Psoriatic arthritis

Having psoriatic arthritis starts with noticing the symptoms. From there, it involves finding a trusted team of health care providers and exploring different treatments until you discover what works best for you. At Advocate Health Care, you’ll work with rheumatic disorder specialists who’ll go the extra mile to help you find better health with treatments that fit for you.

What is psoriatic arthritis?

Psoriatic arthritis is a chronic autoimmune disease that causes pain, swelling and inflammation in your joints along with other symptoms. There’s currently no cure for psoriatic arthritis. Many people learn to live with psoriatic arthritis while maintaining effective treatments and self-care routines. However, psoriatic arthritis can be disabling for some people.

It’s possible to have psoriatic arthritis and also have psoriasis – a scaly skin rash. When it occurs, psoriasis may develop either before or after the onset of psoriatic arthritis.

Five types of psoriatic arthritis

Your health care provider may tell you that you have one of the following five types of psoriatic arthritis based on your individual symptoms:

• Distal interphalangeal predominant psoriatic arthritis: Affects joints near fingers and toes and is the most likely type to include psoriasis symptoms on the nails.
• Symmetric polyarthritis: Involves more than five joints and affects the same joints on each side of your body.
• Asymmetric oligoarticular psoriatic arthritis: When fewer than five joints are affected, and those joints are different on each side of the body.
• Spondylitis: Affects bones of the spine.
• Arthritis mutilans: Leads to serious inflammation of hands and feet that can deform joints and cause bone loss. Rarest type of psoriatic arthritis.

How painful can psoriatic arthritis get?

Some people describe psoriatic arthritis pain as a hot, liquid pain. When a flare-up of pain is bad, it can feel overwhelming. Other people describe psoriatic arthritis pain as severe joint pain that comes with stiffness.

Whether you have severe or moderate pain, it’s important to seek treatment and stick with medication, diet and exercise to manage the pain. Sticking with your treatment plan will help prevent psoriatic arthritis from getting worse, including causing deformed joints.

Psoriatic arthritis causes

The cause of psoriatic arthritis is unknown. There are some things that seem related to it, such as:

• Some infections like strep and HIV
• Stress
• Having an injury to the skin, a bone or a joint
• Taking certain medicines

Some risk factors for acquiring psoriatic arthritis are:

• Having psoriasis
• Family history of psoriatic arthritis, psoriasis or both
• Age 30-50
• Obesity

Triggers for psoriatic arthritis flare-ups

Psoriatic arthritis comes and goes. Most people find they have triggers for flare-ups of psoriatic arthritis. Keeping a diary about your symptoms will help you discover what things seem to bring on a flare-up. Some common triggers to watch out for are:

• Not taking medications
• Lack of sleep
• Stress
• Alcohol consumption
• Smoking
• Eating foods that contain sugar, tomatoes, gluten or dairy products

You may find other foods or situations that seem related to your psoriatic arthritis flare-ups. Being aware of your triggers helps you avoid them when possible.

Self-care for psoriatic arthritis

Practicing healthy habits is important for people with psoriatic arthritis. Some of the things you can do to ease symptoms of psoriatic arthritis are:

• If you smoke, stop smoking
• Limit alcohol consumption
• Engage in low-impact exercise
• Use warmth or cold to ease achy joints
• Rest when needed
• Maintain a healthy weight

One thing that can be helpful even if your psoriatic arthritis isn’t disabling is the use of assistive tools for day-to-day tasks. Using devices like grabber tools and kitchen tools with ergonomic handles can be very comforting when your hands and joints are sore. Such tools help you perform daily tasks while giving your joints a rest.

Nutrition is also important. For example, consuming enough calcium and vitamin D may help slow down any bone deformation.

Psoriatic arthritis diagnosis

There's no test that confirms a psoriatic arthritis diagnosis. Your health care provider will consider your medical history and symptoms, including the presence or absence of psoriasis rashes. They’ll physically examine your joints to assess your range of motion and whether you have pain, tenderness, swelling or warmth in your joints.

They’ll also perform imaging tests like X-rays, ultrasound or MRI to evaluate possible changes or inflammation in your joints, ligaments and tendons. Blood tests will be performed to rule out other conditions such as rheumatoid arthritis.

Psoriatic arthritis treatment

Psoriatic arthritis treatment often involves more than one technique. It may take time to find the mix of treatments and personal habits that help you manage and minimize your pain.

Medications are an important part of psoriatic arthritis treatment. They’re used to treat pain and block the abnormal immune response. Some of the medications used most often for psoriatic arthritis are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Used to treat pain and reduce swelling.
• Disease-modifying antirheumatic drugs: Help prevent psoriatic arthritis from getting worse.
• Immunosuppressants: Limit the abnormal immune system response.
• Biologic medicines: Target parts of the immune system that cause joint damage and inflammation.
• Corticosteroids: Relieve swelling and redness.
• Enzyme inhibitors: Block a specific enzyme to help slow inflammation.

Physical therapy is often recommended for psoriatic arthritis treatment to improve muscle strength and joint function. Occupational therapy may be recommended to help with activities of daily living like cooking and personal hygiene tasks. Some complementary therapies that may help with psoriatic arthritis treatment are acupuncture and massage therapy.

When joints are badly damaged, your doctor may recommend surgery to remove the damaged lining of a joint or surgically replace the joint. Surgery can relieve pain, help the joint work and allow more freedom of movement.