Treatment

At your first visit with your rheumatologist, expect a thorough physical exam, and be prepared to give a detailed personal and family medical history. We’ll review any bloodwork and/or imaging you’ve done and may request additional lab tests or imaging tests such as X-ray, ultrasound, CT or MRI. Rheumatologic conditions can be complex, so we want to have all the information to reach the right diagnosis. We are also committed to getting to know you as an individual so we can not only learn about your symptoms, but understand how they impact your life.

Once we’ve identified the cause of your symptoms, we’ll develop a customized treatment plan based on your individual needs and goals. Your personalized plan may include oral or infusion medications, physical or occupational therapy, joint or tendon injections, and referrals to other specialists. We’ll also talk with you about coping mechanisms, strategies to improve function, and how to enhance your overall quality of life.
Your relationship with your rheumatologist will be ongoing. We’ll continue to see you regularly so we can monitor your condition and make sure your treatment remains effective.

To make the most of your first appointment, we encourage you to bring the following.

• Results of previous lab tests and imaging (X-ray, ultrasound, MRI, CT scans)
• Doctors’ notes from your referring provider and other providers you’re seeing
• Up-to-date list of your medications and dosages
• List of medications you’ve tried for your rheumatology symptoms
• List of allergies and intolerances to medications
• A thorough family history, including relatives with rheumatologic or autoimmune conditions
• List of previous medical problems and surgeries
• Details of travel history, sleep habits, diet, exercise and social history (education, career, sports, drug or alcohol use, etc.)

Our highly trained rheumatologists provide care for a comprehensive range of conditions. If you are experiencing persistent pain, joint swelling, weakness, rash, and/or recurrent fevers, your primary care provider may refer you to a rheumatologist for an evaluation. Our expert team can help you achieve a proper diagnosis and effective care for a variety of conditions.

Common Types of Arthritis

Arthritis is a group of over 100 conditions that cause pain, swelling and stiffness in the joints. Some types are isolated to one joint at a time, while others can impact numerous joints.

Osteoarthritis (OA)

Joint pain and stiffness, reduced range of motion, and swelling caused by OA typically responds well to weight management and exercise, physical and occupational therapy, and oral and topical pain relievers. In more severe cases, patients may need joint replacement surgery. We can help you find the right combination of therapies to improve your comfort and function.

Rheumatoid Arthritis (RA)

RA can cause joint pain and swelling, stiffness (especially in the morning), fatigue, and warm, tender joints. For many patients, we can provide relief through rehabilitation therapy alongside medications like disease-modifying anti-rheumatic drugs (DMARDs), biologics, corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs). In severe cases, we work with orthopedic colleagues to help patients access surgical joint repair or replacement.

Psoriatic Arthritis

Psoriatic arthritis causes joint pain and swelling, skin rashes with silvery scales, and nail changes like pitting or separation. Medications including NSAIDs, DMARDs and biologics provide symptom relief; and physical therapy can help patients maintain joint flexibility. We also help patients design skin care and exercise plans to manage their condition.

Gout and Pseudogout

With gout and psuedogout, joint pain and swelling is sudden and severe, often with redness and warmth in the affected area. Gout typically starts in the big toe, while the most likely sites for pseudogout are the knees, wrists and ankles. We support patients to make lifestyle changes such as reducing alcohol intake and modifying their diet, and can also drain fluid from the impacted joint and prescribe medications including NSAIDs, corticosteroids, and colchicine.

Reactive Arthritis

Along with joint symptoms like pain, swelling and stiffness in the knees, ankles and feet, reactive arthritis can cause redness in the eyes, skin rashes, and urinary problems. It typically develops after an infection in the intestines, urinary tract, or other part of the body, and can be treated using anti-inflammatories, antibiotics, and physical therapy.

Ankylosing Spondylitis (AS)

Patients with AS often suffer from chronic back pain and stiffness, pain and swelling in larger joints like hips and shoulders, and limited range of motion. The condition can be well managed with medications including NSAIDs, biologics, and DMARDs, as well as physical therapy to improve posture and flexibility. In rare cases, patients require joint replacement surgery.

Types of Autoimmune Disorders

Autoimmune disorders occur when your immune system malfunctions. The immune system typically fights infection, but in patients with autoimmune disorders, it attacks the body. Any part of the body can be affected, including the joints and surrounding structures. Your rheumatologist will use blood tests and imaging, along with a thorough examination and medical history, to reach an accurate diagnosis and develop a treatment plan.

Systemic Lupus Erythematosus (SLE)

SLE is marked by fatigue, joint pain and swelling, sensitivity to sunlight, and a rash that often appears as a butterfly shape across the cheeks and nose. Treatment includes physical therapy for joint and muscle strength and medications including immune-suppressants, anti-malarials, and corticosteroids. We also counsel patients about sun protection and eating a balanced diet.

Sjogren’s Syndrome

Sjogren’s Syndrome is an autoimmune condition that can cause dry eyes and mouth, joint pain and swelling, and fatigue. We can prescribe immunosuppressants to calm the immune system as well as artificial tears and saliva stimulants to offer symptoms relief. We also advise patients on proper hydration, oral hygiene, and avoiding dry environments.

Scleroderma

Scleroderma leads to overproduction of collagen, and patients notice hardening and tightening of the skin and connective tissues. If internal organs are affected, it can cause difficulty swallowing, shortness of breath, and high blood pressure. Treatment includes medications to control the immune system and improve skin and organ function.

Mixed Connective Tissue Disease

Patients with Mixed Connective Tissue Disease experience joint pain, muscle weakness, fatigue, and trouble breathing caused by an immune response that attacks the body’s tissues. Medications to reduce inflammation and suppress the immune system, along with lifestyle changes, can help.

Myositis

Muscle weakness and pain in the hips, shoulders and thighs, along with difficulty swallowing, are classic symptoms of myositis. The disorder is caused by inflammation in the muscles, and treatment options include corticosteroids that reduce inflammation, immunosuppressive drugs, and physical therapy aimed at maintaining muscle strength.

Vasculitis

In vasculitis, an autoimmune reaction, infection, or medication causes inflammation of the blood vessels, leading to fever, fatigue, weight loss and possible organ damage. Treatment includes corticosteroids and other medications to reduce inflammation and suppress the immune system.

Antiphospholipid Syndrome

Antiphospholipid Syndrome occurs when the immune system attacks normal proteins in the blood, making clots more likely and raising the risk of complications like deep vein thrombosis (DVT), stroke, and complications during pregnancy. Patients are typically prescribed blood thinners and monitored for complications.

Other Inflammatory Diseases and Non-Inflammatory Conditions

Osteoporosis

Osteoporosis weakens bones, making them more prone to fractures, especially in the hip, spine or wrist. Patients may not have symptoms until they experience a fracture. Osteoporosis is often caused by age, especially in menopausal woman, and can be linked to medications or lifestyle factors. We offer imaging scans to detect osteoporosis, and can treat patients via medications that build bone density, calcium and vitamin D supplements, and weight-bearing exercise.

Adult Onset Still’s Disease

Patients with this rare condition have symptoms including fever, joint pain, a salmon-colored rash, sore throat, muscle pain, and swollen lymph nodes. Anti-inflammatories, corticosteroid and immunosuppressive medications can help control symptoms.

Periodic Fever Syndromes

These syndromes are marked by recurring episodes of fever alongside joint pain, abdominal pain and rashes. Periodic Fever Syndromes are often genetic, and can be treated using anti-inflammatory drugs, colchicine and biologics to reduce inflammation and prevent flare-ups.

Bursitis

Bursitis causes pain, swelling and tenderness in the shoulder, elbow, hip, knee or other joints, and pain usually gets worse with movement. It occurs when the small sacs that cushion the joints are inflamed due to repetitive motion or pressure. Treatments include anti-inflammatory medications, corticosteroid injections, and physical therapy. Ice and rest can also help.

Synovitis

In synovitis, patients can have difficulty moving due to pain, swelling and stiffness in the knee, ankle, wrist or other joint due to inflammation in the synovial membrane, which lines the joints. It is often caused by an injury, infection or autoimmune condition and can be treated with anti-inflammatories, rest, draining excess fluid from the joint, and physical therapy.

Tendonitis

Symptoms of tendonitis include pain and tenderness around a joint, usually the shoulder, elbow, wrist or knee. Tendonitis occurs when the tendon is inflamed due to overuse or repetitive motion. Rest and ice can help, and we can prescribe anti-inflammatory medication, physical therapy and corticosteroid injections. In severe cases, patients may require surgery.

Idiopathic Pericarditis

This condition leads to sharp chest pain that worsens with deep breaths, fever, and shortness of breath. It occurs when the pericardium, or sac surrounding the heart, is inflamed. The cause is often unknown, although it can follow a virus. Treatment includes anti-inflammatories, corticosteroids, and pain medication.

Uveitis

Patients with uveitis experience eye pain and redness, blurred vision, sensitivity to light, and floaters due to inflammation inside the eye caused by infection, autoimmune disease, or injury. Corticosteroid eye drops, oral medications and injections typically provide relief, but severe cases may require immunosuppressive therapy.

Fibromyalgia

Fibromyalgia leads to muscle pain, fatigue, and tenderness throughout the body, along with sleep problems, headaches and difficulty concentrating. It is believed to be the result of abnormal processing of pain signals. Treatment involves managing symptoms through medication, physical therapy, stress management and lifestyle changes including diet and exercise.