Your general practitioner (GP) is always your first port of call. GPs look after the health of people in their local community and deal with a whole range of health problems. They also provide health education, offer advice on smoking and diet, run clinics, give vaccinations and may carry out simple surgical operations.
GPs usually work with a team including nurses, health visitors and midwives, as well as a range of other health professionals such as physiotherapists and occupational therapists. If a GP cannot deal with your problem themselves, they'll usually refer you to a hospital for tests, treatment or to see a consultant with specialist knowledge.
You have the right to be registered with the GP surgery of your choice, as long as you live within its catchment area. Visits to the surgery are free.
It is important to be registered with a GP as they refer you for specialist hospital and community treatment services if needed. The services provided by each surgery can be found in the practice or surgery leaflet available at the surgery.
Once AS is suspected, your GP should refer you to a rheumatologist. If you are having problems with your AS inbetween appointments with your rheumatologist you should go back to your GP.
A rheumatologist is a doctor specialising in arthritis and related conditions. They will confirm if your condition is AS, decide what initial treatment you should receive and oversee the long-term management of your condition.
At your first visit they are likely to take an in-depth history of the problems you have been having, give you a physical examination to assess your flexibility and joint tenderness and may request blood tests, X-rays or scans.
It is important for you to remain under the care of your rheumatologist in the long term. This ensures that you have ready access to expert reassessment.
A radiographer is responsible for carrying out imaging tests such as magnetic resonance imaging scans (MRI) and X-rays. These tests help to identify inflammation in the joints and damage to the bone itself.
They are unlikely to be able to make a comment on the results of the tests. You will have to wait to speak with your GP and rheumatologist about the results and what they mean for you.
A physiotherapist is an expert who assesses physical movement, and helps an individual to improve their physical functioning and reduce physical pain. They help people with AS to maximise an active and independent life both at home and at work. Some physiotherapists specialise in the care and treatment of people with inflammatory conditions such as AS. Click here to read more about physiotherapy.
It is likely that your rheumatology department will have a physiotherapy team attached to the department who specialise in treating rheumatology patients. If your rheumatologist does not suggest an appointment with the physiotherapist it is often a good idea to enquire about it.
It is also possible to ask your GP for a referral to a physiotherapist. These are likely to be based in community clinics rather than hospitals.
Specialist rheumatology nurse
This nurse may also be known as a clinical nurse specialist, rheumatology nurse practitioner or liaison rheumatology nurse. These nurses are specially trained to look after the physical, emotional and social needs of people with conditions such as AS. Some are trained to carry out activities usually done by doctors e.g. examining joints, performing joint injections, reviewing and asking for investigations, and changing treatments if needed. They will work closely with your rheumatologist.
An occupational therapist can provide information and support to help people with AS adapt their lifestyle to minimise the impact that AS may have on their ability to do every day activities and work.
If you think you would benefit from seeing an occupational therapist it's worth mentioning at your appointment with your rheumatologist.
An orthopaedic surgeon is responsible for performing any joint-related operations that are needed.
An ophthalmologist is a specialist who is responsible for examining, diagnosing and treating diseases and injuries of the eye. You may be referred to an ophthalmologist if your AS is causing you to have problems with your eyes, such as uveitis / iritis.
A gastroenterologist is a doctor who specialises in diagnosing and treating conditions related to the gastrointestinal tract. You may be referred to a gastroenterologist if your AS is causing you to have bowel problems.
Last reviewed: September 2010