Expert Advice

There are many questions we have for our health care providers and so often we get nervous and forget to ask them. Our expert medical advisors are available to answer some of those questions. Please be aware that the answers posted here should never replace the advice given to you by your own health care providers. They have not examined you and are not aware of your medical history, they can only answer in general terms.

We’ll post a couple of questions and our experts’ answers here every week or so. Our experts cannot answer you personally, but we’ll post just as many as we can.


I’m 57 years old and was diagnosed as having rheumatoid arthritis six years ago by a rheumatologist. I was started on Azulfidine at that time, and other than prednisone for severe flares, this is the only medicines she has prescribed. At my last appointment a month ago, my rheumatologist made an offhand remark about psoriatic arthritis but didn’t pursue it further. I have had psoriasis since the age of 8. Now I’m wondering whether I do, in fact, have rheumatoid arthritis or whether it’s psoriatic arthritis. How do rheumatologists differentiate the two? I’ll appreciate any information you can give me.

The only reason it matters much is that when someone has PA, but not RA, and the patient takes MTX they have to undergo periodic liver biopsies. 

Dr. Barry Waters

I was just diagnosed with Osteoarthitis, and was told that medication really doesn’t help. The only relief would be to go to a chiropractor to loosen the vertabrae in my neck.. Do you know anything about this?????? 

In OA, medicine primarily just masks the pain, so often it’s safer and just as effective to try physical measures first.

Dr. Barry Waters


I have really bad spine problems that I think are affecting my left foot. Severe pain in that left heel just about in the center. I have been diagnosed with a herniated L5-S1. I also have had a 9 level fusion of the t spine.

Do you think that these problems might have contributed to some extent with the heel pain I am experiencing at present?

Appreciate any insight you might have.

Back problems can certainly cause heel pain, but so can many other things. You need to discuss this with your physician. 


Ken Merriman MD

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