make your symptoms worse or better?
  • Are you currently taking any medication?
  • Do you have any particular concerns about your symptoms (for example, are you worried you may be developing arthritis)?

They will carry out a physical examination, which may involve moving the affected joint or limb to determine your current range of movement and to see the precise points you feel any pain or stiffness.

Blood tests can be helpful when investigating many rheumatic issues. Other common diagnostic investigations are X-ray, ultrasound and an MRI scan, all of which are quickly and easily arranged for you on-site.

Other tests that may be requested by your consultant include a CT scan, DEXA scan (to measure bone mineral density) and a Positron Emission Tomography (PET) scan. These can all be arranged by your consultant if needed, and some of them may be done off-site.

Once a diagnosis has been made, your consultant will tailor a treatment plan. This will always be discussed with you fully so that you can make an informed choice about treatment.

It may be that a diagnosis can be made within your first consultation. When this happens, treatment can often begin right away with either a steroid injection or prescription for medication. 

if surgery is needed, your consultant will discuss options with you and coordinate with the relevant surgeon on your behalf.

If you have any questions or concerns at any time, your consultant will always be very happy to discuss these with you.

If you’re struggling with any of the common symptoms of a rheumatic condition, we believe you won’t find a better place to come for comprehensive investigation, diagnosis, treatment and ongoing support than BMI Bath Clinic. Here’s why:

  • Fast access to a leading expert – Our Rheumatology team have both national and international profiles and continue to be involved in research and development of cutting-edge treatments for rheumatic conditions. When you choose BMI Bath Clinic for your treatment, you will benefit from guidance and advanced treatment options from a recognised leader in the field.
  • Consultant-directed care – You will always see the same consultant and will never have to worry about seeing a more junior doctor. They will oversee every aspect of your care, and if you have any questions or concerns at any time, it is very easy to arrange an appointment with them.
  • A multidisciplinary approach – Our Rheumatology team work closely with specialists in other areas, such as orthopaedic and neurology consultants. A dedicated team of healthcare professionals like radiologists, physiotherapists, radiographers, anaesthetists, and nurses are available on-site. With fast access to any member of this multidisciplinary team, you will always be supported by the most appropriate medical professional throughout your treatment. In addition, complex cases can be discussed with other specialists within a multidisciplinary team meeting to formulate the best treatment plan.
  • 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. We don’t take this for granted and continue to focus on delivering the very highest standards of care to everyone who visits us for help.
  • Easy to book – We offer flexible appointment, so you can find a time that fits your availability. For your convenience, you can book your appointment online or by telephone.
  • Remote Consultations – While Rheumatology consultations are normally carried out in person in the hospital, we can offer remote consultations by telephone or online video call if required.
  • App-based symptom checker – Access to the Ada app (available from the Apple App Store or Google Play Store) provides screening tools to help check symptoms. While not a replacement for an experienced Consultant Rheumatologist, this app can be helpful in monitoring symptoms.
  • Location - Based around two miles from the centre of historic Bath, BMI Bath Clinic is very easy to travel to by private or public transport. Our 100-space private car park is free for patients and visitors, so you won’t need to worry about where to park when you visit with us.
  • Facilities - Formerly a private home, our hospital is situated within a beautifully landscaped setting next door to a National Trust property. Our historic exterior is far removed from the clinical, often impersonal feel that modern hospitals can sometimes have, but inside offers access to an extremely modern hospital with state-of-the-art equipment and facilities.

If you are at all worried or concerned about any symptoms relating to joint or muscle pain, why not book a consultation with one of our Rheumatology specialists? They will help you to get clarity about what is causing your symptoms and what the most suitable treatment options are for you going forward.

We very much look forward to welcoming you to BMI Bath Clinic and helping to get your symptoms better controlled as soon as possible.

Specialists offering Rheumatology

Dr William Tillett

Consultant Rheumatologist

MBChB, BSc, PhD, MRCPrheum)

BMI Bath Clinic

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