Types of Doctors Who Treat Joint Pain: A Complete Guide

Navigating the Joint Pain Specialist Landscape

Joint pain can be treated by multiple types of medical professionals, each with different training, expertise, and approaches. Choosing the right type of specialist for your specific condition significantly impacts the quality of care you receive and your outcomes.

This guide explains the major types of joint pain specialists—their training, what they treat, when to see them, and how to choose among similar specialists.

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Quick Reference: Which Specialist for Your Situation?

Your Situation	Start With	Consider Also
New knee/hip osteoarthritis	Primary care or orthopedist	Rheumatologist (if inflammatory)
Shoulder pain from injury	Orthopedic surgeon (sports med)	PM&R or physical therapist
Inflammatory arthritis (RA, lupus)	Rheumatologist	Primary care for coordination
Chronic pain from osteoarthritis	Pain management specialist	PM&R, orthopedist
Post-surgical pain	Surgeon who did procedure	Pain management if persistent
Joint pain with systemic symptoms	Rheumatologist	Primary care for workup
Back/neck pain with joint issues	PM&R or pain management	Orthopedic spine surgeon if severe
Multiple joint problems	Rheumatologist	Primary care coordination

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1. Primary Care Physicians

Who They Are

Training:

• Medical school (4 years)
• Family medicine or internal medicine residency (3 years)
• Board certified in family medicine or internal medicine

Scope:

• General medical care
• Initial evaluation of joint pain
• Management of mild-moderate osteoarthritis
• Coordination of care with specialists

What They Do for Joint Pain

Initial evaluation:

• Medical history and physical exam
• Ordering basic imaging (X-rays)
• Initial diagnosis of common conditions
• Basic treatment trials

Conservative management:

• Prescribing oral medications (NSAIDs, acetaminophen)
• Recommending physical therapy
• Weight management guidance
• Activity modification counseling

Coordination:

• Referrals to specialists when needed
• Managing overall health while specialists treat joints
• Coordinating care between multiple providers

When to See Your Primary Care Physician

Good starting point for:

• New onset joint pain (unless trauma)
• Mild to moderate symptoms
• Unclear diagnosis
• Multiple medical issues
• Need for specialist referral

Ongoing care for:

• Stable osteoarthritis managed conservatively
• Follow-up after specialist visits
• Overall health coordination

When to See a Specialist Instead

• Severe or rapidly worsening joint pain
• Trauma (falls, sports injuries)
• Joint swelling, redness, warmth (possible infection or inflammation)
• Previous treatments have failed
• Considering injections or procedures
• Possible inflammatory arthritis
• Joint deformity or instability

Choosing a Quality Primary Care Physician

Look for:

• Board certified in family medicine or internal medicine
• Experience with musculoskeletal complaints
• Good communication skills
• Willing to refer to specialists appropriately
• Coordinates care effectively

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2. Orthopedic Surgeons

Who They Are

Training:

• Medical school (4 years)
• Orthopedic surgery residency (5 years)
• Optional fellowship in subspecialty (1-2 years):
  • Sports medicine
  • Joint replacement (arthroplasty)
  • Spine surgery
  • Hand and upper extremity
  • Foot and ankle
  • Trauma
  • Shoulder and elbow

Board certification:

• American Board of Orthopaedic Surgery

What They Do

Surgical:

• Joint replacement (hip, knee, shoulder)
• Arthroscopic surgery (minimally invasive)
• Fracture repair
• Ligament reconstruction
• Cartilage procedures

Non-surgical:

• Many orthopedists also provide conservative care
• Joint injections (corticosteroids, hyaluronic acid)
• Physical therapy prescriptions
• Bracing and orthotics

Subspecialties and When to See Them

Sports Medicine Orthopedists

Best for:

• Sports injuries
• Ligament tears (ACL, rotator cuff)
• Meniscus tears
• Active individuals seeking to return to sports
• Shoulder instability

Approach: Often more conservative, focus on preserving function and returning to activity.

Joint Replacement Specialists (Arthroplasty)

Best for:

• Severe end-stage arthritis
• Failed conservative treatments
• Significant disability from arthritis
• Evaluation for joint replacement

Approach: Surgical focus, but quality surgeons only recommend surgery when appropriate.

General Orthopedists

Best for:

• Broad range of musculoskeletal issues
• Initial evaluation of joint problems
• Both surgical and non-surgical management
• Community practices

Approach: Varies by individual; some are surgery-focused, others offer comprehensive care.

When to See an Orthopedic Surgeon

Good choice for:

• Surgical evaluation
• Acute injuries (ligament tears, fractures)
• Joint replacement consideration
• Arthroscopic procedures
• Comprehensive musculoskeletal care

May not be best for:

• Inflammatory arthritis (see rheumatologist)
• Mild arthritis (primary care may suffice)
• Chronic pain management (pain specialist may be better)
• Systemic autoimmune conditions

Choosing a Quality Orthopedic Surgeon

Look for:

• Board certified by American Board of Orthopaedic Surgery
• Subspecialty training relevant to your condition
• Hospital privileges at reputable facilities
• High volume in procedures you may need
• Balanced approach (discusses both surgical and non-surgical options)
• Good communication and shared decision-making

Questions to ask:

• “Are you board certified in orthopedic surgery?”
• “Do you have subspecialty training in [knee/shoulder/hip]?”
• “How many [joint replacements/ACL repairs] do you perform annually?”
• “What percentage of your patients with my condition end up needing surgery?“

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3. Rheumatologists

Who They Are

Training:

• Medical school (4 years)
• Internal medicine residency (3 years)
• Rheumatology fellowship (2-3 years)

Board certification:

• American Board of Internal Medicine (Rheumatology)

What They Specialize In

Inflammatory and autoimmune conditions:

• Rheumatoid arthritis
• Psoriatic arthritis
• Ankylosing spondylitis
• Lupus (systemic lupus erythematosus)
• Gout and pseudogout
• Polymyalgia rheumatica
• Inflammatory arthritis of unclear type

Also treat:

• Osteoarthritis (when severe or complex)
• Connective tissue disorders
• Vasculitis
• Autoimmune conditions affecting joints

What They Do

Medical management:

• Disease-modifying drugs for inflammatory arthritis
• Biologic medications
• Immunosuppressive therapy
• Monitoring disease activity

Procedures:

• Joint injections (corticosteroids primarily)
• Joint aspiration (removing fluid for diagnosis)
• Trigger point injections

Coordination:

• Working with other specialists
• Managing systemic aspects of autoimmune disease

When to See a Rheumatologist

Essential for:

• Suspected inflammatory arthritis (morning stiffness lasting >30 min, joint swelling)
• Multiple joints affected symmetrically
• Positive blood tests (rheumatoid factor, anti-CCP, elevated inflammatory markers)
• Joint pain with systemic symptoms (fatigue, fever, rashes)
• Diagnosis of autoimmune condition
• Unexplained joint pain and swelling

May also help with:

• Complex or severe osteoarthritis
• Gout or calcium pyrophosphate deposition
• Second opinion for unclear diagnoses

When NOT to See a Rheumatologist First

• Trauma-related joint pain (see orthopedist)
• Isolated joint pain without inflammation (primary care or orthopedist)
• Pain clearly from mechanical/degenerative arthritis (orthopedist or pain specialist)

Choosing a Quality Rheumatologist

Look for:

• Board certified in rheumatology
• Experience with your specific condition
• Affiliated with major medical center (for complex cases)
• Good at explaining complex conditions
• Coordinates well with other providers
• Accessible for disease flares

Questions to ask:

• “How many patients with [RA/lupus/my condition] do you treat?”
• “What is your approach to starting biologic medications?”
• “How will we monitor my disease activity?”
• “How quickly can I be seen if my symptoms flare?“

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4. Pain Management Specialists

Who They Are

Training pathways:

• Anesthesiology route: Medical school → anesthesiology residency (4 years) → pain fellowship (1 year)
• PM&R route: Medical school → PM&R residency (4 years) → pain fellowship (1 year)
• Neurology route: Medical school → neurology residency (4 years) → pain fellowship (1 year)

Board certification:

• American Board of Anesthesiology (Pain Medicine)
• American Board of Physical Medicine and Rehabilitation (Pain Medicine)

What They Specialize In

Interventional pain management:

• Joint injections (all types)
• Facet joint injections (spine)
• Epidural steroid injections
• Radiofrequency ablation
• Nerve blocks
• Spinal cord stimulation

Medication management:

• Complex pain medication regimens
• Opioid management (when appropriate)
• Adjuvant pain medications
• Topical treatments

Multi-modal pain treatment:

• Combining multiple approaches
• Behavioral pain management
• Physical therapy integration
• Alternative therapies

When to See a Pain Management Specialist

Good choice for:

• Chronic pain despite treatment
• Complex pain involving multiple joints
• Spine-related pain (facet arthritis, stenosis)
• Need for interventional procedures
• Failed conservative treatments
• Comprehensive pain management approach

Especially helpful for:

• Spine pain from arthritis
• Sacroiliac joint pain
• Pain after joint replacement
• Widespread musculoskeletal pain
• Need for medication management

Types of Pain Management Specialists

Anesthesiology-trained:

• Strong in interventional procedures
• Expert in nerve blocks and advanced techniques
• May focus heavily on injections

PM&R-trained:

• Rehabilitation and function focus
• Comprehensive approach to pain and function
• May offer broader range of treatments

Important: Training background affects approach. Ask about their background and treatment philosophy.

Choosing a Quality Pain Management Specialist

Look for:

• Board certified in pain medicine
• Fellowship-trained in pain management
• Uses imaging guidance for all appropriate procedures
• Multi-modal approach (not just injections or medications alone)
• Evidence-based practices
• Good communication about realistic expectations
• Appropriate opioid prescribing (conservative, guideline-based)

Avoid:

• “Pill mills” or excessive opioid prescribing
• Clinics that only do procedures without comprehensive evaluation
• High-pressure sales atmosphere
• Promises of curing chronic pain

Questions to ask:

• “What is your training background in pain management?”
• “Do you use fluoroscopy for spinal injections?”
• “What is your philosophy on opioid medications?”
• “What outcomes can I realistically expect?“

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5. Physical Medicine and Rehabilitation (PM&R) Physicians

Who They Are

Training:

• Medical school (4 years)
• PM&R residency (4 years)
• Optional fellowship (1-2 years):
  • Sports medicine
  • Spine
  • Pain management
  • Brain injury

Board certification:

• American Board of Physical Medicine and Rehabilitation

Also called:

• Physiatrists
• Rehabilitation physicians

What They Specialize In

Focus on function:

• Restoring function and quality of life
• Non-surgical management
• Comprehensive rehabilitation
• Treating whole person, not just joints

Conditions treated:

• Musculoskeletal pain
• Sports injuries
• Spine conditions
• Arthritis
• Post-surgical rehabilitation
• Disability from chronic pain

What They Do

Conservative treatments:

• Exercise and physical therapy prescriptions
• Medications
• Bracing and orthotics
• Activity modification
• Ergonomic recommendations

Procedures:

• Joint injections
• Trigger point injections
• Spine injections
• Ultrasound-guided procedures

Coordination:

• Working with physical therapists
• Occupational therapy referrals
• Comprehensive rehabilitation planning

When to See a PM&R Physician

Excellent choice for:

• Non-surgical joint pain management
• Comprehensive rehabilitation after injury
• Maximizing function with chronic arthritis
• Sports injuries (if sports medicine trained)
• Spine pain
• Avoiding or delaying surgery

Particularly good for:

• Active individuals wanting to maintain function
• Complex cases requiring multi-disciplinary approach
• Preference for conservative, function-focused care
• Post-surgical rehabilitation planning

Choosing a Quality PM&R Physician

Look for:

• Board certified in PM&R
• Fellowship training if relevant to your condition
• Experience with musculoskeletal conditions
• Collaborative approach with therapists
• Focus on function and quality of life
• Uses imaging guidance for procedures

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6. Sports Medicine Physicians

Who They Are

Two pathways:

Orthopedic sports medicine:

• Orthopedic surgery residency → sports medicine fellowship
• Can perform surgery

Primary care sports medicine:

• Family medicine or internal medicine residency → sports medicine fellowship
• Non-surgical focus

Board certification:

• American Board of Orthopaedic Surgery with Subspecialty Certification in Sports Medicine (surgical)
• American Board of Family Medicine or Internal Medicine with Certificate of Added Qualification in Sports Medicine (non-surgical)

What They Specialize In

Sports and activity-related injuries:

• Ligament sprains and tears
• Tendinitis and tendinopathy
• Muscle strains
• Overuse injuries
• Joint instability
• Cartilage injuries

Age range:

• Not just young athletes
• Recreational athletes of all ages
• Active older adults
• Weekend warriors

When to See a Sports Medicine Physician

Good choice for:

• Sports or activity-related injuries
• Goal of returning to activity or sports
• Shoulder, knee, or ankle problems
• Active lifestyle maintenance
• Preventive care for athletes

Especially for:

• Rotator cuff injuries
• ACL or meniscus tears
• Tennis elbow, golfer’s elbow
• Running injuries
• Throwing injuries

Surgical vs. Non-Surgical Sports Medicine

Orthopedic sports medicine (surgical):

• Can perform arthroscopic surgery
• Ligament reconstruction
• Cartilage procedures
• Also provides non-surgical care

Primary care sports medicine (non-surgical):

• Conservative management focus
• Emphasis on rehabilitation
• Injections and procedures
• Refers to surgery when needed

Choose based on:

• Likelihood of needing surgery
• Preference for surgical vs. non-surgical care
• Severity of injury

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7. Physical Therapists

Who They Are

Training:

• Bachelor’s degree
• Doctor of Physical Therapy (DPT) program (3 years)
• State licensure required
• Optional board certification in orthopedics or sports

Not physicians, but critical team members

What They Do

Evaluation:

• Movement assessment
• Strength and flexibility testing
• Functional capacity evaluation
• Biomechanical analysis

Treatment:

• Exercise prescription
• Manual therapy
• Modalities (heat, ice, ultrasound, electrical stimulation)
• Education on body mechanics
• Home exercise programs

Specializations:

• Orthopedic PT
• Sports PT
• Geriatric PT
• Aquatic therapy

When to See a Physical Therapist

Essential for:

• Conservative management of most joint conditions
• Post-surgical rehabilitation
• Strengthening weak muscles around joints
• Improving mobility and function
• Learning proper exercise technique

Often first-line treatment for:

• Knee osteoarthritis
• Rotator cuff tendinopathy
• Low back pain
• Many sports injuries

Direct Access

Many states allow:

• Seeing PT without physician referral
• Direct access to physical therapy
• Self-referral for evaluation and treatment

Limitations:

• Insurance may require physician referral
• PTs cannot order imaging or prescribe medications
• Should refer to physicians for concerning findings

Choosing a Quality Physical Therapist

Look for:

• Doctor of Physical Therapy (DPT) degree
• Board certification in orthopedics (OCS) or sports (SCS) (bonus)
• Experience with your specific condition
• Evidence-based approach
• Good communication and education
• Progressive exercise programs
• Manual therapy skills

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8. Interventional Radiologists

Who They Are

Training:

• Medical school
• Diagnostic radiology residency (4-5 years)
• Interventional radiology fellowship (1-2 years)

Subspecialty focus

What They Do for Joint Pain

Image-guided procedures:

• Joint injections under fluoroscopy or CT
• Bursa injections
• Nerve blocks
• Ablation procedures

Less common for routine joint care:

• Typically consulted for difficult cases
• Complex anatomy
• Failed procedures by other providers

When You Might See One

• Difficult-to-access joints (hip, SI joint)
• Failed previous injection attempts
• Need for precise imaging guidance
• Referral from orthopedist or pain specialist

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Building Your Joint Pain Care Team

The Team Approach

Many conditions benefit from multiple specialists:

Team for knee osteoarthritis might include:

• Primary care physician (coordination, medications)
• Orthopedic surgeon (evaluation, injections, possible future surgery)
• Physical therapist (exercise, strengthening)
• Nutritionist (weight management)

Team for rheumatoid arthritis might include:

• Rheumatologist (primary manager, disease-modifying drugs)
• Primary care physician (overall health)
• Orthopedic surgeon (if joints severely damaged)
• Physical therapist (function maintenance)
• Occupational therapist (adaptive strategies)

Coordination is Critical

Ensure your team:

• Communicates with each other
• Reviews each other’s notes
• Has unified treatment goals
• Doesn’t duplicate testing
• Provides consistent messaging

You can help by:

• Keeping all providers informed
• Bringing records to appointments
• Requesting providers communicate
• Advocating for coordinated care

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How to Choose the Right Specialist Type

Step 1: Consider Your Condition

Inflammatory vs. mechanical:

• Inflammatory (swelling, warmth, morning stiffness >30 min): Rheumatologist
• Mechanical/degenerative (worse with use, better with rest): Orthopedist, PM&R, or pain management

Acute vs. chronic:

• Acute injury: Orthopedist or sports medicine
• Chronic pain: Pain management or PM&R

Single joint vs. multiple joints:

• Single joint: Orthopedist or sports medicine
• Multiple joints, especially symmetric: Rheumatologist

Step 2: Consider Your Goals

Want to avoid surgery:

• PM&R
• Primary care sports medicine
• Pain management

Want surgical evaluation:

• Orthopedic surgeon

Want comprehensive medical management:

• Rheumatologist (inflammatory)
• Pain management (chronic pain)

Want to return to sports/activity:

• Sports medicine

Step 3: Consider Treatment Phase

Initial evaluation:

• Primary care (unless clear need for specialist)

Conservative treatment trial:

• Primary care
• Physical therapist
• PM&R

Failed conservative care:

• Orthopedic surgeon
• Pain management
• Rheumatologist (if inflammatory)

Considering surgery:

• Orthopedic surgeon

Post-surgical:

• Surgeon (initially)
• Physical therapist
• Primary care (long-term)

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Red Flags: Wrong Specialist or Poor Quality

Watch for:

Wrong Specialist Type

• Treating inflammatory arthritis without rheumatologist involvement
• Spine surgeon for mild arthritis better treated conservatively
• Primary care managing complex rheumatologic conditions alone
• Pain management without trying appropriate conservative care first

Poor Quality Regardless of Type

• Not board certified in their claimed specialty
• Offering treatments outside their scope of practice
• Refusing to refer to appropriate specialists
• Dismissing other specialists’ recommendations
• Promoting unproven treatments heavily
• High-pressure sales tactics

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Frequently Asked Questions

Can I see multiple types of specialists?

Yes. Many conditions benefit from multiple perspectives. Just ensure:

• Specialists communicate with each other
• You inform all providers about treatments from others
• Treatment plans are coordinated, not duplicative or conflicting

Do I need a referral?

Depends on insurance:

• HMO plans: Usually require referrals from primary care
• PPO plans: Often allow self-referral to in-network specialists
• Medicare: No referral needed for most specialists
• Check your specific plan before scheduling

How long does it take to see specialists?

Typical wait times:

• Primary care: 1-2 weeks
• Orthopedic surgeon: 2-6 weeks
• Rheumatologist: 4-12 weeks (often longest wait)
• Pain management: 2-6 weeks
• PM&R: 2-6 weeks

Urgent cases may be seen sooner if communicated.

What if specialists disagree?

Common situation. To resolve:

• Understand the reasoning behind each recommendation
• Ask specialists to communicate directly
• Seek a third opinion if needed
• Consider which specialist has most expertise in your specific condition
• Discuss with primary care physician who knows you best

Can a surgeon provide good non-surgical care?

Yes, many can. But consider:

• Some surgeons focus primarily on surgical candidates
• Others offer comprehensive care including conservative options
• Ask about their approach to non-surgical management
• Seek a surgeon who discusses all options, not just surgery

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Summary: Quick Specialist Selection Guide

Specialist Type	Best For	Training Focus
Primary Care	Initial evaluation, mild-moderate OA, coordination	General medicine
Orthopedic Surgeon	Surgical evaluation, acute injuries, joint replacement	Surgery and procedures
Rheumatologist	Inflammatory arthritis, autoimmune conditions, gout	Medical management
Pain Management	Chronic pain, spine pain, failed treatments	Interventions and medications
PM&R	Function restoration, non-surgical care, rehabilitation	Function and disability
Sports Medicine	Sports injuries, active lifestyle, return to activity	Athletic injuries
Physical Therapist	Exercise therapy, strengthening, function improvement	Movement and rehabilitation

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Related Resources

• How to Choose a Quality Joint Pain Specialist
• 25 Questions to Ask Before Getting Joint Injections
• Red Flags: Warning Signs of Questionable Providers
• What to Expect at Your First Joint Pain Consultation
• Understanding Insurance Coverage for Joint Treatments