April 5, 2011 -- 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.
Byron Janis and Arthritis Foundation Join Forces
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."
Variety of Treatments
"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.
"Psoriatic arthritis is a very variable disease," said Dr. Nortin Hadler, professor of medicine, microbiology and immunology at the University of North Carolina at Chapel Hill. "It tends to involve just a few joints and can wax and wane over time. Hence, the fashion in which it interferes with function is very individualized."
"For many patients, most of the time, modifying their activities serves them well," said Hadler. "For some with more joints involved with greater intensity, psoriatic arthritis can be a major challenge.
"And for the occasional patient, it has the potential to do a great deal of damage to the involved joint."
Today, Hadler said treatment is tailored to the individual with a variety of options depending on the severity of the condition.
While the condition can be devastating, doctors said that early diagnosis and treatment from a rheumatologist can prevent a lot of suffering.
Once diagnosed with his condition, Janis underwent acupuncture for several years, which he said he found very beneficial. His other treatments throughout the years included NSAIDS, methotrexate, Celebrex and small quantities of prednisone.
The Future of Arthritis
Now as part of the alliance with the Arthritis Foundation, Janis will attend national and regional galas, where he will perform and speak out about the history of his condition.
And the musician said he is particularly interested in juvenile arthritis.
"I tell the children to have more than one dream," said Janis. "One of them will come true."
For Janis, it was becoming a pianist. He said, despite the pain, there were many performances that are particularly memorable "but one surely would be opening the first cultural exchange between the United States and Soviet Union in 1960, at the height of the Cold War and to see how music could melt that hostility," said Janis.
"I shall always remember their tears as they stood near the stage as the concert ended."