Are specialists necessary?

It probably depends if you're doing okay with your ordinary doctor as to whether or not you need a rheumatologist. Our preference to keep things as simple as possible is important. You don't say how long you've had PMR or your dosage and if reductions are going okay? If both your doctor and you feel confident about your treatment progress, why would a rheumatologist be necessary. Just my opinion.

I'm on a long waiting list to see a rheumatologist, but only in case I need to see one down the track. I'll possibly postpone any rheumatologist appointment if things are going alright at the time. What I don't want is a rheumatologist to change a treatment plan that is working well to something that my doctor then feels obliged to follow, right or wrong.

If you have a good rapport with an experienced internist who is accessible
to you that is very fortunate. You don’t need a specialist to manage an uncomplicated case of PMR. If your labs check out and you are progressing
on an adequate dose protocol you should do well.Stay invested in your care
and keep in touch with your internist.

I have a couple of comments. Last year, 6 months before I was diagnosed with PMR and GCA, I had an eye exam by an optometrist. I have had cataracts for several years, and when the optometrist saw them, she basically told me that she couldn't believe I was walking around with such bad cataracts. I saw an ophthalmologist after being diagnosed with GCA, and the ophthalmologist told me my cataracts were in the first stage on a scale of 1 to 4, with 1 being the mildest. I was very surprised at the difference in their evaluations.

One reason to go to a specialist might be to monitor for the development of GCA. I wonder if I had seen an ophthalmologist instead of an optometrist last year if they would have seen the changes in my eyes and diagnosed GCA 6 months earlier. Also a rheumatologist would be more aware of the possibility and dangers of developing GCA, and would monitor you more closely.

I see a PA at my Dr. office. She is quite good. I can get an appointment in 1-2 weeks. I self diagnosed myself. She would not treat me without my seeing a Rheumatologist. I went to Mayo clinic for that. But my PA will handle all the ongoing care. The family Dr office is quite large. They have several physicians and PA's . Mine told me I was the only one in the office diagnosed with PMR. That seems a little strange. Maybe they just dont look for it.

In my case 2 gps, 2 pas, an acupuncturist, and a pt all failed to diagnose PMR. One pa at least sent me to the rheumatologist because of my obvious osteoarthritis. He diagnosed me in 5 minutes. When I reported back to these health care professionals, they had never heard of it. Well, one pretended to, but obviously didn’t. I say do what’s best for you. If it’s too expensive or delays treatment, forget it.

I suffered quite a lot before I managed to get a visit with my doctor who guessed it was PMR. It was complicated because I tested positive for Lyme disease and the initial PA visit prescribed antibiotics. Eventually I met with my doctor who was not that familiar with PMR and as a backup I found a rheumatologist who was very helpful and available by messaging within a day. Quick response is important if you need it because PMR can be very painful and debilitating.

MY rheumatologist responds as needed. He is not watching and monitoring me. It really is based on how you are feeling. Plenty of strategies discussed on this blog at Mayo. I found that the more I learned about it the better I was able to improve. It is a slow recovery and there are more than one method for treatment. I check this blog every day.

It is a frustrating and mysterious disease whose diagnosis is based on how well you respond to medication. There is no test for PMR. And the rheumatologist cheerfully explained its not well understood what causes it, though there are suspected triggers like stress and Lyme disease to name a couple. Good luck to all. tapering down to 4mg next week and 6 months on prednisone so far starting at 15. 15 was enough to take care of most of my symptoms but not all. Currently I have a few sore spots in my hands and I am building back up physical activities like working out, rowing and ballroom dancing. Getting active again has been key for me.

Thank you.

Hello, in my case, rheumatologist did not bring anything to the table that was not already being taken care of in a more timely fashion by my primary care. The rheumatologist in my case did not seem as curious about my condition and they did not really have anything to add. Plus, they were extremely busy. My primary care doctor has been great. I think it really depends on the specifics of your situation/doctors.

Thank you .

In retrospect ... it seems funny to me now but I didn't think I needed any "medical doctors" when I was diagnosed with PMR. My wife took me to her primary care doctor (PCP) because she didn't want to help me get dressed at the age of 52. I told my wife that all I needed was some prednisone and I would be okay. I took prednisone for 20 years prescribed by my "eye doctor" for recurring autoimmune flares of uveitis.
https://www.mayoclinic.org/diseases-conditions/uveitis/symptoms-causes/syc-20378734
My wife didn't think I should self medicate with prednisone for all the recurring pain I had for 20 years. This particular time I didn't have uveitis so I couldn't go to my ophthalmologist and I didn't have any prednisone to take.

I was perturbed that my wife made an appointment for me to see her PCP! I reluctantly decided to go so her doctor could prescribe prednisone to me. I was already diagnosed with reactive arthritis 20 years ago but I didn't think any medical doctor could help me. I thought it was reasonable to take leftover prednisone prescribed for uveitis whenever I had pain.

My wife went with me to see her PCP so I wouldn't leave out any details about why I needed prednisone. My wife did most of the talking. I only said that I needed prednisone and I would be okay. My wife didn't spare any details but I was thinking her PCP was "reasonable. " She wouldn't prescribe prednisone to me and said I was unreasonable. I was annoyed when my wife's primary care doctor agreed with my wife. She lectured me about self medicating with prednisone. When I asked what I should do for the pain she rolled her eyes and said I needed an immediate referral to see a rheumatologist.

For 6 months and several rheumatology visits, prednisone was restricted. Three rheumatologists then conferred with each other and diagnosed PMR. After being diagnosed with PMR, it was like I had an unlimited supply of prednisone for the next 12 years.