Since his Carnegie Hall debut in 1948, Byron Janis has been known as one of the world's greatest pianists. He was regarded as a child prodigy at the age of 4 and has played for several American presidents.
And even after he was diagnosed with a progressive and painful form of arthritis – one that threatened to rob him of his career – he played on.
In 1973, doctors diagnosed him with psoriatic arthritis. The legendary pianist was told by doctors, "it doesn't get any better" and that "every concert had the potential of being a serious threat" to his health.
"It was as though a knife had gone through me," said Janis.
Following the diagnosis, his passion became a painful labor of love throughout his career, as concerts and performances caused the musician serious pain in his joints. Still, he continued to perform.
"What it took to maintain my career is hard to describe," continued Janis. "Every concert was a painful mountain to climb, but I didn't doubt the impossible was possible in spite of the doctors' prognosis that I would never play again."
"In many ways, Byron was like an elite athlete who, despite his pain and damage to his joints overcame the arthritis, and can serve as a role model to many," said Dr. Steven Abramson, professor of medicine and pathology and director of the division of rheumatology at NYU Langone Medical Center.
In 1985, former First Lady Nancy Reagan announced that Janis had arthritis, and he has been a national spokesman for the Arthritis Foundation ever since.
Most recently, Janis collaborated with the Arthritis Foundation to donate 25 percent of the proceeds from the sales of his DVD documentary, "The Byron Janis Story," his book, "Chopin and Beyond—My Extraordinary Life in Music and the Paranormal" and his upcoming album, "Byron Janis—Live from Leningrad."
"Arthritis has taught me to look inside myself for new sources of strength and creativity," he said. "It has given my life a new intensity. I have arthritis, but it does not have me."
Nearly 50 million Americans suffer from arthritis, and the condition is second only to heart disease as a cause of work disability, according to the Arthritis Foundation.
"It is great that so many celebrities are talking about their positive experience overcoming a potentially disabling and deforming disease," said Dr. Joan Von Feldt, professor of medicine at the University of Pennsylvania.
Psoriatic arthritis is particularly problematic in people whose livelihood depends on fine motor activities of the fingers such as musicians and surgeons, said Dr. Joan M. Bathon, professor of medicine at Columbia University College of Physicians and Surgeons.
"This is because psoriatic arthritis can cause what is called ankylosis of the joints, which means that the bones grow together and the joint, and thus movement of the joint are obliterated," said Bathon. "That means the pianist would not be able to bend a finger in order to press a key.
"It can be quite devastating."
"Rest is usually the first recommendation for inflamed joints, so when Mr. Janis was still playing the piano, he likely worked through pain and stiffness until his arthritis was controlled with medications," said Von Feldt.
The variety of psoriatic arthritis treatments include non-steroidal inflammatory drugs, oral system therapies and biologic agents.