What Kind of Doctor for Knee Pain? | Orthopaedist vs Rheumatologist

A doctor with stethoscope around his neck, white coat

Research says that knee pain affects 25% of adults. It gets better on its own most of the time, but what if it gets worse? What kind of doctor for knee pain will be best? (4)

Generally, your options will be between an orthopaedist and a rheumatologist. Your choice should depend on your symptoms and what’s causing your knee pain.

In a nutshell: An orthopaedic knee doctor can help if the pain comes from direct trauma. But, a rheumatologist will be better if you have systemic symptoms.

A 3rd option would be physical therapists.

We’ll talk about all these options in better detail further down, but let’s start with orthopaedics.

Orthopaedists: For knee joint or musculoskeletal pain

An orthopaedic doctor diagnoses and treats injuries related to your joints, bones, muscles, and tendons. They do this through a physical exam and, sometimes, imaging tests.

After the diagnosis, you may undergo a non-surgical treatment. Like rest, referral to physiotherapy, or pain medicine.

But, people with severe symptoms may need surgery. For example, orthopaedic surgeons perform knee joint replacements. This helps manage knee pain from severe osteoarthritis.

Also, some orthopaedists are specialists in certain body parts. Like the spine or the knee. Others are specialists in certain populations. Like athletes or children.

When to see an orthopedic surgeon?

It’s best to visit an orthopedic surgeon for your knee pain if you have:

  • Knee pain after a trauma. Like most sports injuries, for example.
  • An acute injury that causes severe pain when walking or standing.
  • Gradual loss of range of motion in your knee.
  • Pins and needles or tingling down your leg.

Common injuries that orthopedic surgeons treat:

Knee fractures

Fractures are medical emergencies that can be extremely painful. An orthopedist will check the fracture and treat it.

Depending on the type of fracture, the orthopedic surgeon may put a cast or perform surgery. Afterward, the doctor will tell you whether or not you should walk with your fracture.

Severe knee ligament tears

Severe tears often happen during contact sports or car accidents. We have four main ligaments in each knee:

  • Anterior cruciate ligament.
  • Posterior cruciate ligament.
  • Medial collateral ligament.
  • Lateral collateral ligament.

Any of them can have a severe tear, which is hard to heal on your own. An orthopedist and a physio will work together to aid your recovery process.

Severe knee osteoarthritis

This happens when the cartilage on our joints wears out. Advanced arthritis cases may not be able to bear weight on the leg. Here, the best treatment could be a knee replacement for pain management.

A physio will also work with the orthopedist to help you manage the joint pain.

Rheumatologists: For knee pain with systemic symptoms

A rheumatologist is an internist or pediatrician with further training in joint pain. But, they often focus on treating systemic autoimmune diseases.

These are medical conditions where your immune system attacks your own body. These cause joint pain and swelling. But, they also affect other organs, like the skin, eyes, or liver.

Also, rheumatologists don’t perform surgery. Their treatments focus on medications and other strategies.

When to see a rheumatologist?

Visit a rheumatologist if you have knee pain and:

  • A family history of autoimmune diseases.
  • If it started “out of nowhere” (i.e. without trauma).
  • You have other symptoms associated with the pain. Like a fever, skin changes, digestive issues, or fatigue.
  • Flare-ups or it gets better or worse with no clear reason.
  • You’re taking medication for other underlying diseases. Like cardiovascular problems, for example.

Common conditions that rheumatologists treat:

Rheumatoid arthritis (RA)

Rheumatoid arthritis is an autoimmune disease that often affects many joints at once.

Early diagnosis is key to stopping the progression of this disease – and rheumatologists are trained to do exactly that.

A rheumatologist can also make referrals to physical and/or occupational therapy. This can reduce pain during flare-ups and improve your quality of life.

Psoriasis muscular pain

Psoriasis is another common autoimmune disease. It affects the skin, speeding up the growth process of skin cells. This forms thick plaques on the scalp, elbows, chest, and/or the face.

Some types of psoriasis also cause joint or musculoskeletal pain.

In this case, dermatologists work in tandem with rheumatologists.

Tick bite joint pain

Ticks can spread several diseases, the most common being Lyme disease.

During the first 30 days after the bite, you may feel some fatigue, headache, and a fever. Most people also develop a rash in the shape of a bull’s eye.

If untreated, Lyme disease can cause several health issues, including:

  • Joint pain,
  • Swelling,
  • Rashes, or
  • Cardiac problems

A rheumatologist will work with other physicians to help you manage these symptoms.

Physical therapists: For non-surgical treatment of knee pain

Like orthopedic doctors, physical therapists diagnose and treat injuries of the musculoskeletal system.

The difference is that PT treatment focuses on hands-on strategies, exercise, and education. They don’t prescribe drugs or perform surgery.

A physio will also teach you the best way to manage your symptoms at home. They’ll also tell you how to prevent future pain episodes.

Physical therapy also specializes in human movement and pain management. This is useful when recovering from the following:

  • Acute injuries like sprains or tears, regardless of their severity.
  • Joint surgery, like knee replacement.
  • Chronic diseases of the joints, including rheumatoid arthritis and osteoarthritis.
  • Neurologic conditions, like cerebral palsy, stroke, or Parkinson’s disease.
  • Pulmonary diseases, like COPD or cystic fibrosis.
  • Sports injuries.
  • Work-related injuries.

When to see a physical therapist?

Visit a physical therapist if you have pain:

  • That doesn’t get better with home care.
  • After a mild or moderate injury. Like a sprain or a strain.
  • After physical activity. Or muscle aches during/after work.
  • Without a fracture, a fever, an infection, or any other medical emergency.

Common injuries that physical therapists treat:

Recovering from almost any knee injury

Most knee injuries will improve faster with a PT. A physio can help you recover from a meniscus tear, a ligament tear, a sprain, tendinitis… You name it!

The recovery process focuses on reducing pain and strengthening your muscles. This is how PTs make sure you get back on track as soon and as safely as possible.

Recovering from knee surgery

Physical therapy is key before and after knee surgery.

First, a therapist will prepare your lower leg for the surgery. The goal is to have as much strength as you can before going into the OR. This will help you recover faster.

Afterward, the physio will treat your painful knee and help you regain your range of motion.

Chronic knee pain

Chronic pain in the knee can be a consequence of osteoarthritis. Repetitive knee injuries, like bursitis or sprains, can also cause this.

And, according to studies, physical therapy is the most effective treatment for chronic knee pain.

FAQs:

What doctor should I see for knee pain?

In general, go to a physical therapist or an orthopedist. Go to a rheumatologist if you also have other symptoms. Like a fever, skin problems, digestive issues, etc.

If you’re not sure, visit your primary care physician. They will know which doctor will be best for you.

What will an orthopedic doctor do for knee pain?

This depends on the cause of your pain. They may prescribe some rest, a referral to physical therapy, or medication.

People with severe symptoms may need surgery for pain management.

When should I see a rheumatologist for knee pain?

If your knee pain also appears with systemic symptoms. Like a fever, gastrointestinal problems, skin issues, pain in other joints, or fatigue.

Conclusion: What kind of specialist for knee pain?

Orthopedic doctors are best for trauma injuries. Rheumatologists are best for autoimmune diseases. Physical therapists can help with almost every type of joint pain.

If you’re not sure, visit your primary care physician. They’ll know which specialist will be best for your knee pain.

Also, please pay a visit to your doctor if:

  • Your joint pain started after a direct hit or fall.
  • The pain doesn’t let you do your daily activities.
  • The symptoms don’t improve or worsen after 72 hours.

Resources

  1. “Orthopedic Surgeons: Restoring mobility and keeping our nation in motion.” American Academy of Orthopedic Surgeons. Retrieved on September, 2021 from: https://www7.aaos.org/member/directory/definition.htm
  2. “What is a Rheumatologist?” American College of Rheumatology. Retrieved on September, 2021 from: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist
  3. “Becoming a PT.” American Physical Therapy Association. Retrieved on September, 2021 from: https://www.apta.org/your-career/careers-in-physical-therapy/becoming-a-pt
  4. Nguyen, Uyen-Sa D T et al. “Increasing prevalence of knee pain and symptomatic knee osteoarthritis: survey and cohort data.” Annals of internal medicine vol. 155,11 (2011): 725-32. doi:10.7326/0003-4819-155-11-201112060-00004