When diagnostic uncertainty exists, expert consultation may prevent overtreatment such as inappropriate use of steroids in lupus or surgery for low back pain. Consultation may also prevent inappropriate treatment of laboratory abnormalities erroneously thought to represent musculoskeletal disease. One example is the inappropriate use of allopurinol for an an elevated uric acid. Early, appropriate intervention can reduce morbidity, maintain function and prolong life. Many rheumatic diseases are chronic, and the symptoms fluctuate.
Patients often require repeated evaluation and modifications in therapy.
More frequent specialty consultation and follow-up care is associated with better outcomes in patients with musculoskeletal complaints. Rheumatologists utilize a team approach incorporating orthopedists, nurses, physical and occupational therapists, social workers, podiatrists, vocational counselors and clinical psychologists to support meet patients' needs. Prescribed exercise programs reduce pain and improve function in many diseases. Not all of these services may be used in all patients. In many cases, the need for these services varies over the life of the patient.