Are you Living with Psoriatic Arthritis? Here’s How to Manage Your Symptoms
Psoriatic Arthritis Overview
Psoriatic arthritis is one of the most common forms of arthritis, after osteoarthritis and rheumatoid arthritis. The disease carries many of the same symptoms of osteoarthritis and rheumatoid arthritis; however, one distinguishing characteristic is the presence of psoriasis. In 85% of cases of psoriatic arthritis, individuals also experience psoriasis in addition to joint pain and inflammation. According to the National Psoriasis Foundation, 30% of individuals living with psoriasis will go on to develop psoriatic arthritis – with initial onset typically occurring in their 40s and 50s. The exact cause of psoriatic arthritis is unknown; however, genetics and the environment are thought to play key factors. The majority of individuals diagnosed with psoriatic arthritis have a family member who has also been diagnosed with the disease, or who lives with psoriasis. Certain environmental conditions are thought to trigger the onset of the disease, such as viral or bacterial infections, or stress.
85% of People with Psoriatic Arthritis have Psoriasis
Psoriatic arthritis is an autoimmune disease, where the body attacks its own healthy joints. Chronic and progressive, there are five major types of psoriatic arthritis:
- Symmetric arthritis: Affecting the same joints on both sides of the body. This type of psoriatic arthritis has many overlapping symptoms with rheumatoid arthritis.
- Asymmetric arthritis: Affecting different joints on both sides of the body. This is the most common type of psoriatic arthritis.
- Distal interphalangeal predominant: Affecting the joints in the fingers and toes closest to the nails. This type of psoriatic arthritis mimics many of the same symptoms of osteoarthritis.
- Spondylitis: Affecting the spinal column, this type of psoriatic arthritis causes inflammation in those joints. While many individuals living with psoriatic arthritis have symptoms occurring in the lower back and spine, only 5% of individuals have spondylitis.
- Arthritis mutilans: The most severe form of psoriatc arthritis, representing less than 5% of cases. This form of psoriatic arthritis debilitates and deforms the joints of the hands and feet. Arthritis mutilans is very damaging and very progressive.
Ways Psoriatic Arthritis Can Affect your Health
Common symptoms of psoriatic arthritis include joint pain, inflammation, dactylitis (“sausage-like” fingers and toes), fatigue, heel pain, tendonitis, and back pain. However, the disease can also have an impact of your health in a secondary way. That is, a number of conditions can pop up and negatively impact your health, as a result of psoriatic arthritis.
- Heart disease: The inflammation caused by psoriatic arthritis can also have a lasting impact on the arteries. Controlling the inflammation caused by psoriatic arthritis can reduce the risk of developing residual cardiovascular disease.
- Heart attack: Your risk of suffering from a heart attack is increased if you have psoriatic arthritis. Even after controlling for high blood pressure and diabetes, psoriatic arthritis patients still experience an elevated risk. Doctors attribute this to the presence of inflammation.
- Fibromyalgia: Pain and fatigue are common symptoms of psoriatic arthritis. However, psoriatic arthritis patients also experience pain and generalized fatigue beyond the affected joints, leading to this secondary condition.
- Obesity: Being obese is a condition that affects psoriatic arthritis before it’s diagnosed and after it has been confirmed. Obesity is thought to be a potential trigger to the onset of the disease, as it plays a role in inflammation. After diagnosis, obesity can have a further impact on the disease, as it places additional stress on the joints, leading to more pain.
- Cancer: If you have psoriatic arthritis, you have an increased risk of developing certain cancers, such as skin cancer and lymphoma.
- Mental illness: Individuals living with psoriatic arthritis are also more prone to developing depression and anxiety. Drug therapy can help, but sometimes the medications used to treat psoriatic arthritis can also cause mental health issues.
Recognizing the Triggers
Individuals living with psoriatic arthritis typically experience “flares” – where symptoms of the disease come and go. One of the keys to managing psoriatic arthritis is to understand what triggers these flares to minimize the occurrence of symptoms.
- Stress: Stress is the number one contributing factor in triggering flares. And also plays a big presence in the onset of psoriatic arthritis. Closely related is lack of sleep, a lot of times caused by stress.
- Skin injuries: The Koebner Phenomenon is the explanation behind why basic cuts or a sunburn can case major flare-ups of psoriatic arthritis symptoms. Essentially what happens is when you have trauma affecting one part of your body (e.g., a cut on your leg) can trigger inflammation in a close-by area (e.g., your knee). The likely contributing factor to this phenomenon is that psoriatic arthritis is an autoimmune disease, causing abnormal inflammatory responses.
- Medications: Certain medications used to treat other conditions (other than psoriatic arthritis) can trigger flare-ups of psoriatic arthritis. These drugs include psychiatric drugs (e.g., lithium), anti-malaria drugs (e.g., chloroquine), blood pressure medications (e.g., propranolol), prednisone, and quinidine (a heart medication).
- Alcohol: Drinking can increase the presence of psoriasis and has a pro-inflammatory effect on joints, causing flares of psoriatic arthritis symptoms.
- Diet: Certain foods can trigger psoriatic arthritis in individuals, including gluten, sugar, dairy, and tomatoes. Conversely, other foods might diminish the prevalence of flares, including, anti-inflammatory foods, such as fish, olive oil, walnuts, and flaxseed. Antioxidant-rich vegetables and fruits also contribute to a healthy eating pattern for individuals with psoriatic arthritis; these vegetables include kale, broccoli, carrots, spinach, blueberries, and strawberries.
To manage psoriatic arthritis symptoms and flares, individuals can avoid and/or minimize any of the abovementioned triggers to ward off pain and inflammation.
Lifestyle Changes to Manage Psoriatic Arthritis
Being knowledgeable about your symptoms, triggers, and treatments can help you successfully manage psoriatic arthritis. When flare-ups occur, keep track of what foods you ate, if you were under a lot of stress, whether you had a cut, whether you had a good night’s sleep, etc. Knowing what is triggering your symptoms is half the battle. The other half is managing it.
How can you take control of your symptoms?
- Take the medications prescribed by your doctor regularly – don’t skip doses: Skipping or stopping doses of medications prescribed to treat the inflammation and pain associated with psoriatic arthritis commonly causes flare-up of symptoms.
- Be as proactive as you can about cuts and burns: If you’re going to be out in the sun, make sure to wear sunscreen to minimize the occurrence of any sunburns. While you can’t prevent cuts and scrapes from occurring, you can minimize the probability by being gentle with yourself. Slow down, don’t rush, take your time.
- Get a good amount of sleep: Try to maintain a full 8 hours of sleep per night. Avoid stimulants that might keep you awake at night (e.g., caffeine, too much screen time). If you don’t get enough sleep at night, try to plan a good nap to counter the effects of losing sleep.
- Practice stress management: If you know your stressors, avoid them. If you can’t avoid them, take part in activities that can lower your stress levels. For example, practice yoga or meditation to quiet your mind.
- Exercise regularly: Regular exercise can increase your range of mobility, ease your stiff joints, and decrease pain. Exercise can also boost moods and relieve stress, and keep your weight in check. Consider doing exercises that are less stressful to the joints, such as swimming and biking.
- Take things slower: Because fatigue is a common symptom of psoriatic arthritis, take rest breaks often. Break activities into multiple part. Don’t overexert yourself.
Summing it all Up
In summary, there is no cure for psoriatic arthritis, but there are fantastic treatment and management options to reign in symptoms and flares. Keep track of your triggers. Follow your doctor’s recommendations for medications. Stay active. Doing so can greatly decrease your symptoms and allow you to live a pain-free and stress-free life.