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Rheumatology

Rheumatology

Meet Our Rheumatology Providers

There are hundreds of diverse and sometimes unrelated rheumatic disorders, many are accompanied by inflammatory symptoms and most cause undue pain in the bones and joints. Though rheumatic conditions can vary greatly, the goals of treatment are largely the same: To reduce pain and inflammation, to slow or stop joint damage, and to help people feel better so they can stay active.

Preventive care includes immunizations, lead screening, developmental screening and vision screening. Wellness checks and routine physical are an essential part of preventive care. Treatment options for rheumatic disorders, like the conditions themselves, vary widely in style and scope. Therapies may include long-term lifestyle changes, exercise and diet regimens, drug therapies, surgical options, and of course education.

Many rheumatic disorders are difficult to identify in the earliest stages. Rheumatologists at Central Maine Healthcare have been specially trained to examine areas of pain and swelling and to discover the root cause. As some disorders respond better to treatment in their primary stages, it’s important to get a correct diagnosis as early as possible.

Conditions We Treat

Central Maine Healthcare offers comprehensive, high quality rheumatology care with board-certified Internal Medicine providers who are also board certified in Rheumatology. We are committed to providing our patients with advanced medical knowledge that will enable them to enjoy the best possible quality of life.

Conditions treated:
Arthritis
Bursitis
Gout

Lupus
Osteoporosis
Psoriatic arthritis

Rheumatoid arthritis
Tendonitis

Arthritis

Arthritis, characterized by inflammation of the joints, is a disease that causes pain, stiffness, swelling and limited range of motion in any joint of the body. Anyone — including children — can be affected by arthritis, but the condition usually affects older people. According to the Centers for Disease Control and Prevention, about 30% of people between the ages of 45 and 64, and almost half of those ages 65 and older, have arthritis.

There are more than 100 types of arthritis, but the most common, by far, is osteoarthritis. Also known as degenerative joint disease, osteoarthritis is diagnosed when the cartilage — the cushiony cells that line the joints and protect the bones — breaks down. As a result, the bones can rub together, leading to damage that can reduce function and cause disability. The hips, knees and hands are most commonly affected by osteoarthritis. Other types of arthritis include:

  • Rheumatoid arthritis — a progressive and debilitating autoimmune disorder that can impact multiple joints at one time
  • Psoriatic arthritis — a type of arthritis that affects people with psoriasis
  • Gout inflammatory arthritis that develops because of too much uric acid
  • Lupus — an autoimmune disease that causes pain and inflammation in the joints, internal organs and skin

Risk Factors for Arthritis: Your risk for osteoarthritis increases as you age, and women are at a higher risk than men for the condition. Repetitive joint stress from work or sports, along with obesity, also increase the risk for osteoarthritis. Some bacterial and viral infections can cause joints to develop arthritis, and cigarette smoking can contribute to rheumatoid arthritis. Genetics also play a role in some forms of arthritis.

Arthritis symptoms:
Joint pain (most common)
Limited range of motion

Stiffness
Swelling

Tenderness

Diagnosis of Arthritis: Arthritis can often be diagnosed based on a symptoms review, but your provider may want you to get an imaging study — such as a CT, MRI, ultrasound or X-ray — to see the extent of the damage to your joints and track its progression. Blood work can also help determine the presence of inflammation.

Treatment for Arthritis: The frontline treatment for arthritis is medication. Over-the-counter pain relievers and non-steroidal anti-inflammatory medications, along with pain-reliever creams, may help. Your healthcare provider may also recommend prescription medications to relieve inflammation. Patients with autoimmune-related arthritis may need prescription immunosuppressants. When joint pain is severe, physical therapy and/or joint replacement surgery may be recommended. You can also do the following to manage arthritis:

  • Talk to your provider about what types of exercises can help.
  • Lose weight
  • Quit smoking
  • You may want to install grab bars in the bathroom and/or wear a brace or splint to support the joint. A cane or walker can help ease pain in your joints, too.

Bursitis

Bursitis is inflammation of the bursae, which are small pouches of fluid in the joints that keep bones, muscles and other structures from rubbing during movement. The bursae helps prevent wear and tear. Often resulting from overuse, bursitis can be painful, but a variety of conservative treatments, including rest and exercises to stretch and strengthen nearby muscles, can provide relief.

Risk Factors for Bursitis: Anyone can get bursitis, but the bursae often become inflamed because of too much friction — as with repetitive use — or due to an injury. People who spend a lot of time at a computer, or those who perform manual labor on construction sites, for example, are at a higher risk for bursitis. Other risk factors include:

  • Aging
  • Gout
  • Infection of the bursae
  • Injury to a joint, especially if it alters movement patterns
  • Overuse of a joint, such as performing repetitive motions during work or recreation

Symptoms of Bursitis: When the bursae are irritated, fluid collects at the site and causes swelling, redness and/or warmth. The area hurts consistently, but pain can increase when the affected joint moves or someone puts pressure on it.

Diagnosis of Bursitis: Your provider will start the process of diagnosing bursitis by asking about your medical history, including any chronic conditions or allergies you may have, the medications you take, and the nature of your symptoms and what you’ve done to treat them. The provider will conduct a physical exam, taking care to scrutinize your joints for swelling and other signs of bursitis. Other useful diagnostic tests include:

  • Blood tests. Rarely, a bacterial infection can cause bursitis. Blood tests can determine whether an infection is present.
  • Fluid samples. A sample of fluid from a swollen joint can reveal infection.
  • Imaging studies. X-rays can rule out or reveal bone problems that could be causing your symptoms. An MRI or ultrasound can show inflammation of the bursae.

Treatment for Bursitis: Your provider may recommend rest, ice, compression and elevation (RICE) as an initial treatment for bursitis, and you may receive an antibiotic if an infection is the cause. If the RICE method doesn’t provide pain relief, other treatment options include:

  • Bracing
  • Corticosteroid injections
  • Draining fluid from affected joints
  • Over-the-counter anti-inflammatory and pain-reliving medications
  • Physical therapy
  • Splinting

If other treatments do not work, surgery may be necessary to repair damage in affected joints.

Gout

Gout is a common, highly painful form of arthritis caused by uric acid crystals in the joints, often starting in the big toe. Uric acid is formed by the breakdown of purines, which are organic compounds found in soft tissues and certain foods. When there’s too much uric acid in your blood, it can collect as crystals in the joints. Gout alternates between periods of symptom flares and remission, with weeks to years separating the two. This condition has no cure, but medications can relieve symptoms and lifestyle changes may reduce the risk of flares.

Risk Factors for Gout: Men are much more likely than women to develop gout. Factors that can increase your risk include:

Diet of significant red meat, liver, tuna, mackerel, herring, sardines, scallops, mussels and other purine-rich foods
Family history of gout
Alcohol consumption
Congestive heart failure
Diabetes
High blood pressure
Insulin resistance
Obesity
Organ transplantation
Reduced kidney function
Use of aspirin/drugs with salicylate
Use of diuretics
Use of levodopa and cyclosporine
Use of the vitamin niacin

Symptoms of Gout: Gout can affect any joint, but it’s more common in the toes, ankle and knee. The condition rarely affects more than one joint at once. During flares, an affected joint may be painful, stiff and swollen, as well as red and warm to the touch.

Diagnosis of Gout: Your provider will ask about other medical conditions you may have and the medications you take. Be prepared to provide detailed information about your symptoms, including which joint is affected, what the pain feels like, when it began and how long it’s been going on.

  • Physical exam. The provider will examine the affected joint signs of gout, such as swelling and heat.
  • Imaging tests. An X-ray, ultrasound or MRI allows the provider to assess the condition of the joint and rule out other possible causes of your symptoms.
  • Blood test. High levels of uric acid in your blood are a clue that gout may be present.
  • Fluid sample. The provider may wish to draw fluid from the affected joint to look for uric acid crystals.

Treatment for Gout: Most treatments for gout involve lifestyle changes that can help keep patients in remission as long as possible. If you have gout, you should avoid alcohol and foods that are high in purines and fructose. Drinking plenty of water can lower uric acid levels in the blood, and low-impact physical activity contributes to weight loss and can reduce joint pain. Stress can fuel flares, so try to reduce stress levels. Medical options to relieve pain and swelling include nonsteroidal anti-inflammatory drugs such as aspirin, oral or injectable corticosteroids, and colchicine.

Lupus

Lupus is an autoimmune disorder that causes inflammation throughout your entire body. Symptoms may cycle through periods of improvements and flare ups — but the chronic disease is not curable. However, medications, lifestyle changes and careful monitoring with the help of our providers can help you get back to feeling close to normal.

Risk Factors for Lupus: No one yet knows what causes lupus, although genetic factors are thought to be a factor. Around 90% of people with lupus are female, and most develop the disease between ages 15 to 44. People who are African American, Asian-American, Latino, Native American or Pacific Islander are slightly more likely to develop the disease, as are people who have a close family member with lupus or a different autoimmune disease.

Symptoms of Lupus: There are many different symptoms of lupus, and they vary from person to person. Symptoms can also change as the disease evolves or worsens. Some of the most common symptoms are:

Arthritis or joint pain
Chest pain
Fatigue
Fever
Hair loss
Low blood cell count
Mouth sores
Muscle pain
Sensitivity to sun
Swollen glands
Rashes, often butterfly-shaped on the face

Diagnosis of Lupus: After we evaluate your medical history and symptoms, they will order blood and urine tests, as poor kidney function can be another sign of lupus. The blood will be screened for specific antibodies. If you test positive for the antinuclear antibody — a test that helps identify autoimmune disorders — you will undergo additional bloodwork that can help diagnose lupus. Your provider may also order a tissue biopsy of your skin or your kidney.

Treatment for Lupus: There is no cure for lupus, and your treatment plan will likely change throughout the course of your life, as symptoms flare and subside. We will help you decide what medications and other medical care you might need. Common medications used in lupus treatment include corticosteroids and the antimalarial drug hydroxychloroquine. You may also need medications to treat heart or kidney problems that lupus can cause.

Osteoporosis

Osteoporosis literally means “porous bone.” This disease weakens bone density and mass, leading to fragile bones that can easily be broken in a fall. Over 53 million people in the U.S. have osteoporosis or are at high risk for developing it, but the disease can be prevented and treated in most cases.

Risk Factors for Osteoporosis: Women are far more likely to get osteoporosis than men, especially white and Asian women, and women who have smaller frames. Older people are significantly more likely to develop the disease. Other risk factors include a family history of osteoporosis, smoking, excessive alcohol consumption, low activity levels, a diet low in calcium and Vitamin D, and longtime use of some medications, including glucocorticoids. Some chronic diseases can also lead to bone loss.

Symptoms of Osteoporosis: Osteoporosis often has no external symptoms and is not discovered until a person has a sudden fracture. Some patients with osteoporosis in their vertebrae have back pain or develop a hunched back.

Diagnosis of Osteoporosis: A bone mineral density test is the first step toward an osteoporosis diagnosis, after a general physical exam. A dual energy X-ray absorptiometry (DXA or DEXA) test, which works much like a normal X-ray, can measure bone mineral density at various points across your body, like your thigh, your hip and your spine. If the DXA shows possible osteoporosis, your provider may order more bloodwork or other scans.

Treatment for Osteoporosis: Prevention of osteoporosis is the best treatment. A healthy diet with good amounts of calcium and Vitamin D, along with regular exercise and strength-training, can go a long way toward helping prevent osteoporosis for many people. Post-menopausal women at risk may also want to consider taking estrogen supplements.

For patients where osteoporosis has already developed, nutrition and exercise will be a part of treatment. Certain medications like bisphosphonates, calcitonin, estrogen and other hormones may be prescribed. Fall prevention will also be important, especially for older patients, and orthopedic shoes, canes or shower stools could be recommended to help maintain safe mobility.

Tendonitis

Tendonitis is a common condition that puts wear and tear on the tendons — tissues in the body that connect muscles to bones. Any type of repetitive motion, including playing sports like tennis or bowling, playing an instrument, or working in a factory, can cause tendonitis.

Tennis elbow is one of the most common types of tendonitis. Golfers often experience a similar repetitive injury called “golfer’s elbow.” Achilles tendonitis, another form of tendonitis, is common among runners, and basketball players are familiar with jumper’s knee. Other types of tendonitis include biceps tendonitis and rotator cuff tendonitis.

Risk Factors for Tendonitis: From athletes to office workers, anyone who engages in any type of repetitive movement on a regular basis can get tendonitis. If you have diabetes, arthritis, gout, overactive or underactive thyroid, you also have an increased risk of tendonitis.

Symptoms of Tendonitis: The first signs of tendonitis are usually pain and tenderness where the tendon attaches to the bone. The pain, often a dull ache, is usually present when the joint is moved. Tendonitis can also cause mild swelling around the sore joint.

Diagnosis of Tendonitis: If you think you have tendonitis, talk to your provider. Your provider will review your medical history and conduct a physical exam, where you can describe your symptoms and they will evaluate the area. Tendonitis can usually be diagnosed just based on the provider’s exam. However, these additional tests may be performed:

  • An MRI to see if the tendon is inflamed
  • Injecting an anesthetic into the area to see if the pain diminishes.
  • Testing to see if there’s an infection. This is done by taking fluid from the area.
  • X-rays to see if there are other injuries or problems in the area

Treatment for Tendonitis: The frontline method for treating tendonitis is usually the RICE technique: rest, ice, compression and elevation. Medications, such as aspirin, naproxen or ibuprofen can help reduce pain and inflammation.

If you have tendonitis, you can prevent it from getting worse by strengthening the area with stretching exercises and wearing a brace, band or splint on the injured area. Patients who experience more severe tendonitis may need an injection that contains a steroid called cortisone and a numbing medication. Physical therapy and surgery may be recommended for more severe cases.

Contact Us:

Central Maine Rheumatology
685 Sabattus St.
Lewiston, ME
207-784-1699

A to Z Search for Services

Central Maine Healthcare covers all of your physical and mental health needs.
Click on a service below to learn more about what we offer and where to find care near you.

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  • Addiction Services

    We are committed to understanding and serving people who are living with addiction. We provide compassionate trauma-informed care based on best practi… Learn More >

  • Bariatric Surgery

    Central Maine Bariatric Surgery understands how important weight loss is for patients. We have been established since 2007 and have a team ready to su… Learn More >

  • Breast Health

    When it comes to caring for your breast health, Central Maine Healthcare offers a spectrum of services to help screen, diagnose, and treat. From the m… Learn More >

  • Cancer care

    The Cancer Care Center at Central Maine Medical Center is an integrated, multi-disciplinary program that combines a full spectrum of services and med… Learn More >

  • Cardiovascular services

    Central Maine Heart and Vascular Institute (CMHVI) brings skilled medical specialists and innovative treatments to the people of central Maine and bey… Learn More >

  • Diabetes and Endocrinology

    Diabetes and other endocrine-system conditions are complex, and when you’ve been diagnosed with one, it’s hard to know what to do next. Learn More >

  • Ear, Nose and Throat

    At Central Maine Healthcare, our board-certified ear, nose and throat (ENT) specialists understand how this connected system works and can identify th… Learn More >

  • Emergency Care

    If you’re experiencing a life-threatening emergency, dial 9-1-1 immediately or go to your nearest ER. Emergencies happen when you least expect them,… Learn More >

  • Gastroenterology

    Your digestive system involves so many parts of the body – your throat, stomach, intestines, colon, rectum, pancreas, gallbladder and liver. So, whe… Learn More >

  • Imaging Services

    Welcome to Central Maine Medical Center Imaging Services. We take pride in providing our community with technologically advanced, up-to-date imaging s… Learn More >

  • Integrative Medicine

    At Central Maine Healthcare, we’re focused on the whole you — mind, body and spirit. That’s why we specialize in integrative medicine, with a va… Learn More >

  • Laboratory Services

    Central Maine Healthcare offers lab services at convenient locations for tests as part of your routine appointment or for screening of specific condit… Learn More >

  • Long-Term Care

    At Central Maine Healthcare, our long-term care feels exactly like home. We believe in taking complete care of you or your loved one’s physical, med… Learn More >

  • Neurology

    Central Maine Healthcare's neurologists and other doctors are specialists in epilepsy, movement disorders and other neurological disorders. Learn More >

  • Nutrition Services

    Clinical Nutrition A Registered Dietitian (RD) is a “food and nutrition expert” who has completed a Bachelor’s or Master’s degree ... <a class… Learn More >

  • Orthopedic care

    The Orthopedic Institute of Central Maine (OICM) serves the people of Central, Western and Midcoast Maine. OICM works collaboratively with our outpati… Learn More >

  • Palliative Care

    Central Maine Healthcare's palliative care is specialized medical care for people with serious illness. This type of care is focused on providing reli… Learn More >

  • Pediatrics

    CMH’s kid-friendly team members and ambience — as well as our kid-sized examination tables and tools — instantly put children at ease. And we fi… Learn More >

  • Pharmacy

    The CMMC Pharmacy is open to the public and accepts all major insurance plans. As part of your healthcare team, let our pharmacy assist you with manag… Learn More >

  • Plastic and Reconstructive Surgery

    Plastic and reconstructive surgery is a personal choice, and a personal journey. At Central Maine Healthcare, our double-board certified physician a… Learn More >

  • Primary Care

    At Central Maine Healthcare, we make primary care easy and accessible to community members like you. We believe in providing compassionate, quality ca… Learn More >

  • Pulmonary

    At Central Maine Healthcare we provide diagnosis and treatment to our patients as well as education to both the patient and family. Learn More >

  • Rehabilitation and Therapy

    Whether you have suffered an injury at work or on the field, are recovering from surgery or just want to better manage pain, the Orthopedic Institute… Learn More >

  • Rheumatology

    Rheumatology is the study and treatment of rheumatic disorders, a wide range of conditions affecting the joints and connective tissue and typically ca… Learn More >

  • Sleep Medicine

    At Central Maine Healthcare, we know what a peaceful night’s sleep means for your health and life. Our board-certified sleep medicine specialist and… Learn More >

  • Surgical services

    Central Maine Heart and Vascular Institute (CMHVI) brings skilled medical specialists and innovative treatments to the people of central Maine and bey… Learn More >

  • Telehealth Services

    Central Maine Healthcare now offers telehealth services, bringing you the care you need when you’re unable to leave home. Online and telephone visit… Learn More >

  • Trauma Center

    We offer three ERs right in the communities we serve – each staffed 24/7 with board-certified emergency providers and specialty trained team members… Learn More >

  • Urology

    Using the latest and most advanced screening technology allows our medical team to scan with amazing detail. This allows us to more accurately detect… Learn More >

  • Women’s and children’s health

    Women of all ages have unique health and medical needs, which is why Central Maine Healthcare has spent decades building services, treatment, educatio… Learn More >

  • Wound Care

    Central Maine Medical Center’s Comprehensive Wound Center is a centralized location for all aspects of wound care. Our team of specialists provides… Learn More >

Rumford Hospital

Rumford Hospital is a 25-bed, not-for-profit critical access hospital (CAH), offering inpatient and outpatient services to the River Valley community. Rumford Hospital provides patients with local access to 24-hour emergency care and an array of healthcare services, including primary care, diagnostic and medical-surgical nursing services, women’s health and ambulatory surgery. The hospital’s swing bed program provides care for patients who need skilled nursing services.

420 Franklin Street
Rumford, ME 04276

Main: (207) 369-1000
Emergency: (207) 369-1051
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Central Maine Medical Center
Bridgton Hospital
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Central Maine Medical Center

Central Maine Medical Center (CMMC) in Lewiston is the flagship facility of Central Maine Healthcare. CMMC is a 250-bed, not-for-profit, Level III Trauma Center, offering comprehensive inpatient and outpatient services to the people of central Maine. CMMC provides 24-hour emergency care, a state-of-the-art Cancer Care Center, an award-winning stroke center and extensive specialized care. CMMC is also the southern Maine base for LifeFlight of Maine, the state’s only medical helicopter service.

300 Main Street
Lewiston, ME 04240

Main: (207) 795-0111
Emergency: (207) 795-2200
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Bridgton Hospital
Rumford Hospital

Telehealth Services

Central Maine Healthcare now offers telehealth services, bringing you the care you need when you’re unable to leave home. Online and telephone visits are available at most of our outpatient locations.

What is Telehealth?

Telehealth is a service provided to connect you with your healthcare provider virtually, without having to leave the comfort of your home. Telehealth includes phone appointments and video appointments with your provider using technology such as a smartphone, computer or tablet. Depending on your needs and the purpose of your intended visit, you are able to speak your provider about medical conditions and concerns, receive a diagnosis and request prescriptions. To find out if a telehealth visit is right for you, contact the Patient Service Representative at one of our outpatient practices. We can discuss your options with you and schedule the visit.

Telephone Visits

Telephone visits are now available in all CMH primary care and specialty care practices, so you can conduct your healthcare visit by phone from the comfort of your home. Available for both current and new CMH patients, these appointments are scheduled by calling your practice of choice and requesting the appointment. Phone visits are the same cost as an office visit and are covered by all in-network insurance providers.

Online Visits by Smartphone, Computer or Tablet

Many Central Maine Healthcare primary care and specialty care practices now have the ability to conduct online visits. You can visit with your provider using a smartphone, computer or tablet. Below is a list of practices that are currently offering this service. We will continue to update the list as more are added.

Central Maine Internal Medicine – Lewiston
Central Maine Healthcare Orthopedics – Auburn
Topsham Family Medicine – Topsham
Central Maine Family Practice– Lewiston
Family Health Care Associates– Auburn
Central Maine Family Medicine Program– Lewiston
Gray Family Health Center– Gray
Minot Avenue Family Medicine– Auburn
North Bridgton Family Practice & Walk in Clinic– Bridgton
Naples Family Practice– Naples
Bridgton Hospital Specialty Clinics– Bridgton
Central Maine Bariatric Surgery– Lewiston
Swift River Family Medicine– Rumford
Elsemore Dixfield Family Medicine– Dixfield
Rumford Hospital Specialty Clinics– Rumford
Topsham Care Center– Topsham
Central Maine Surgical Associates– Lewiston
Central Maine Pediatrics– Lewiston
Central Maine Gastroenterology– Lewiston
Central Maine Pulmonary– Lewiston
Central Maine Obstetrics-gynecology– Lewiston
Central Maine Rheumatology– Lewiston
Central Maine Sleep Medicine– Lewiston
Central Maine Podiatry- Lewiston
Central Maine Plastic Surgery– Auburn
Central Maine Neurology– Lewiston
Central Maine Medication Management Clinic- Lewiston
Ent Head and Neck Surgery– Lewiston

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