Although aesthetics are a large focus of my practice, keep in mind I have 20 years of experience in Internal Medicine and Pulmonary Medicine.  I am Board Certified in both Internal Medicine and Pulmonary Diseases, and I have  earned the reputation, substantiated by many of my associates and patients, as being one of the best in differential diagnosis and determining the cause of a person’s problems when many other doctors may have given up.

Arthritis can have many causes. It can be caused by degeneration, aging, being overweight or from an immune disorder, such as Rheumatoid Arthritis. Some of these disorders can be treated with an array of drugs, while others are more frustrating. Patients always ask me about Glucosamine and Chondroitin, or Knox Gelatin. They want to know if these can help. Often, you’ll see these combined with MSM, Magnesium, Calcium and anti-oxidants. My answer here is “I think they are over-hyped”.  The only thing that I have found to work, aside from things like Motrin, is exercise and omega-3 fish oils, which need to be taken in high enough doses in order to make a difference. My patients are usually recommended to take the fish oil from The Sear Zone, which sells pharmaceutical grade fish oil without any Mercury or PCB’s.  Usually 4 pills a day, but the dose may vary if the person is already on a platelet thinning drug, such as aspirin. Fish oils, are in many ways, the new Chicken Soup of medicine.

Your Internist can help tell you what type of arthritis you have, with a physical exam and some simple blood work and possibly an X-ray.  Even with the best treatment, sometimes arthritis can progress to the point of a joint replacement, but in general, we believe in an aggressive approach to treating the underlying disorder before this may become an issue.

The treatment of many different types of auto-immune arthritis has changed over many years, essentially with more aggressive and earlier intervention in the arthritis, especially Rheumatoid and Psoriatic arthritis. The use of “anti-TNF” drugs has revolutionized the treatment of these diseases, though these drugs carry risks, such as an increased risk of infections as well as possibly increasing the risk of lymphoma and leukemia. Some of these drugs have been withdrawn from the market due to the fact that they caused a re-activation of the JC virus in the brain and led to severe neurological effects.  This must be considered before starting any type of aggressive therapy.      

Best,

Josh