Dr Seth will discuss your condition and treatment options with you.

Here is information about some of the treatments offered.

Pain-relieving medications

There are many pain relieving medications available, including:

  1. Non-opioid analgesics eg: Paracetamol.
  2. Anti-inflammatory drugs (also known as the non-steroidal anti-inflammatory drugs (NSAIDs) eg: Aspirin, Ibuprofen, Naproxen, Diclofenac.
  3. Compound analgesics eg Co-codamol, which combines paracetamol with a dose of opioid analgesic codeine.
  4. Opioid analgesics eg codeine, tramadol, morphine (only available on prescription).
  5. 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
  • 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.


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.