Rheumatology Services

In Hertfordshire

Arthritis is a condition that causes painful joints – there are over 200 different types of arthritis and it is my role to diagnose which one you have in order to provide the most effective treatment.

The most common is osteoarthritis or “wear and tear”, which we all start to develop over the age of 45.

Rheumatoid arthritis can occur at any age but tends to occur either in childhood, between the ages of 30 and 40 or late onset. I like to see patients as soon as possible to start treatment, as this can make a huge difference.

A common misunderstanding is between the ‘osteos’. Osteoporosis, or brittle bones, is generally a silent condition which in the past was only diagnosed if you broke your bones easily. Now it can be diagnosed through assessment of risk factors and a DEXA scan.

Osteoarthritis is a degenerative condition causing pain and swelling. It can affect three distinct areas:

• hand and thumb pain
• neck and spine
• knees and hips - often treated with replacement surgery in the end

The role of a rheumatologist is to treat with exercise and injections. There is a role for complimentary medicine as well.

Most rheumatologists, especially myself, would be more than happy to discuss diet and complimentary medicine.

With rheumatoid arthritis, this can work well alongside conventional medicine. There is much in the papers about diets and in particular those that are anti-inflammatory. Always be cautious where “cure” is mentioned – this is just a selling technique; and also where someone says with certainty that “you must not eat this or that”.

What you need to ask is whether there have been proper controlled studies/trials comparing this diet or tablet to a placebo, where many patients have been involved. Stick to the main websites such as Arthritis Research UK. http://www.arthritisresearchuk.org/

This form of arthritis can sometimes develop in patients who suffer from the skin condition psoriasis. Joints become swollen, stiff and painful. These symptoms can often change – with periods of improvement or flare-ups.

Here at the clinics, I assess and diagnose patients for this psoriatic arthritis. Treatment options include non-steroidal, anti-inflammatory drugs (NSAIDs), steroid medication (corticosteroids) to reduce pain and swelling, disease-modifying anti-rheumatic drugs (DMARDs) and biological treatments.

This is when your immune system mistakenly attacks against your body instead of combating bacteria and viruses and they can target just one organ, joints or the whole body. There are various autoimmune diseases and we can help you combat and deal with any number of them.

This is a long-term condition that causes pain all over the body, with symptoms including increased sensitivity to pain, extreme tiredness, muscle stiffness, difficulty sleeping, headaches, IBS and problems with memory and concentration.

Lupus is an autoimmune condition that can cause fatigue, rashes (particularly on the face, wrists and hands) and swelling and pain in the joints.

My specialist rheumatology clinics can assess and diagnose this condition for patients before formulating the most effective treatment and advice.

Gout is a form of arthritis. Symptoms include:

• Severe pain and swelling in one or more joints
• Hot and tender joints
• Red shiny skin around the affected area

Treatment for this condition can include ice packs, rest, lifestyle changes and medication.

Each patient is unique and I take the time to assess you thoroughly before agreeing on the best course of treatment.

This long term condition affects the spine and can cause pain and stiffness, swelling and general fatigue.

Symptoms can be relieved through carefully designed exercise, physiotherapy and medication.

There are many possible causes of back pain and accurate diagnosis is crucial for effective treatment.

Following a thorough assessment, treatment may include exercise, painkillers, lifestyle changes, manipulation, massage, mobilisation or medication.

Tendons hold muscles and bones together and when these become inflamed or damaged, this causes pain, stiffness, weakness and swelling.

Tendonitis may be caused by a sporting injury or through a repetitive action or overuse.

After accurate diagnosis, tendonitis can be treated with pain relief, rest, carefully designed gentle exercise, ice packs and a variety of medication.

The most common type of injuries include ankle sprains, groin pulls, hamstring strains, shin splints, tennis elbow and different types of knee injury. We can help you manage and treat these injuries to reduce their impact on your day-to-day life.

If your joints are more flexible than others, it can be painful when you move and it is something that often runs in families. Improving muscle strength and fitness to better protect your joints can be very helpful and we are always here to help.