Not only that, Dr. Matteson says, if left untreated, the disease can cause problems in the heart, eyes and other organs and ultimately shorten life expectancy.

“Often what we see is, by the time a patient comes to the clinic, they have evidence that joint erosion has taken place,” Dr. Matteson says. “Starting treatment early is huge.”

Phil tried taking prednisone, but the side effects were awful, he says. Then doctors at the Mayo Clinic prescribed weekly injections of a biologic drug that blocks TNF-alpha, an immune system protein that drives up inflammation. Biologic medications, including adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade) and golimumab (Simponi), can be very effective for autoimmune diseases like psoriatic arthritis and RA, but Dr. Matteson says they don’t work for everyone and they do have risks. Because they suppress the immune system, people who take them are at risk of serious infections.

New Game Plan

Phil didn’t pick up a golf club for about six weeks. In early January of this year, he started practicing again with his world-renowned coach, Butch Harmon. The two have laid out a game plan that Phil believes can put him back at the top of his sport.

Even though Phil won the Masters green jacket in 2010 – and a $1.35 million purse – his year wasn’t what he had hoped for.

“I was excited about how I ended 2009 and had expected 2010 to be a great year,” he says. “I think my best golf may still be ahead of me, that 2011 can be the year I thought 2010 was going to be.”

For PGA golfers at his level, January through March is a 12-week tune-up for the Masters Tournament, the first of the four major golf tournaments. But Augusta National, where Phil has won three times, is an unforgiving course. Currently the No. 4 ranked golfer in the world, Phil knows that come April, he’ll have to be at his best to defend his championship against the likes of Tiger Woods, Lee Westwood and Jim Furyk, and win for a fourth time there.

“I like where I am physically and am optimistic about 2011,” he says.

When Phil was fresh off the diagnosis and initial treatments, he talked about taking the biologic injections for a year or so, then being done with it. He now understands that his expectations were unrealistic.

“My condition is something that’s going to be part of my life from here on out,” Phil says. “From what I understand, this disease, or its effects, will come and go for the rest of my life. I might take medicine for a year and then go off of it. Then, when and if it flares up, I’d go back on the medicine. I’m OK with taking medicine the rest of my life if I have to.”

Dr. Matteson says remission – not a cure – is the goal right now. “These are ongoing problems that have to be managed on a continuing basis. You think it’s gone because the symptoms have quieted, then it flares up. In that sense, it’s like a forest fire.”

Bill Sanders, a freelance writer living in Atlanta, has covered six Masters Tournaments.

This interview took place after Phil Mickelson entered into a partnership with Amgen-Pfizer, an Arthritis Foundation sponsor, in November, 2010.