Rheumatology

Rheumatologists at Greenwich Hospital are specialists in the diagnosis and treatment of arthritis. Arthritis is inflammation of one or more joints, which results in pain, swelling, stiffness, and limited movement. There are more than 100 different types of arthritis. The two most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA), also called osteoarthroses or degenerative joint disease, is the most common type of arthritis. Caused by wear and tear, it is a chronic condition characterized by the breakdown of cartilage in the joint. This causes the bones to rub against each other, resulting in stiffness, pain and loss of movement in the joint. The joints most often affected are the knees, hips, hands, and spine.

Rheumatoid arthritis (RA) is an autoimmune disease that occurs when the immune system mistakenly attacks the cell lining inside the joint. It is mainly characterized by inflammation and can lead to long-term joint damage, resulting in chronic pain and disability.

Diagnosis and Treatment

The goal of most arthritis treatment is to limit pain and inflammation, while ensuring that the joint continues to function as well as possible. Greenwich Hospital rheumatologists work with other specialists, such as orthopedists and physiatrists, to develop treatment plans tailored to each patient. These plans take into consideration the specific type of arthritis the patient has, and the severity of their condition.

Treatment plans often involve both short-term and long-term relief approaches. These include:

• Non-steroidal anti-inflammatory medications such as aspirin and ibuprofen for pain and inflammation
• Fast acting medications such as acetaminophen, NSAIDs and corticosteroids (such as prednisone) given orally or by injection
• Disease-modifying anti-rheumatic medications such as methotrexate, hydroxychloroquine
• Biologic drugs, such as Embrel, Orencia, Rituxin and Remicade, that prevent inflammation
• Weight reduction and exercise
• Surgery to repair or replace a joint

Physical Medicine and Rehabilitation

The physiatrists and therapists at Greenwich Hospital's Department of Physical Medicine specialize in treatment for osteoarthritis and rheumatoid conditions. These experts work with patients to manage pain and increase mobility and strength.

Learn more about Physical Therapy

Rheumatologists at Greenwich Hospital are specialists in the diagnosis and treatment of fibromyalgia. Fibromyalgia is a form of muscular rheumatism that causes pain in the muscles and soft tissues. It is most prevalent in women of childbearing age.

Symptoms of Fibromyalgia

Pain may begin in one area of the body, such as the neck and shoulders, but the entire body may become affected. The pain ranges from mild to severe and may be described as burning, soreness, stiffness, aching, or gnawing pain. While each individual may experience symptoms differently, some common things to look for include:

• Moderate to severe fatigue
• Decreased exercise endurance
• Sleep problems
• Depressed mood
• Anxiety
• Headaches
• Abdominal pain and bloating
• Diarrhea, alternated with constipation
• Urinary urgency

The symptoms of fibromyalgia may resemble other medical conditions or problems. Patients should always consult a physician for a diagnosis.

Fibromyalgia Diagnosis

Diagnosis is usually based on the symptoms the patient is experiencing. Specific treatment depends on:

• Age, overall health, and medical history
• Extent of the condition
• Tolerance for specific medications, procedures, and therapies
• Expectation for the course of the condition
• Opinion or preference
• Fibromyalgia Treatment

Fibromyalgia cannot be cured, but can often be successfully managed with proper treatment or therapy:

• Anti-inflammatory medications (to relieve pain and improve sleep)
• Pregabalin
• Exercise and physical therapy (to stretch muscles and improve cardiovascular fitness)
• Relaxation techniques
• Heat treatments
• Occasional cold applications
• Massage