Healthy Living
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Psoriatic Arthritis Treatments

Psoriatic Arthritis Treatments

Psoriasis is an auto-immune disease that affects up to four percent of the world’s population. It impacts men and women equally, with early symptoms usually showing up in their twenties.

Over one-third of people diagnosed with psoriasis will also develop psoriatic arthritis. The disease often appears between the ages of 30 and 50 and shows up about ten years after being diagnosed with psoriasis.

Psoriatic arthritis causes pain, swelling, and stiffness in and around the joints. It may be noticeable both inside and outside the body, causing red, flaky skin covered with silvery patches. If you’ve been diagnosed with psoriatic arthritis, defining a treatment plan early on will help you manage the symptoms more effectively.

What are the symptoms of psoriatic arthritis?

People with psoriatic arthritis often have several symptoms all around the body. It can include:

  • Mild to severe joint pain
  • Swelling in and around the joints
  • Joint stiffness, especially if you’ve been stationary
  • Nail changes, including pitting and separation from the nail bed
  • Red, painful eyes
  • Fatigue

The most commonly affected joints include:

  • Neck
  • Shoulder
  • Elbow
  • Wrist
  • Thumb and finger joints
  • Base of spine
  • Knees
  • Ankles
  • Toe joints

Diagnosing psoriatic arthritis

At this time, there is no official test to diagnose psoriatic arthritis. This is why it’s essential to work with a doctor familiar with psoriatic arthritis and who works with patients regularly. It is similar to rheumatoid arthritis, reactive arthritis, and gout, so it takes careful observation to diagnose your symptoms correctly. A doctor may start by asking:

  • Do you frequently have swollen joints?
  • Have you ever been diagnosed with arthritis?
  • Have you noticed holes or pits in your fingernails?
  • Do you frequently have pain in your heel?
  • Do your fingers or toes swell for no apparent reason?

Multiple yeses may be an indicator of psoriatic arthritis.

If your doctor suspects psoriatic arthritis, they’ll refer you to a rheumatologist. The more history you can provide, the easier it will be to make an accurate diagnosis.

Tests may include blood tests, x-rays, ultrasound scans, and other types of imaging to get an accurate view to help confirm a diagnosis. This process may take time, but there are treatments you can start early to help alleviate symptoms.

Managing your symptoms with lifestyle choices

You’ll quickly find that some actions increase symptoms while others help reduce inflammation. There are steps you can take to be more comfortable throughout the day.

  • Joint care – this involves tweaking your everyday activities. For example, a jar opener can help open jars without putting stress on joints.
  • Healthy weight – excessive weight strains joints, leading to more pain and less mobility.
  • Stop smoking – smokers have a higher risk of developing psoriasis.
  • Limit alcohol – alcohol reduces the effectiveness of other treatment options.
  • Exercise – choose exercises that are less stressful on the joints, such as yoga, walking, or tai chi.
  • Pace yourself – trying to complete daily activities while also dealing with pain and inflammation can leave you tired and overwhelmed. Become a better planner, leaving time in your day for rest and relaxation.

Treating psoriatic arthritis with medications

While there is no cure for psoriatic arthritis, treatments exist to help control inflammation, prevent joint pain, and lessen skin irritation. Your doctor may prescribe one or more medications depending on the severity of your disease. Drugs include:

  • NSAIDs – nonsteroidal anti-inflammatory drugs (NSAI) help reduce the pain and inflammation that arises with mild psoriatic arthritis. You can start with non-prescription medications such as ibuprofen or naproxen sodium (Aleve). Depending on your symptoms, your doctor may also prescribe a more potent NSAID. Side effects may include stomach irritation, liver or kidney damage, and heart issues.
  • DMARDs – if you’re not responding well to an NSAID, your doctor may turn to a disease-modifying antirheumatic drug (DMARD). These conventional medications have been shown to slow the progression of psoriatic arthritis, saving joints and other tissues from more severe damage. They’re stronger than NSAIDs but may take more time to take effect. Side effects can include liver damage, lung inflammation, and scarring.
  • Biologics – if DMARDs no longer work, your doctor may prescribe a biologic, which is a newer version of a DMARD. They work to block specific proteins that cause inflammation. Their main side effect is increasing the risk of infection.
  • Steroids – these powerful anti-inflammatory drugs can help reduce pain and inflammation. They can be taken by mouth or injected directly into the joints. These are used only as a last resort, as serious side effects can occur, including brittle bones, hypertension, and diabetes.

In rare cases, a doctor might also prescribe surgery. If nothing else helps to relieve the pain, a synovectomy may be used to remove the lining of the joint or arthroplasty for joint replacement. If the joint can’t be easily replaced, fusion may help strengthen it, making it more stable and less painful.