If you have been handed artificial tears and told there is nothing else to do, this page is for you. I am a board certified rheumatologist and this is the condition I spend the most time on.
Most people arrive having heard some version of this.
Your antibodies are positive, or maybe they are negative and your biopsy was positive, or maybe nothing was clearly positive and you were told it is probably Sjögren's anyway. Use these eye drops. Sip water. Come back in a year.
And none of that is wrong, exactly. It is just an incomplete account of a disease that is doing a great deal more to you than drying out your eyes.
Those symptoms are not separate problems. In most of the people I see, they are the same problem showing up in different places.
Sjögren's is usually described as an immune attack on the glands that make tears and saliva. That description is accurate and it is not the whole picture.
The glands sit in the head and neck, in a dense region of fascia, lymphatic vessels, and nerves. The same territory carries the vagus nerve, the drainage pathways for the face and skull, and the muscles that tighten when a body has been in pain or on alert for a long time.
The model I work from is a loop. Inflammation in that region causes the surrounding fascia to tighten and guard. Tight fascia compresses the lymphatic vessels that were supposed to clear the inflammation out. The inflammation stays. The nervous system, reading persistent irritation, stays in a defensive state. A nervous system stuck in defense reduces glandular secretion and amplifies pain signaling.
Each part of that loop makes the next part worse.
Which is why treating only the immune component, or only the dryness, so often leaves people still exhausted, still aching, and still not recognizably themselves.
I want to be honest that this is a framework, not established consensus in rheumatology. It is how I make sense of what my patients describe and what I feel under my hands, and it is consistent with a growing literature on fascia, lymphatic function, and pain sensitization. I am telling you how I think so you can judge it for yourself.
Ninety minutes on the first visit, with your full records read beforehand. Sjögren's is frequently diagnosed late, and it is also frequently mislabeled. Before anything else I want to be confident about what we are treating, what else is going on alongside it, and what has been missed.
I am trained in Fascial Counterstrain, and I use it on the neck, jaw, and skull base region where so much of the non dryness symptom burden seems to sit. This is hands on work, done in the room, as part of your regular visit. Almost no rheumatologist offers it.
Breathing, vagal tone, sleep, and stress are not soft additions to the treatment plan. In a disease where secretion and pain amplification are both under autonomic control, they are part of the mechanism. You get a short daily home program, a few minutes long, not a lecture.
I am a rheumatologist. I monitor what needs monitoring, I order and interpret the labs, and I prescribe and adjust medication when medication is the right answer. Integrative does not mean I stopped practicing rheumatology.
Sjögren's is a systemic autoimmune disease and it carries real risks that require real surveillance. Among them is an elevated lifetime risk of lymphoma, which is why persistent gland swelling always needs to be taken seriously and never simply treated as tightness.
Everything on this page is added to standard rheumatologic care. None of it is a substitute for it.
You should continue seeing an ophthalmologist for your eyes and a dentist who understands Sjögren's for your teeth, because dry mouth causes real dental damage and it happens quietly.
If you need a biologic or a medication that requires an insurance prior authorization, I will tell you, I will write the clinical case, and I will hand you to a rheumatologist I trust who does that part of the work.
The practice opens in Orange County, California in Summer 2027.
Much of what I have described is hands on and happens in the room. If you are within driving distance of Orange County, that is the full version of this care.
I expect to see patients from Irvine, Newport Beach, Costa Mesa, Tustin, Santa Ana, Anaheim, Huntington Beach, Laguna, Mission Viejo, and Long Beach.
I speak Korean and I am glad to see patients in Korean.
Telemedicine will be available across multiple states for the parts of care that translate to video. It is real, and it is not the same as being in the room.
I am not accepting patients yet. When I do, the list goes first.
I open in Summer 2027. Members of the list hear first and get priority booking.