There are a great many inflammatory conditions which can cause pain and discomfort throughout the body. Here we’re looking at the diagnosis and management of two in particular: Systemic Lupus Erythematosus (Lupus) and Polymyalgia Rheumatica (PMR).
Lupus is usually diagnosed using a number of different blood and diagnostic tests. You may be offered an anti-nuclear antibody test, an anti-Ro test, a Complement level test, an Erythrocyte sedimentation rate (ESR) test, kidney and liver function tests, blood cell counts and may involve x-rays and scans depending on which organs of your body your doctor believes to be effected.
Treating and Managing Lupus
Lupus may be treated by a range of medications, dependent on the extent of the condition and its severity. You may be prescribed nonsteroidal anti-flammatories and antimalarial drugs which work to reduce inflammation. You may also be offered steroid tablets to help control symptoms and complications such as pleurisy and kidney inflammation. Other drugs sometimes prescribed include disease-modifying anti-rheumatic drugs (DMARDs) and biological therapies. Many of these drug types are offered when a previous treatment hasn’t proved effective and your doctor should try as many different options as it takes to find what is effective for you.
It is important to remember if you are treated with a biological therapy drug or steroid tablets then you need to carry an alert card to ensure anyone treating you is aware of your medication, should you be unable to tell them yourself.
It is possible to get an outright diagnosis of PMR based on symptoms if you are aged over 60. If you have the following symptoms, your GP is likely to make an immediate diagnosis:
- Morning stiffness that last 45 minutes or longer
- High levels of inflammation measured by blood tests
- New hip pain on both hips
- No evidence of rheumatoid arthritis
- No swelling on the small joints of the hands and feet
- Shoulder pain on both sides
Where there is doubt however then you are likely to be referred to a rheumatologist who may carry out further tests including an Erythrocyte sedimentation rate (ESR) test, a plasma viscosity test and a C-reactive protein test. Scans such as an MRI or PET may also help get a full diagnosis.
Treating and Managing PMR
The symptoms of PMR are usually resistant to regular painkillers but steroid treatment has been found to be very effective. Corticosteroid tables are often prescribed and have a powerful effect in reducing the inflammation that is absolutely central to treating PMR. Steroid treatment won’t cure PMR but within a few weeks you should feel the benefits of the treatment. If you do take steroid tables then you will need to carry an alert card so any medical professionals who may treat you are aware of your medication.
Many people with PMR are prescribed bisphosphonates to counteract the effect steroids can have on bone density and therefore preventing the development of osteoporosis. You may also be prescribed NSAIDs simply to help reduce that morning stiffness so you can get on with your day. All treatment should be discussed with your doctor in depth to ensure it is the best option for your particular condition.
Do you have questions about Inflammatory Conditions?
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