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Integrated Rheumatology - Nikki Tugnet | Rheumatologist

Private Service, Rheumatology

Today

8:30 AM to 5:00 PM.

Description

Dr Nikki Tugnet is the world’s first dually-trained Rheumatologist and Yoga Medicine® Therapeutic Specialist. With years of experience in the medical field and holistic health practices, I provide an integrative approach to healthcare: Integrated Rheumatology is my private practice.

Our mission is to help you to optimise your health with the best of medical, yoga & lifestyle therapy.

Our services include: 

  • Disease-modifying antirheumatic medications (DMARDs), including infusions of biological medications, such as rituximab
  • Telemedicine (phone or video consultations)
  • Joint or soft tissue injections
  • Lifestyle education to optimize quality of life 
  • Consults for Clarity
  • Mind-Body Medicine to reduce pain or inflammation:
    •  - Yoga Therapy Programmes
    •  - Meditation & Mindfulness
    •  - Myofascial Release
    •  - Breathing Exercises
    •  - Progressive Muscle Relaxation
What is Rheumatology?

Rheumatology is the specialty of medicine that includes arthritis and autoimmune diseases. Arthritis means inflammation of a joint. A joint is where two or more bones meet and move in relation to each other. They are separated by a rubbery substance called cartilage which is smooth and slippery, allowing for easy movement. Cartilage covers the end of each bone. Tendons and ligaments attach bones to muscles and other bones. Cartilage, tendons and ligaments are enclosed within a membrane around the joint which releases a fluid into the joint space to keep it well lubricated. Autoimmune disease is where an abnormality in the immune system leads to the body’s defence harming its own cells by mistake. A rheumatologist is a doctor who has specialised in this area of medicine. Your GP will refer you to see a rheumatologist if they think you have an autoimmune disorder or if they need assistance diagnosing or treating arthritis.

Consultants

  • Dr Nikki Tugnet

    Consultant Rheumatologist & Yoga Medicine® Therapeutic Specialist

Ages

Adult / Pakeke

How do I access this service?

Referral

A referral letter from your GP or healthcare provider is needed for appointment booking.

Contact us

We welcome self referrals but will require a referral letter from your healthcare provider.

Referral Expectations

Your GP will refer you to us if they think you may have arthritis or an autoimmune disease and they require a specialist opinion regarding the diagnosis or treatment of the condition.

Prior to coming to your appointment you may be asked to undergo tests such as blood tests or x-rays.
A history of your symptoms will be taken, as well as a review of any medications you are on (so please bring these with you). You will then be examined which may include a general examination or only examination of your joints, depending on what condition your specialist is looking for. You may have further testing to establish the diagnosis.
The specialist will discuss with you the possible diagnosis and what further tests or treatments are recommended. They will contact your GP about your diagnosis, results of tests and a treatment plan. You may have ongoing follow-up in our clinic or be discharged back to the care of your GP.
You may also be referred to a physiotherapist, orthotist, or occupational therapist.
A physiotherapist provides physical therapy to assist with any disability you have.
An orthotist provides practical aids/footwear to help in overcoming any disability.
An occupational therapist reviews what equipment/advice will assist in activities of daily living if you have a disability.

Tests that may be required during or after your visit to the clinic include the following:

Joint Aspiration

Local anesthetic is injected into the skin to numb the area and then a needle similar in size to that used to take a blood test is inserted into the space of your joint to take a sample of fluid. This is then sent to the laboratory for testing to aid in the diagnosis of your arthritis.

Radiology

X-rays are useful to examine joints and these may be requested of joints that give you pain and sometimes joints that have no symptoms to help with the diagnosis.
An X-ray is a high frequency, high energy wave form. It cannot be seen with the naked eye, but can be picked up on photographic film.

MRI (Magnetic Resonance Imaging) gives even more detailed pictures of joints and organs so may be requested.
An MRI machine does not work like an X-ray or CT; it is used for exact images of internal organs and body structures. This method delivers clear images without the exposure of radiation.
The procedure uses a combination of magnetic fields and radio waves which results in an image being made using the MRI’s computer.

Fees and Charges Categorisation

Fees apply

Fees and Charges Description

We are a Southern Cross Affiliated Provider.

Hours

8:30 AM to 5:00 PM.

Mon – Fri 8:30 AM – 5:00 PM

Late night appointments be arrangement

Languages Spoken

English, Hindi, Punjabi

Common Conditions / Procedures / Treatments

Osteoarthritis (OA)

Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight. The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well. The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience. Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz

Otherwise known as degenerative arthritis. OA occurs when there is a breakdown of the cartilage, leaving the bones unprotected. It is very common and usually affects people as they get older. You can get it at any age and are more likely to if you have previously injured a joint, or are overweight.

The symptoms can be very mild with just occasional pain with activity. Worsening symptoms include pain with activity and stiffness with rest. Joints can become swollen and restricted in movement. Joints can change shape as the bone changes in response to loss of protection. You otherwise feel well.

The diagnosis is made on the basis of the history, examination findings and sometimes x-rays. The severity of joint damage seen on x-ray does not always correlate with the degree of pain you experience.

Treatment includes guided exercises, weight reduction if needed, pain relief and sometimes surgery. For more information see www.arthritis.org.nz

Rheumatoid Arthritis (RA)

RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown. Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep. Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis. Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz

RA is an autoimmune disease where the body’s immune system attacks the lining of the joints. This results in inflamed (red, hot, swollen), stiff and painful joints and eventually the destruction of the cartilage and bone of joints. RA can occur at any age. The cause is unknown.

Symptoms do not only involve the joints but you may suffer from tiredness, low energy, fevers, poor appetite with weight loss and poor sleep.

Diagnosis is made on the basis of your history and examination of your joints. X-rays may be normal in the early stages of the disease. MRI can be more sensitive at picking up early changes but can also be normal. Blood tests are done looking for an antibody that is present in about 75% of people with RA. This is called the rheumatoid factor. Unfortunately people who don’t have RA can have a positive rheumatoid factor test. Other blood tests can also help make the diagnosis.

Treatment includes medications to relieve pain and inflammation. It also involves medication aiming at modifying the immune system to stop it from damaging the joints further. There are several medications in this group and your specialist will discuss side effects and benefits with you so you can work out which suit you best. For more information see www.arthritis.org.nz

Fibromyalgia

This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes antidepressant medication. For more information see www.arthritis.org.nz

This is a syndrome of widespread aches, pains and fatigue. There may be morning stiffness and sleep problems. The diagnosis is made on the history of the pain and accompanying symptoms as well as the presence of tender points at specific sites on the body. There are a number of different theories and reasons for this condition. There will often be blood tests and maybe x-rays to exclude other diagnoses. Treatment involves pain killers, exercises, rest and sometimes antidepressant medication. For more information see www.arthritis.org.nz

Systemic Lupus Erythematosus (SLE)

This is an autoimmune disease where the immune system harms cells of the body. It can affect the joints, skin, nervous system, kidneys and heart. It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently and can have symptoms that come and go. Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers. The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz

This is an autoimmune disease where the immune system harms cells of the body.  It can affect the joints, skin, nervous system, kidneys and heart.  It is a disease for which there is no cure. It can be managed and usually controlled with medication. It affects different people differently and can have symptoms that come and go.   Symptoms initially can include tiredness, muscle and joint pain and swelling, hair loss, rash, and fevers.  The diagnosis is made on the basis of the history and examination findings as well as blood tests and urine tests. For more information see www.arthritis.org.nz

 

Yoga

We believe that yoga is the number one Mind-Body modality to help you to build body awareness, breath awareness and mindfulness in everyday life. If you are living with arthritis, autoimmune illness or chronic pain, cultivating a strong mind-body connection can help to reduce flares of pain and fatigue, which can reduce the stress and burden of chronic, often invisible, illness. Read more about yoga here.

We believe that yoga is the number one Mind-Body modality to help you to build body awareness, breath awareness and mindfulness in everyday life.
If you are living with arthritis, autoimmune illness or chronic pain, cultivating a strong mind-body connection can help to reduce flares of pain and fatigue, which can reduce the stress and burden of chronic, often invisible, illness. Read more about yoga here.

Disability Assistance

Wheelchair access, Wheelchair accessible toilet, Mobility parking space

Additional Details

Face to face / Kanohi ki te Kanohi, Phone, Online / virtual / app

Public Transport

The Auckland Transport website is a good resource to plan your public transport options.

Parking

Ask our reception team about the parking options

Pharmacy

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Contact Details

8:30 AM to 5:00 PM.

Contact us online here

Yoga
Class information: https://www.nikkitugnet.com/#yoga
Class location: Om Yoga Studio, Stonefields, Auckland

Ponsonby Specialist Centre, 1 - 3 Cowan Street
Ponsonby
Auckland
Auckland 1011

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Street Address

Ponsonby Specialist Centre, 1 - 3 Cowan Street
Ponsonby
Auckland
Auckland 1011

This page was last updated at 12:02PM on August 13, 2024. This information is reviewed and edited by Integrated Rheumatology - Nikki Tugnet | Rheumatologist.