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Treatments

Biological Therapy

Biological therapy is an advanced form of treatment that aims to restore the normal function of the immune system or stimulate it to work against conditions such as arthritis, Crohn's disease, cancer and more. These treatments utilize substances called biological response modifiers (BRMs), which are naturally produced by the body in small amounts to fight disease, as an effective response to autoimmune disorders.

There are several different biological therapies available to manage these conditions. The best type of therapy depends on the type and severity of your condition, and can be determined after a thorough evaluation by Dr. Shanahan. Some of the most commonly used biological therapies include:

  • Monoclonal antibodies
  • Interferon
  • Interleukin-2
  • Colony-stimulating factors
  • Etanercept
  • Infliximab

These therapies can also be used to stimulate the immune system to reduce the side effects of other treatment options.

As with any type of treatment, there are certain side effects associated with biological therapy. These side effects vary depending on the type of therapy performed, but may include flu-like symptoms, a rash, bruising, bleeding and more. Dr. Shanahan will discuss these side effects with you and address any concerns you may have prior to treatment.


Gout Treatments

Since gout develops as a result of too much uric acid in the blood that then leads to painful arthritic symptoms, treatment for this condition focuses on reducing and maintaining uric acid levels. With normal uric acid levels, many patients are able to experience symptom relief and prevention of painful flare-ups.

There are several different treatments available for gout, depending on each patient's individual condition. Dr. Shanahan will develop a customized treatment plan for each patient based on their individual condition. Certain dietary changes can help reduce the amount of uric acid in the blood. It is important to avoid purine-rich foods such as shellfish, organ meats and certain vegetables. Limiting alcohol intake and managing weight overall can help reduce attacks of gout symptoms.

For most patients, medication will be recommended to relieve pain and inflammation in the affected joint. This may include nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids or colchicine. These medications may be prescribed to be taken when symptoms are present or to help reduce the occurrence of flare-ups.

Certain medications may also be taken over a prolonged period in order to lower uric acid levels and reduce the risk of complications such as kidney stones, kidney disease and other types of arthritis. These may include Benemid, Anturane and Allopurinol. These medications are usually administered after acute attacks have ceased.


Joint Injections

Steroid and viscoelastic supplementation injections are advanced treatment options for patients with arthritis, gout and other sources of joint pain that have not responded well to exercise and oral medications. These injections deliver relief directly to the source of the pain and are considered safe for nearly all patients.

They can be used to relieve pain in nearly any joint affected by an inflammatory condition, including the:

  • Knee
  • Shoulder
  • Ankle
  • Elbow
  • Wrist
  • Thumb
  • Hip

Corticosteroid injections consist of cortisone and provide immediate anti-inflammatory relief directly to the affected joint. Some injections may be administered with a local anesthetic to reduce any potential discomfort. Most patients experience effective symptom relief within a few days, with only a minimal risk of side effects. Results can vary significantly from a few days to a few months.

Viscoelastic supplementations such as Orthovisc, Euflexxa and Hyalgan are made from hyaluronan, a substance naturally found in healthy joint fluid, to help cushion, protect and lubricate the knee for significant symptom relief. These injections are administered on a weekly basis and can relieve pain for up to six months, although results may vary depending on the individual and the type of injection.


Shingles Vaccine

Shingles, or herpes zoster, is a reactivation of previous (or latent) chickenpox virus infection. Following resolution of chickenpox virus (varicella) infection in childhood, the virus may remain dormant in a nerve root along the spinal cord.   In approximately 1 out of 3 persons, the virus can reactivate and cause infection along a dermatome, or skin region that is innervated by the nerve root from which the infection has arisen. This causes a stripe, or patch, of burning pain and vesicles or blisters to form suddenly on the skin, sometimes associated with fever. In up to 20% of patients who develop shingles, chronic nerve pain, termed postherpetic neuralgia, can plague patients for months or years following resolution of the infection and skin rash. In rare cases, shingles may develop in the optic nerve which can cause blindness. Occasionally, the virus may become disseminated and cause a systemic infection that may be life-threatening. Shingles are most common in people over the age of 60. However, patients with autoimmune disease, particularly those treated with corticosteroids and other immune system suppressing medications, are up to twice as likely to develop shingles.

 

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