Treatment of Rheumatic & Autoimmune Diseases

Goals of Treatment

Today, we have many treatment options and clinical interventions that can help you live the life you want to live. 

Reduce joint pain

Reduce stiffness & increase mobility

Slow or halt disease

Reduce need for more meds

Reclaim more control of your disease

The Rheumatologist's Toolbox

1. Rheumatic & Autoimmune Drugs

These medications relieve pain, improve mobility & slow disease progression.

Anti-inflammatories & analgesics

Non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors help reduce pain and improve your functional abilities by reducing inflammation. They start acting quickly.
Examples: ibuprofen, naproxen, diclofenac gel (Voltaren), meloxicam (Mobic), etodolac (Lodine), celecoxib (Celebrex), and many others.

Oral and injected steroids

Corticosteroids (steroids) reduce inflammation and help regulate the immune system. They start acting quickly and are often used temporarily while waiting for DMARD drugs to start working.
Examples: prednisone, hydrocortisone, dexamethasone (Decadron), methylprednisolone (Medrol), and triamcinolone.

DMARDs & immunosuppressants

Disease-modifying anti-rheumatic drugs & immunosuppressants help slow or halt joint damage. Includes TNF-alpha inhibitors, T-cell costimulatory blockers, B-cell depleting meds and IL-6, IL-17 & JAK inhibitors. They can take weeks or months to have an effect.
Examples: methotrexate, hydroxychloroquine (Plaquenil), leflunomide (Arava), etanercept (Enbrel), adalimumab (Humira), rituximab (Rituxan), tocilizumab (Actemra)m, secukinumab (Cosentyx) & others.

2. Physical Activity

Dr. Girnita’s physical therapy & exercise program specifically for inflammatory arthritis & related conditions helps restore and protect mobility, improve pain, minimize drug dosages, and reduce inflammation.

Video rheumatology visit

3. Lifestyle Medicine

One-on-one consultation and online self-care coaching courses including nutrition & stress management helps reduce inflammatory triggers that worsen your disease and cause flares. 

Surgical Procedures

The soft-tissue inflammation associated with many rheumatic and autoimmune conditions can eventually damage joints and organs, resulting in pain, loss of function and broader health impacts. 

Patients usually consult with their rheumatologist, their primary care doctor and the orthopedic surgeon to decide whether surgery is the right choice. 

Surgical procedures range from removal of soft tissue inside the joint to surgical release of trapped nerves, arthroscopic procedures, and full replacement of the knee, hip, wrist, elbow or shoulder to cardiovascular or other procedures.

Treatment Considerations for Family Planning & Pregnancy

Both women and men with rheumatic and autoimmune conditions should consult with their rheumatologist early in their family planning process. Certain meds can endanger your or your baby’s health. 

It’s often possible to adjust meds so that treatment can continue while you’re trying to get pregnant and during pregnancy. However, changing meds is often necessary to help ensure a healthy pregnancy and baby. And some meds must be stopped in both men and women who are planning a family. 

Are narcotics normally prescribed?

Dr. Girnita does not prescribe narcotics. Narcotic meds are not normally used to treat rheumatic and autoimmune diseases because they don’t reduce the inflammation that causes pain, and have serious side effects and complications including sedation, dizziness, slowed breathing, nausea, chronic constipation and dependence.

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