Dr Seth will discuss your condition and treatment options with you.
Here is some information about some of the treatments offered.
Pain-relieving medications
There are many pain relieving medications available, including:
- Non-opioid analgesics eg: Paracetamol.
- Anti-inflammatory drugs (also known as the non-steroidal anti-inflammatory drugs (NSAIDs) eg: Aspirin, Ibuprofen, Naproxen, Diclofenac.
- Compound analgesics eg Co-codamol, which combines paracetamol with a dose of opioid analgesic codeine.
- Opioid analgesics eg codeine, tramadol, morphine (only available on prescription).
- Neuropathic medications including amitriptyline, gabapentin, and pregabalin.
Disease modifying anti-rheumatic drugs (DMARDs)
Disease modifying anti-rheumatic drugs (DMARDs) act by altering the underlying disease rather than treating the symptoms. They reduce the pain, swelling and stiffness over a period of weeks to months by slowing down the disease and its effects on the joints.
Commonly used DMARDs include:
- Methotrexate
- Hydroxychloroquine
- Sulphasalazine
- Leflunomide
- Mycophenolate
- Azathioprine
Less commonly used DMARDS include: Ciclosporin, Cyclophosphamide and Gold injections.
Biological therapies
Biological therapies target individual molecules and work more rapidly than conventional DMARDs.
Some biological therapies called ‘anti-TNF’ drugs target a protein called tumour necrosis factor, which increases inflammation when excess amounts are present in the blood or joints.
Anti-TNF drugs include:
- Adalimumab
- Infliximab
- Etanercept
- Certolizumab pegol
- Golimumab
Other biological treatments target different proteins, and include:
- Abatacept
- Tocilizumab
- Rituximab
Medications specific to the treatment of Gout
The following medications are specific to the treatment of gout:
- Colchicine
- Allopurinol
- Febuxostat
Medications specific to the treatment of Osteoporosis
There are many treatments available to treat Osteoporosis and reduce your risk of having a fracture, and these include:
- Calcium and Vitamin D
- Bisphosphonates (alendronate, risedronate, zoledronate)
- Teriparatide
- Raloxifene
- Strontium ranelate
- Denosumab
Local steroid injections
An injection may be recommended for your condition to reduce the inflammation within a joint and in turn reduce the pain.
Depending on the condition, you may be offered an injection:
- directly into an inflamed joint (intra-articular injection)
- into soft tissues close to the joint (peri-articular injection)
- into a muscle (intra-muscular injection)
Dr Seth specializes in performing the both intra-articular and soft tissue steroid injections using an ultrasound-guided approach to ensure the highest level of accuracy and safety for her patients.
Dr Seth also performs joint aspiration if there is excess fluid in a joint causing discomfort and reducing range of movement and/or function.
If you have an aspiration of a joint, or an injection into a joint, you should rest it, or at least avoid strenuous exercise for the first 1-2 days.
Therapies
The following therapies can be helpful when treating a rheumatic condition, and these include: Physiotherapy, Hydrotherapy and Occupational therapy, and Dr Seth can recommend and arrange these for you.
