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Diagnosis and Treatment

Each connective tissue disease is diagnosed based on particular symptoms, a thorough physical examination, and the results of lab tests, including blood work. In some cases, the symptoms of one disease can overlap with those of another so much so that it is difficult to distinguish between them. In this situation, a doctor may make a diagnosis of overlap disease or undifferentiated connective tissue disease. When a disease affects a specific organ or tissue, a doctor may also perform a biopsy. The results from this test, which involves removing tissue and looking at it under a microscope, can be used to either confirm a diagnosis or monitor the disease’s progression.

Treatment for connective tissue diseases is unique to the specific condition.

Lupus Erythematosus

Treatment is directed at controlling symptoms and preventing flare-ups. (Note that people may be sensitive to sunlight; sunscreen should be worn to prevent flare-ups.) Treatment plans are personalized to meet each person’s needs. Someone with a mild form may require no treatment at all. Treatment plans include:

Medication

The type of medications depend on the organs affected and extent of symptoms. One or more of the following may be prescribed:

  • Acetominophen to manage pain
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce inflammation
  • Oral cortisone to reduce inflammation and control the immune system
  • Antimalarial medication to reduce fatigue, rashes and joint pain
  • Cytotoxic drugs to control inflammation and suppress the immune system

Diet

  • Alcohol and smoking may trigger inflammation and lead to flare-ups.
  • An unbalanced diet may contribute to flare-ups.

Exercise

  • Regular exercise may help manage pain and stress.
  • Medical professionals can design an exercise program to reduce stiffness, increase muscle strength, strengthen the heart, and control weight and energy levels.

Rheumatoid Arthritis

Controlling symptoms and preventing flare-ups are the goals of treatment. Each plan is customized to meet the needs of each person. Early treatment is essential to minimize the risk of disability and/or deformity. Treatment plans include:

Medication

One or more of the following may be prescribed:

  • Nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce inflammation and pain
  • Disease-modifying anti-rheumatic drugs (DMARDS) to slow down or prevent immune attack of the joints
  • Corticosteroids to reduce swelling
  • Biologic response modifiers to block specific hormones involved in inflammation

Exercise

  • Regular exercise may help manage pain and stress.
  • Medical professionals can design an exercise program to reduce stiffness, prevent further joint damage, increase muscle strength, strengthen the heart, and control weight and energy levels.

Application of heat/cold

  • Heat may relax aching muscles and reduce joint pain.
  • Cold may reduce pain and swelling.

Surgery

People whose disease does not respond to other treatments may consider surgery. Surgical procedures may be used to

  • clean out damaged joint tissue
  • realign joints
  • fuse joints
  • rebuild parts
  • replace joints

Scleroderma

Treatment, which is customized for each person, is directed at controlling symptoms. Treatment strategies include the following:

Medication

One or more medications may be prescribed. These include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDS) to reduce inflammation and pain and reduce stiffness
  • Disease-modifying anti-rheumatic drugs (DMARDS) to slow down progression of the disease
  • Oral cortisone to suppress inflammation and control the immune system
  • Penicillamine to stop or slow over-production of collagen
  • Depending on organs affected, medications to control specific problems may be used.

Exercise

  • Exercise can be useful for improving blood flow in affected areas.
  • Certain exercises can help maintain muscle strength and joint mobility.

Skin and body care

  • The affected skin is prone to drying. Use of humidifiers in the home, baby oil in baths, and application of creams and lotions will help keep skin moist.
  • To improve blood circulation in the affected areas, people with the condition should wear socks and gloves in cold weather and avoid smoking, which causes blood vessels to constrict.
  • People with calcium deposits under the skin should avoid putting pressure on these areas, as the skin may break and become infected.
  • Those whose scleroderma affects the esophagus may have trouble swallowing and should chew slowly. Eating smaller, more frequent meals will help decrease acid reflux.

Surgery

People with severely restricted blood flow to an area of the body may require surgery to reduce blood-vessel spasms that lead to poor circulation. Surgery may also be recommended to remove calcium deposits under the skin.

Dermatomyositis

Treatment is directed toward managing symptoms. Many people experience only a single attack and are able to stop treatment. Others may have several attacks that respond well to treatment. (Note that people may be sensitive to sunlight; sunscreen should be worn to prevent flare-ups.) Rarely, some people have chronically active disease and must continuously take immunosuppressive medications. Treatment plans include:

Medication

One or more medications may be prescribed. These include:

  • Oral cortisone to reduce inflammation and regulate the immune system
  • Disease-modifying anti-rheumatic drugs (DMARDS) to slow down progression of the disease
  • Gamma globulin

Rest/Exercise

  • When the disease is active, rest is recommended to prevent muscle strain.
  • When the disease is inactive, exercise is recommended to keep muscles from weakening.

As research into many of these diseases is ongoing, people may want to stay abreast of new treatments or medications used to treat these conditions. Visit the Clinical Trials page [link to CSPA clinical trials page], to see if new forms of treatment are being tested.

Footnote:

*All information on medical treatments on this site is provided as an overview only. For a complete and up-to-date list of side effects, warnings and precautions, read the product’s package insert and consult your doctor or a pharmacist.
**If you are considering an alternative or complementary therapy, discuss it with your doctor first, and always be sure to keep your doctor up to date about any vitamins, supplements, or other forms of alternative treatment you are taking. Like any medication, alternative therapies can interact with other medications/treatments and, in some cases, have side effects of their own. Remember that “natural” does not necessarily mean “safe.”

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