Arthritis Causes, Symptoms, and Treatment

May is Arthritis Awareness Month and SIMEDHealth Rheumatologist, Dr. Rodriguez, discusses the different types of arthritis, arthritis causes, symptoms, and treatment options.



In the U.S. 58.5 million people have arthritis. According to the CDC, "Arthritis is a leading cause of work disability, with annual medical care and lost earnings costs of $303.5 billion." Joints are where the bones meet, and arthritis is inflammation or destruction of a joint. SIMEDHealth Rheumatologist, Dr. Miguel Rodriguez, discusses the common symptoms of arthritis including pain, swelling, stiffness, redness, and decreased range of motion. If you have these symptoms or you or someone you love is suffering from arthritis, talk to your doctor to receive proper treatment. To schedule an appointment with our Rheumatology clinic, click here.


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Osteoporosis with Dr. Miguel Rodriguez

We had questions about osteoporosis and SIMEDHealth Rheumatologist Dr. Miguel Rodriguez had answers!


Dr. Rodriguez sees patients at our Gainesville and Ocala locations; to schedule an appointment, visit .


1. What is osteoporosis?

Osteoporosis is a common bone disease that leads to an increased risk of fracture. Throughout our lives, our bones are constantly being broken down and built up again. Osteoporosis occurs when too much bone is lost and/or too little is made. This causes bones to become brittle and easier to break. In more severe osteoporosis, a minor trip, bump or even a sneeze may be all it takes to break a bone.

2. What are the symptoms of osteoporosis?

Most people with osteoporosis do not know they have the disease until they break a bone which is why osteoporosis is often called a “silent” disease. Once a bone fractures, it can be very painful and may take a very long time to heal. Some symptoms can become more noticeable with worsening disease and may include:

  • A gradual loss in height because of compressed vertebrae
  • Stooped posture or “Dowager’s hump”
  • Persistent back pain from collapsed or fractured vertebrae or other bone pain
  • More frequent fractures

3. What are the risk factors for osteoporosis?

Your risk of osteoporosis depends on:

  • Your age – bone density declines at a faster rate after the age of 50
  • Your diet – a regular intake of calcium and other minerals helps maintain bone health
  • How much you exercise and what type of exercise you do - weight-bearing exercises increase bone density
  • Sex hormone levels – women after menopause and men with low testosterone are at higher risk
  • Sun exposure – sun is needed in small amounts for our skin to make vitamin D
  • What other medical conditions you have – people with celiac disease, Crohn’s disease, or rheumatoid arthritis have a higher risk of osteoporosis
  • What medicines you take – corticosteroids, antiandrogens, and aromatase inhibitors increase risk
  • If you are deficient in any vitamins and minerals such as vitamin D or calcium
  • How much you smoke or drink – smoking or a high alcohol intake increases risk
  • How much you weigh – people who are underweight generally have lower bone densities
  • If you have had any previous fractures

4. How is osteoporosis diagnosed? 

Doctors usually diagnose osteoporosis during routine screening for the disease. The U.S. Preventive Services Task Force recommends screening for:

  • Women over age 65
  • Women of any age who have factors that increase the chance of developing osteoporosis

Your doctor may order a test that measures your bone mineral density (BMD) in a specific area of your bone. The most common test for measuring bone mineral density is dual-energy x-ray absorptiometry (DXA). It is a quick, painless, and noninvasive test. DXA uses low levels of x-rays as it passes a scanner over your body while you lie on a cushioned table. The test measures the BMD of your skeleton and at various sites that are prone to fracture, such as the hip and spine. Bone density measurement by DXA at the hip and spine is generally considered the most reliable way to diagnose osteoporosis and predict fracture risk.

A person can also be diagnosed with osteoporosis if they have a fragility fracture. Fragility fractures occur as a result of “low energy trauma”, often from a fall from standing height or less.

5. What medications are available to treat osteoporosis?

There are a number of different medicines used to treat osteoporosis. Some work by decreasing how fast bone is broken down, others increase the rate at which bone is built back up. Some can only be used in postmenopausal women.

Common medicines prescribed for osteoporosis include:

  • Bisphosphonates such as Actonel, Atelvia, Boniva, Binosto, Fosamax, Reclast, and Zometa
  • Hormone therapies, that replace missing hormones or mimic the actions of hormones, such as Calcitonin, Duavee, Evista, Femhrt, Forteo, Premarin, or Tymlos
  • Prolia – directly targets cells breaking down bone

6. Can osteoporosis be reversed?

Yes! Several treatments have been shown to improve bone density which slows or reverses the progression of osteoporosis, reducing the risk of fracture. However, osteoporosis cannot be cured indefinitely.  It requires ongoing actions to maintain your bone density. It’s never too late to treat your osteoporosis.  Don’t wait for a fracture to take action.


The COVID Coach

Since March, the world has been feeling the effects of the spread of the COVID-19 virus. Social distancing and stay at home orders have lessened most people’s social interactions and time outside. While these are essential to slow the spread of the coronavirus, it can have a detrimental effect on people’s mental health.

A free app that can be downloaded to your phone called COVID Coach can help you connect to resources to affect your mental well-being positively. Miguel Rodriguez, MD, a rheumatologist with SIMEDHealth’s Arthritis Center, previewed the COVID Coach app. “During these stressful times of health concerns, financial instability, limited access to resources, and uncertainty about the future, it is important we practice self-care,” Dr. Rodriguez says. “Self-care is any activity that we do deliberately to take care of our mental, emotional, and physical health. It is something that you actively plan.”

Dr. Rodriguez adds, “Scheduling as little as 5-15 minutes every day to work on self-care can make a big difference. COVID Coach has multiple different coping tools you can try out to find the ones you like. Then save preferred tools to your favorites so you can come back to the ones that work for you.”

“It’s essential, and okay to acknowledge that you are experiencing increased stress as a result of COVID-19. Along with adequate sleep, exercise, staying connected to friends and family, and continuing your medical care, the COVID Coach app may aid in keeping your stress at a lower, more manageable level.

Does Food Play a Role in How Autoimmune Diseases Behave?

According to the American Autoimmune Related Diseases Association, 50 million Americans currently are living with an autoimmune disease. We recently sat down with Rheumatologist Dr. Maurice Rodriguez to discuss the effects of food on the body for people with autoimmune diseases.

Dr. Rodriguez says, “An autoimmune disease is a condition where the body reacts against itself.” Normally our immune system fights against foreign substances, like bacteria, but people with an autoimmune disease have an immune systems malfunction and it ends up attacking its own tissue. This can have very long term and destructive effects on their bodies. There are more than 80 types of autoimmune diseases with the most common being Rheumatoid arthritis, Lupus, and Celiac Disease but are different symptoms for each autoimmune disease, though a common symptom for all of them is inflammation and joint swelling.

What we eat can play a role in how autoimmune diseases behave but it is not clear how and why. A large part of the immune system is in the gut so it is safe to say there is a connection. That being said, eating healthy can help overall but eating unhealthy can add fuel to the fire. Rodriguez says “Eating well will not solve the problem but help the patient feel better overall which can make a real difference in the quality of life.”

 Examples of Foods that can help the most:

  • Fatty Fish (omega 3)
  • Leafy Greens
  • The whole spectrum of food can help get the most vitamins and nutrients

Examples of Foods that hurt the most:

  • Sugar
  • Processed food
  • Anything that comes in a box
  • Ingredients you can’t pronounce
  • If your grandma wouldn’t recognize it


Dr. Rodriguez’s advice to people living with an autoimmune disease: find out as much as you can about your disease and take ownership of it. Eating right and exercising will help everything work better. Small steps towards eating better consistently over time will help and be easier on you. Also, “don’t do anything strange.”

Rheumatologist Dr. Rodriguez also treats and diagnoses osteoarthritis, joint pain problems, chronic pain, and non-operative orthopedics. If you are experiencing inflammation and other autoimmune disease symptoms or are already diagnosed with an autoimmune disease but you want to learn more about eating well, click here to schedule an appointment with Dr. Rodriguez.

Run a Half Marathon: Learn How to Prepare

Woman running a marathon while smiling

Run a Half Marathon: New Year’s Resolution

Thank you to everyone who submitted their New Year’s resolution for the Health Goals 2018 project. New Year’s Resolution #1 was submitted by Kelly of Gainesville. Kelly wants to “recover from an ankle injury and complete a half marathon.” 

Dr. Miguel Rodriguez, a SIMED rheumatologist in the Gainesville Arthritis Center, has run numerous marathons. He weighed in on the situation and provided a few tips.

1. Get a good pair of running shoes for your specific foot type. The following shoe stores can evaluate how you run and recommend the right shoes for you:
- The Gainesville Running and Walking Store -
- Lloyd Clarke Sports -
- Fit2Run -

2. Make sure to warm up and cool down and stretch your feet and ankles.
- Dr. Rodriguez recommends and uses the YOFIT foot stretcher. -
- If you don’t want to purchase a foot stretcher, you can still stretch your ankle and feet using your surroundings as a tool. For instructions and a video walk-through, visit the New York Road Runners website:

3. Follow a half-marathon training plan.
- There are apps and many available resources online that will prepare you for a half marathon. Dr. Rodriguez suggests using Jeff Galloway’s half marathon training plan:

4. Avoid overeating.Paleo diet food with raw ingredients to prep for a half marathon run
- Running and being more physically active is not an excuse to eat poorly. Stick to a paleo or Whole 30 approach for your food.
The Whole 30 diet focusses on healthy, unprocessed food. People who follow the diet avoid consuming grains, alcohol, added sugar, dairy and other unhealthy foods. You would wait until 30 days after starting the diet to weigh yourself for the first time. Learn more:
The paleo diet also avoids processed food, dairy, grains and alcohol and focusses on eating food as our ancestors did many years ago. Learn about the paleo diet:
- You can also use the slow cooker to make sure you always have food ready. When you increase your activity, you will get hungry. The internet has an abundance of free recipes for whatever you want to eat. One of Dr. Rodriguez’s favorite recipes is Slow Cooker Kalua Pig:

5. If you are looking for support, resources are available in the area.
- The Florida Track Club hosts group runs:
- Local running stores also host events:

With these tips in mind, you will be well on your way to running a half marathon. Remember to take your time and move at your own pace. If you experience any pain, take a break and consult a doctor if necessary. 

To schedule an appointment with Dr. Rodriguez in Gainesville, call (352) 378-5173 or request an appointment online. For an appointment with another rheumatologist, call:
Gainesville: (352) 378-5173
Ocala: (352) 291-0245
Chiefland: (352) 378-5173
Lady Lake (The Villages): (352) 391-6450
Or request an appointment online.