Conditions We Treat

Ankylosing Spondylitis

AS is an inflammatory, an autoimmune condition that typically begins in young adulthood but often gets overlooked or incorrectly diagnosed as pain from a previous injury or aging. In this type of arthritis, the joints and ligaments of the spine become inflamed, producing joint pain and stiffness. The disease often presents first in the lower back and can progress to the upper back, chest, and neck over time. AS can also manifest in the joints of the shoulders, knees, hips, or ankles. In some cases, the vertebrae grow together, causing the spine to become rigid.

AS is a chronic disease that can exhibit a wide variety of symptoms. Genetics appears to play a large role in AS, since approximately one in five people that contract AS have a relative with AS. In addition, the gene HLA-B27 can be found in over ninety percent of people with AS. AS is more common in the male population and most often appears between the ages of 16 and 35. Even so, AS occurs in less than 1% of adults in the United States.

Treatment and disease management typically consists of maintaining good posture while standing, sitting, and sleeping, getting regular exercise to strengthen the back and neck, encouraging flexibility of the chest and ribcage, and medications to reduce inflammation and relieve pain. Adherence to these disease management procedures allows most people with AS to lead normal, productive lives.

Autoimmune Disease

Autoimmune disease is an illness that occurs when the body tissues are attacked by their immune system. The immune system, which comprises special cells, proteins, tissues, and organs, defends people against germs and microorganisms every day. In most cases, the immune system does a great job of keeping people healthy and preventing infections.   

With autoimmune diseases, the body’s immune system cannot distinguish between healthy body tissue and damaging substances called antigens. The immune system mistakes healthy tissue for an outside invader and attacks it, producing a hypersensitive reaction that destroys normal body tissues.  An autoimmune disease can present in the following ways: abnormal organ growth, change in organ functionality, or the destruction of one or more kinds of body tissue.


Gout is characterized by an acute onset of severe pain, tenderness, redness, and swelling of joints. Although gout most often affects the large joint of the big toe, it can affect other joints such as the ankle and knee. Unlike many other forms of arthritis, the cause of gout pain and swelling is well known. In patients with gout, accumulations of uric acid crystals in the joint result in pain and swelling. As with many other types of arthritis, gout tends to have periods of flare-ups followed by periods of seeming remission. 

People with gout should avoid certain foods that have been shown to potentially increase the level of uric acid in their bloodstream. High levels of uric acid in the blood (hyperuricemia) contribute to the formation of uric acid crystals in the joints. The list of foods to avoid includes sardines and anchovies, organ meat (kidney and liver), large portions of red meat and seafood, and alcohol (beer in particular). 

When properly diagnosed and treated with appropriate medications, gout can be controlled, and flare-ups can largely be prevented. Proper treatment is necessary to avoid permanent damage to joints if gout is ignored over the long term.


There are several different types of lupus, a disease that can affect joints, skin, internal organs, and other parts of the body. Much like Rheumatoid Arthritis, lupus is an autoimmune disease. In autoimmune diseases, the body’s immune system produces antibodies that attack the body’s cells and tissues. Also, like Rheumatoid Arthritis, lupus is often a chronic condition characterized by periods when the disease is active (flares) interspersed with periods of relative disease inactivity (remissions). 

The most common form of lupus is systemic lupus erythematosus (SLE). As the name suggests, SLE affects multiple body systems such as the heart, lung, skin, joints, and nervous system. About fifty percent of all cases of SLE affect mainly the internal organs, while the other fifty percent of cases affect mainly the skin and the joints. SLE accounts for approximately 70% of all lupus patients.

 Fifteen percent of those people with lupus have a form of disease that affects the skin. This type of lupus is referred to as discoid lupus or cutaneous lupus. This strain of lupus causes recurring skin rashes that can also leave scars.

 Genes appear to play a significant role in determining who gets lupus. Studies have shown that lupus is more prevalent in families in which one or more family members have lupus or a related autoimmune disease. About ninety percent of people with lupus are female.  Although it can strike at any age, lupus usually appears in the 18- to 45-year-old population. 

Treatment for lupus often involves anti-inflammatory drugs (NSAIDs) to reduce inflammation and immunosuppressive drugs to suppress the autoimmune response. Getting plenty of rest and exercise and eating a balanced diet is also beneficial to successfully managing lupus

Osteoarthritis (OA)

This is the most common form of arthritis, affecting about 21 million Americans. In OA, the cartilage in the affected joint(s) breaks down, resulting in joint pain and swelling. OA typically progresses in multiple phases, beginning with a loss of cartilage elasticity. This loss of elasticity means that the cartilage is more easily damaged by injury or overuse. When the cartilage starts to break down, the bone in the affected joint thickens, and bone spurs develop. In addition, bits of bone or cartilage may be found floating in the space between the bones of the joint. At this point, the breakdown of the cartilage causes the lining of the joint to become inflamed. In reaction to the inflammation, the body produces proteins and enzymes that cause additional damage to the joint.

In OA, affected joints typically hurt the most after periods of inactivity or after periods of overuse. OA can affect the middle and end joints of the fingers, the knees, the hips, the neck, and the spine. This disease usually starts after the age of 40 and develops slowly for years. With OA, joint redness and swelling are typically minimal and morning stiffness is generally short. As a result, people with OA usually do not experience a general feeling of sickness due to the disease.

Risk factors for OA include heredity, obesity, weak muscles, injury, overuse, and aging. Managing OA consists of engaging in activities and behaviors aimed at counteracting some of these risk factors. Physical or occupational therapy may be used. Aerobic exercise and plenty of stretching are often very helpful, as is maintaining a healthy weight. Medications typically used in the treatment of OA include pain relievers, anti-inflammatory drugs, and glucocorticoid injections. A class of drugs known as hyaluronic acids may also be used to lubricate and cushion the affected joints. 


Our bones are constantly renewed — new bone is made as old bone is broken down. When we are young, our bodies make new bone faster than it breaks down old bone, and our bone mass increases. This process slows down after we reach our 20s and most people reach their peak bone mass by age 30. After that, bone mass is lost faster than it is created. How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. Peak bone mass is somewhat inherited and also varies by ethnic group. The higher your peak bone mass, the more bone you have “in the bank,” and the less likely you will develop osteoporosis as you age.

Osteoporosis causes bones to become weak and brittle to the point that even mild stresses can cause a fracture. These fractures most commonly occur in the hip, wrist, or spine. Osteoporosis affects men and women of all races. But white and Asian women who are past menopause are at the highest risk. Medications, a healthy diet, and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

Psoriatic Arthritis (PsA)

Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis, which features red patches of skin topped with silvery scales. Most people first develop psoriasis and are later diagnosed with psoriatic arthritis, but joint problems can sometimes begin before skin patches. Approximately 1 in 20 people with psoriasis will develop psoriatic arthritis.

PsA is the result of an overactive immune system. It is characterized as an autoimmune inflammatory condition that can cause chronic pain and stiffness in and around the joints and tendons. If left untreated, it may lead to permanent joint damage.  

In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints.


Scleroderma is a condition that involves the hardening and tightening of the skin and connective tissues. The disease results from an overproduction and accumulation of collagen in body tissues. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. Doctors don’t know exactly what causes abnormal collagen production to begin, but the body’s immune system appears to play a role.

There are different types of scleroderma. It often affects only the skin, but it can also harm structures beyond the skin, such as blood vessels, internal organs, and the digestive tract. While there is no cure for scleroderma, various treatments can ease symptoms and improve quality of life.

In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints.

Sjögren’s Syndrome

Sjögren’s is a systemic autoimmune disease, meaning that it can affect the entire body. Although it typically involves the glands that produce moisture, such as the salivary and tear glands, it can also create other severe complications, including profound fatigue, chronic pain, significant organ involvement, neuropathies, and lymphomas.   

Symptoms may remain steady or worsen over time, and there is no single progression of the disease, which can make this disease challenging for patients and their physicians. While some people experience mild discomfort, others suffer debilitating symptoms and significantly impaired functioning in their daily lives. However, early diagnosis and proper treatments can prevent severe complications and significantly improve patients’ quality of life.

About half of the time, Sjögren’s occurs along with another autoimmune connective tissue disease such as Rheumatoid Arthritis, Lupus, or Scleroderma.  It is estimated that four million Americans have the disease, making it one of the most prevalent autoimmune diseases in the country.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune disease characterized by inflammation of the lining of joints and surrounding tissues.  In autoimmune diseases, and immune system mistakes healthy tissue for an outside invader and attacks it. In the case of RA, the immune system attacks cells found in your joints and other organs. This attack causes fluid to build up in the affected joints, and the joints become swollen, hot, and painful. In addition, the inflammation produces enzymes, antibodies, and proteins that damage the cartilage in the joint. Over time, the cartilage is destroyed, and the joint bones become unstable and extremely painful.

RA affects about 2.1 million people in the United States. The number of women with RA outnumbers men with RA by nearly 3-to-1. RA is a chronic disease that often presents a pattern of periods when the disease is active (flares) interspersed with periods of relative disease inactivity (remissions). It usually manifests between the ages of 20 and 50.

Unlike OA, rheumatoid arthritis may develop very suddenly. It usually affects the finger joints closest to the hand, wrists, elbows, and shoulders but can involve any number of other joints. RA typically affects joints on both sides of the body and leaves the sufferer with a general feeling of sickness and fatigue. The morning stiffness that comes with RA generally lasts for hours.

Although there is no cure for RA, there are many successful treatments available to manage the disease. Early treatment is vital to stop the progression of bone and joint damage, which can be pretty severe with RA. As with other forms of arthritis, the successful management of RA involves lifestyle changes and proper medication. The medications used to treat RA fall into two categories. It is common to use two or more drugs in the treatment of a person’s RA.

The first category of medication used in the treatment of RA addresses the symptoms of the disease. These include anti-inflammatory drugs, analgesics to reduce pain, and corticosteroids. The second set of medications used on RA is the disease-modifying drugs (DMARDS). As the name suggests, DMARDS can modify RA’s progression and help prevent deformity and disability. However, since the DMARDS can affect the immune system, patients need to be carefully monitored by their physician while taking these drugs.


Vasculitis is a general term for several conditions that cause inflammation in your blood vessels. It is also called angiitis or arteritis. It can make your blood vessels weak, stretched, bigger, narrower, or they might close entirely.

There are many types of vasculitis, and they may vary greatly in symptoms, severity, and duration. Most types of vasculitis are rare, and the causes are generally not known. Vasculitis might affect just one organ or several. The condition can be short-term or long-lasting and can affect persons of both sexes and all ages. Depending on the type you have, you may improve without treatment. However, most types require medications to control the inflammation and prevent flare-ups.