In Rheumatology, many of the diseases are chronic, meaning that there is no cure for the disease, but there are number of excellent treatment options which can help control it. Treatments are broadly divided into Non-pharmacologic and Pharmacologic.

Non-pharmacologic treatments may include exercise, improving sleep, diet, physical therapy and massage therapy. Complementary and Alternative medicine is also of interest to many patients, and while some of these treatments may not have as much evidence with their use, they can still be used in combination with Western Medicine and many patients find them helpful.

Dietary Modifications:

  • There are many "anti-inflammatory" diets which can be helpful for some patients. If you examine the diets, they are essentially "healthy" diets with lots of fruits, vegetables, fish, which minimize processed foods and sugars

  • For gout, dietary modification is one of the many ways to avoid triggering a gout attack. Your diet should include limiting purines (red meat, shellfish, alcohol) and staying well hydrated

Pharmacologic treatments may include:

  • Non-Steroidal Anti-Inflammatories (NSAIDS). For example: Advil/Motrin (ibuprofen), Aleeve (naproxen), Voltaren/Arthrotec (diclofenac) etc. These medications offer analgesia, but are typically used for their anti-inflammatory properties. Tylenol (Acetaminophen) is not an NSAID and offers only analgesia but can be safely combined with NSAIDs for pain control.

  • Corticosteroids or "Steroids". For example: Prednisone. These are hormones similar to Cortisol, which is a natural stress hormone. Prednisone is not the same as the anabolic steroids that bodybuilders use. Steroids have powerful immunosuppressive and anti-inflammatory properties. They work well in the short term, but because of the many side effects, they need to be tapered down to the lowest effective dose. Steroids are also available in injectable forms like Depomedrol or Kenalog and these can provide local anti-inflammatory effects with less systemic side effects.

  • Disease-Modifiying Antirheumatic Drugs (DMARDs). For example: Plaquenil (hydroxychlroquine), Methotrexate (oral or injection), Sulfasalazine, Arava (Leflunomide) etc. DMARDs have no analgesic properties, but they alter the course of disease by decreasing inflammation and are proven to decrease long term disability. These medications are slow to act, and may take several months of regular use before any noticeable benefit.

  • Biologics. For example: Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab), Simponi (golimumab), Cimzia (certolizumab), Rituxan (rituximab) etc. Biologics are engineered proteins which have very specific targets in the inflammatory cascade. These are potent medications and patients will need to be screened for underlying chronic infections like hepatitis and tuberculosis before starting treatment. Like DMARDs, biologics have also been proven to decrease inflammation and long term disability.

This is not a comprehensive list of treatment options. Reliable information about Rheumatology and treatment options can be found at the websites below.