March 3, 2011 -- A few weeks before the 2010 U.S. Open, golf pro Phil Mickelson began to experience severe joint pain. Even his regular practice routine suddenly became difficult to endure.
"I didn't think much of it," said Mickelson. "But I didn't know what it was or what it could be."
But 40-year-old Mickelson still couldn't shake it. He and his family left for a vacation in Hawaii, where Mickelson's aches and pains became so excruciating that he could barely get out of bed, never mind swing a golf club.
"I got really scared," said Mickelson. "I started wondering what it was, and if it was even treatable."
Mickelson immediately went to see a rheumatologist, who diagnosed him with psoriatic arthritis, a chronic, inflammatory arthritis caused by an overactive immune system. Symptoms and signs include stiffness, pain and swelling of joints, reduced physical function and reduced quality of life.
While athletic injuries can predispose people to early osteoarthritis, a degenerative disease of cartilage, there is no study that suggests sports predispose people to psoriatic arthritis, which usually hits those in their 30s and 40s.
Up to 30 percent of people who have psoriatic arthritis have had psoriasis, a common skin disease that causes itchy, dry red patches topped with silvery scales on the skin.
Mickelson said that he had psoriasis about eight years ago, and a dermatologist had treated him for it. After diagnosis, doctors put Mickelson on an individualized treatment program right away. Today, the golfer, who has won four major championships and 38 PGA titles, is back to his practice regimens and workouts.
'On Course With Phil'
And on Wednesday, Mickelson launched 'On Course With Phil,' created in collaboration with Amgen and Pfizer, and the Joint Smart Coalition, which includes the Arthritis Foundation and the National Psoriasis Foundation.
The program is meant to educate peopl about chronic inflammatory conditions and encourage people to get checked if they have any symptoms.
Early Diagnosis is Key
"This is meant to give people who have similar symptoms the tools and resources that will help them get questions of their own answered," said Mickelson. "I was so lucky, because I got on it right away, so I was able to slow or stop any further damage."
"It's important to get diagnosed early to slow or prevent long-term damage," said Dr. Christopher Ritchlin, a professor of medicine at the University of Rochester School of Medicine, who serves as a consultant to "On the Course With Phil."
Mickelson and Ritchlin stressed that there are thousands of people who go untreated for the debilitating disease they lack information information.
"The severity of the disease and the pace of joint damage are variable, but it is usually progressive," said Dr. Beth Jonas, an assistant professor of rheumatology, allergy and immunology at University of North Carolina at Chapel Hill. "Once joint damage occurs, it is irreversible, so it does not make any sense to wait until things get really bad to seek medical help. If the disease is treated early, damage can be limited or even avoided in some cases."
"Psoriatic arthritis is a very variable disease. It tends to involve just a few joints and can wax and wane over time," said Dr. Nortin Hadler, a professor of medicine and microbiology and immunology at Chapel Hill. "Hence, the fashion in which it interferes with function is very individualized."
New and Effective Treatments
Ritchlin said that treatments for psoriatic arthritis have greatly improved in the last decade. There are now several ways to manage the illness.
"We're really stressing this early intervention in order to talk about the effective treatments," said Ritchlin. "Twenty years ago, I couldn't have told you that. There are a lot of variables that go into treatment, but there are a lot of options."
Variety of Treatments
The variety of psoriatic arthritis treatments include nonsteroidal inflammatory drugs, oral system therapies and biologic agents, which act closer to the cause of the disease.
"If you have a joint that is painful or swollen you may be considerably limited in your ability to use or stress that joint," said Jonas. "However, since we now have very effective therapies, it is conceivable that people with psoriatic arthritis can participate fully in exercise and athletics and even have a career in competitive sports. Most people whose disease is well-managed can exercise, although some patients remain limited."
Dr. Joan Von Feldt, a professor of medicine at University of Pennsylvania, said that Mickelson's early diagnosis was key to his ability to get back to golf.
"The medicines are so powerful nowadays that Mr. Mickelson should expect to go back to his normal superstar career, with the help of his rheumatologist," said Von Feldt. "I've always been a fan of Phil Mickelson, and so I was thrilled that he would use his misfortune and turn it into an opportunity to help others."
And now, because Mickelson took advantage of those medical breakthroughs, he's back on the green.
"I feel much better, and I'm able to do everything that I'm able to do what I can do what I can do," he said. "I'm back to my practice schedule and really excited for the season."