Latest by Mark Borigini, M.D.

Ask the Expert: My Pain Medication No Longer Works, What Should I Do Now?

Question: I have been living with RA since 1991. For the last 5-6 years I have been on Vicodin of various strengths. The Vicodin no longer works, not even taking the edge off of the pain anymore. My doctor is hesitant to give me anything stronger. He ...

Deformity, Depression and Disability"”The Chain of Events that Must be Broken

Obviously, poorly controlled rheumatoid arthritis can lead to deformities of the joints, particularly the hands and feet. This in turn could lead to a poor self-image, which in turn could lead to feelings of inadequacy and depression. An article in t...

To Exercise or Not to Exercise: The Effects on Chronic Pain

A person in chronic pain most likely does not want to have exercise on the top of his or her list of things to do. However, it is now becoming standard practice to prescribe exercise as a weapon in the never-ending battle against chronic pain. Rest i...

When Relieving Pain Puts Patients in Danger--What to Do?

Current guidelines on pain management advise that patients at risk for ulcer disease be prescribed either a cox-2 inhibitor such as Celebrex, or a traditional anti-inflammatory (such as Motrin or Naprosyn) in combination with a proton-pump inhibitor ...

Stopping RA Before it Begins

While there is no cure for rheumatoid arthritis, it appears that physicians can stop the progression to rheumatoid arthritis in those patients who have so-called "undifferentiated arthritis." This, along with the halting of joint destructi...

Complementary and Alternative Medicine in Rheumatoid Arthritis

Not a week goes by without a patient inquiring about the use of complementary and alternative medicine (CAM) in treating rheumatoid arthritis. Sometimes these are patients who have limited budgets and might not be able to afford the newer treatments ...

Ask the Expert: Rheumatoid Personality?

Dear Dr. Borigini, Years ago, when I was diagnosed at 16 years of age with JRA (juvenile rheumatoid arthritis), two physicians told me that there was such a thing as the "rheumatoid personality." They hinted that there was a certain person...

Ask the Expert: Ulcerative Colitis and RA

Dear Dr. Borigini: Is joint pain a symptom commonly associated with ulcerative colitis? I’ve heard that rheumatoid arthritis and UC are related, but I have never really talked with my doctor about it. Recently I have had random joint pain, and I’m wo...

Ask the Expert: Methotrexate Side Effects

Dear Dr. Borigini, I have been living with RA for about 8 years, diagnosed at age 25. I have been taking methotrexate and having good results with this treatment. My frustration however, is two fold. I have been unable to lose weight or to lower my c...

Do Not Forget the Risks of Methadone in Pain Management

Methadone is an effective drug, with a convenient dosing schedule and a relatively low cost. But it can interact with numerous other medications, and act very differently in different patients.