What is rheumatology?

Rheumatology is the branch of medicine that looks after rheumatic and musculoskeletal diseases. These diseases are usually caused by problems in the immune system, inflammation, infections, or the gradual deterioration of joints, muscles and bones. The service covers the full range of adult rheumatological conditions, from osteoarthritis and soft tissue rheumatism to inflammatory arthritis and complex systemic disorders, such as connective tissue diseases and vasculitis. Osteoporosis assessment by a dual energy X-ray absorptiometry (DEXA) scan and an osteoporosis clinic are also part of our service and are held at Corbett Outpatient Centre. We hold routine clinics, specialty clinics and combined clinics with medical colleagues (chest physicians, renal physicians and dermatologists) and surgical colleagues (orthopaedic and ENT surgeons and ophthalmologists).

Outpatient services are provided on three of our Trust’s sites (Russells Hall Hospital, Corbett Outpatient Centre and Guest Outpatient Centre) with day case facilities and services provided at Russells Hall Hospital. The service is multidisciplinary with dedicated physiotherapy, occupational therapy, chiropody, orthotic and psychology sessions, supporting the medical and specialist nursing teams.

The rheumatology team aims to work closely with the community and primary care settings to provide shared care for chronic arthritic patients.

Subspecialty clinics

In addition to routine clinics, we hold a large number of specialist clinics. Please click the below links for further information:

Medications

Whilst some soft tissue rheumatic conditions can be managed with anti-inflammatories and analgesics, most of the autoimmune rheumatic conditions are treated with steroids, or immunosuppressive drugs, be they conventional disease modifying anti-rheumatic drugs (DMARDs) or biologic drugs. Click on the links below for further information.

DMARDS

Disease-modifying anti-rheumatic drugs (DMARDs) act by altering the underlying disease rather than treating symptoms. They’re not painkillers, but they’ll reduce symptoms over a period of weeks or months by slowing down the disease process. This group of drugs are slow-acting and can take several weeks to work, so it’s important to keep taking them even if they don’t seem to have any effect at first. If you don’t respond well to one of these drugs, or if you develop any side-effects, then your doctor may try one of the others.

The below infomration is provided by Versus Arthritis:

Versus Arthritis

Copeman House

St Marys Court, St Marys Gate

Chesterfield

S41 7TD

Main number – 0300 790 0400

Email – enquiries@versusarthritis.org

Website – https://www.versusarthritis.org/

The most common DMARDs we use, with links to further information, are:

Please click here for more information about our biologic drug service.

Blood monitoring

Most of these DMARD drugs require monitoring, most commonly through regular blood tests. Your doctor or Clinical Nurse Specialist will advise you about the specifics of the monitoring required and the frequency of blood tests; in general, monitoring blood test requirements becomes less frequent with time. However, if you do not have the required blood tests done, the drug will not be prescribed.

Non-drug treatments

Therapies, such as physiotherapy, occupational therapy and psychological support, are extremely important in managing rheumatic conditions and are provided alongside medication. Click on the links below for further information.

Physiotherapy

We run a physiotherapy service at the Therapy Department at Russells Hall Hospital and the Physiotherapy Department at Corbett Outpatient Centre.

We accept referrals for 1:1 treatment and also for group based treatment.

For 1:1 treatment all patients will receive an assessment. Following this assessment appropriate treatment options will be discussed with you. Treatment may include exercises, advice on exercising with a rheumatological condition, acupuncture and some manual therapy techniques. Patients can also be referred to our group sessions.

Our group sessions are all based at Russells Hall Hospital. We have a hydrotherapy pool, where patients complete individual exercises in a group based session. We run a gym based exercise class for people looking to increase their general activity in a supervised environment.

Occupational therapy

We are based in the Outpatient Therapy Department on the Ground Floor, East Wing, at Russells Hall Hospital. Our aim is to support and provide education to patients on how to manage their condition. This may include specific information about pacing, joint protection and splinting. We also provide relaxation and mindfulness sessions.

Group based education sessions

These are jointly provided by physiotherapy and occupational therapy:

‘Tools for Life’ is an education group offering advice and strategies for living with arthritis
‘Inflammatory arthritis education session’ is a one off session for patients who have been recently given this diagnosis. This session provides the opportunity to make the patient aware of the services available to them.
‘Fibromyalgia group’ is an education group for patients with this diagnosis. We run this group with the rheumatology health psychologist. The aim of this group is to provide self-management strategies to help patients living with this condition.
Psychology

Dr Elizabeth Hale is a Chartered Health Psychologist and works with the rheumatology team to provide specialist services supporting patients at any point in their treatment journey. The rheumatology team here at DGH believe in a ‘whole person’ approach, which includes your emotional well-being. Liz can help with making difficult treatment decisions (such as not liking injections) and other worries and concerns that arise due to physical health challenges such as anxiety and depression. She utilises a variety of therapeutic approaches including Mindfulness. Together with the Therapies team she helps to support people with chronic pain conditions such as fibromyalgia.

For information about the work Psychologists do, see: www.bps.org.uk/public

You can contact Dr Hale via your usual rheumatology secretary who will pass on a message.

How to be referred

Patients need to be referred to us via their GP, who must use the e-Referral Service. Referrals are triaged daily into urgent, suspected inflammatory arthritis or routine appointments.

We are delighted to provide an Advice and Guidance service to GPs. If a patient is already under the follow up care of a consultant rheumatologist, please contact that consultants’ secretary, if you need to get in touch.

How to get involved

How to donate to our rheumatology fund

Some patients have very kindly donated to our rheumatology charitable fund over the years, and these donations have been so gratefully appreciated. If you would like to make a donation, please contact Lindsay Corns, our rheumatology secretary team leader. She will be able to give you written information of our charity account details and thank you personally for your thoughtfulness and your kind donation.

How to get involved in research

Please click here for information about rheumatology research.

Contact Information

Dr Karen Douglas	Telephone number 01384 456 111 (ext.5842)
Dr Nicola Erb	Telephone number 01384 456 111 (ext.5842)
Dr Holly John	Telephone number 01384 456 111 (ext.5807)
Dr Levasseur	Telephone number 01384 456 111 (ext.5853)
Dr Rav Sandhu	Telephone number 01384 456 111 (ext.5807)
Dr Adrian Pace	Telephone number 01384 456 111 (ext.5808)
Dr Feryal Malik	Telephone number 01384 456 111 (ext.3596)