Psoriatic Arthritis Treatment: Learn to Manage your Symptoms

Over 125 million people have psoriasis, a common skin condition that causes red, itchy skin with signature silvery scale patches. Afflicting 2-3% of the world’s population, psoriasis affects Caucasians more so than other races and it is the most common autoimmune disorder in the United States.

In addition to skin troubles, individuals with psoriasis are also more susceptible to joint troubles. Up to 30% of individuals who have psoriasis will also develop psoriatic arthritis. Psoriatic arthritis is one of the most common types of arthritis, following osteoarthritis and rheumatoid arthritis. Psoriasis precedes the onset of psoriatic arthritis in 85% of cases; however, in rare instances individuals can develop psoriatic arthritis without having prior psoriasis symptoms. The onset of psoriatic arthritis typically occurs between the fourth and fifth decade.

30%
30% of Psoriasis Patients who will Get Psoriatic Arthritis

 

What are the Symptoms of Psoriatic Arthritis?

If you are experiencing joint pain and have a history of psoriasis, you should get checked out by a doctor to see if you have psoriatic arthritis. In addition to joint pain and inflammation, some of the more common symptoms of psoriatic arthritis include:

  • Painful joints that appear swollen and red
  • Joints that are warm to the touch
  • Nail pitting and other nail changes (e.g., nails lifting from the nail bed; fungus-like appearance)
  • Stiff joints, especially when first waking up or after long periods of rest
  • Fatigue
  • “Sausage-like” fingers and toes (called dactylitis)
  • Tendonitis
  • Lower back pain
  • Achilles tendonitis
  • Plantar fasciitis
  • Conjunctivitis (commonly referred to as pink eye)
back pain

Depending on where your symptoms occur can also be a key factor in determining what type of psoriatic arthritis you have. Currently, five types of psoriatic arthritis have been identified:

  • Symmetrical polyarthritis – psoriatic arthritis that occurs on both sides of the body
  • Asymmetric oligoarticular – psoriatic arthritis that affects joints on one side of the body
  • Spondylitis –psoriatic arthritis affecting the joints in the lower back and near the spine
  • Distal interphalangeal – psoriatic arthritis in the joints of the fingers and toes
  • Arthritis mutilans – a form of psoriatic arthritis that severely incapacitates use of the joints, especially affecting the hands and feet

 

Psoriatic Arthritis Diagnosis

How will your doctor diagnose a case of psoriatic arthritis? Your doctor will take your medical history, your family history, and do a physical examination. Additionally he or she will perform a number of tests to single-out a diagnosis of psoriatic arthritis. Because psoriatic arthritis shares many of its symptoms with other types of arthritis, often, one of the tell-tale signs of psoriatic arthritis is the presence of psoriasis.

During a physical examination, your doctor will be looking for swollen joints, “sausage-like” fingers and toes, nail pitting and other nail changes, and look for tender areas that psoriatic arthritis tends to cause (e.g., in the heel or in the soles of your feet). In addition to taking your medical history, your doctor will likely use a number of imaging and laboratory tests to help with a diagnosis.

doctor

Imaging tests, such as x-rays and MRIs, can be ordered by your doctor for diagnosis purposes. X-rays can be used to examine joint damage, while MRIs are issued to examine damage to the tendons and ligaments.

Laboratory tests to test for psoriatic arthritis include Rheumatoid Factor (RF) tests and joint fluid tests. RF is an antibody present in individuals who have rheumatoid arthritis; however, it does not appear in individuals with psoriatic arthritis. Because rheumatoid arthritis and psoriatic arthritis have so many overlapping symptoms that it’s hard to diagnose between the two, presence of RF can rule out psoriatic arthritis. Joint fluid tests sample fluid from inflamed joints. Presence of uric acid crystals in the fluid are indicative of gout instead of psoriatic arthritis. Gout also has many similar characteristics of psoriatic arthritis.

 

Treatment Options

There is no cure for psoriatic arthritis. However, with prompt and proper treatment, psoriatic arthritis symptoms can be controlled and pain lessened significantly. Drug treatment therapies, natural remedies, and lifestyle changes are class treatment options for psoriatic arthritis.

drugs

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs): One of the most common medications prescribed to treat psoriatic arthritis, NSAIDs are designed to reduce joint inflammation and the pain associated with it.  There are a number of OTC options for NSAIDs (e.g., Advil and Motrin) and also several prescription NSAIDs. Several side effects can occur from long-term use, including stomach irritation and bleeding, with an increased risk for heart attack and stroke.

Disease-modifying antirheumatic drugs (DMARDs): These anti-inflammatory drugs are made to prevent joint damage by inhibiting inflammatory chemicals that cause joint inflammation and resulting joint pain. Common DMARDs prescribed for psoriatic arthritis include methotrexate and sulfasalazine.

Corticosteroids: These drugs are designed to work like the body’s natural cortisol (produced by the adrenal glands), which works as an anti-inflammatory agent.  Long-term use of corticosteroids can cause weight gain, facial swelling, and osteoporosis. Most individuals with psoriatic arthritis take corticosteroids orally, but the drug can also be injected into inflamed joints to provide temporary pain relief.

Biologics: Biologics stop inflammation at the cellular level and include two types to treat psoriatic arthritis: anti-tumor necrosis factor-alpha (TNF-alpha) and ustekinumab. TNF-alpha drugs block proteins that kickstart the inflammation process. Ustekinumab drugs also inhibit proteins that cause inflammation. Biologics are known to suppress the immune system, leaving you susceptible to infections and illnesses. Both types of biologics are also prescribed to treat psoriasis.

 

Natural Remedies

There are several natural remedies to treat psoriatic arthritis and related psoriasis. Most of these remedies are based on anecdotal evidence over scientific fact; however, many people swear by their treatment utility.

Apple cider vinegar: used to treat psoriasis and is applied directly to the skin. Individuals have found apple cider vinegar to be particularly useful for psoriasis of the scalp.

Oats: Taking oat baths have become a well-known natural remedy to treat the itchiness associated with psoriasis.

Tea tree oil: Known as an anti-inflammatory agent, tea tree oil helps to control skin inflammation caused by psoriatic arthritis. Prolonged use of this essential oil may ultimately irritate individuals with sensitive skin.

Turmeric: Widely noted for its anti-inflammatory properties, turmeric is taken often by people who suffer from arthritis. Turmeric can be taken by eating foods with turmeric in them or by taking turmeric capsules.

Capsaicin: Capsaicin blocks pain receptors to decrease the pain associated with psoriatic arthritis. Within topical creams, capsaicin has been found to be effective in treating psoriasis.

Fish oil: Omega 3 fatty acids block inflammation and suppress painful swelling.

Ginger: Ginger root is known for its anti-inflammatory properties and treating joint inflammation caused by arthritis.

Aloe vera: Applied topically, aloe vera has a cooling agent to soothe skin with psoriasis.

Oregon grape: Similar to aloe vera, creams containing Oregon grape are thought to minimize skin irritations caused by psoriasis.

Epsom salts: A good Epsom salt bath soak can work wonders to reduce joint inflammation and joint pain.

 

Lifestyle Changes

Maintaining a healthy weight: Being overweight causes extra strain on the joints. If you are an individual with psoriatic arthritis, maintaining a healthy weight can decrease the amount of stress on your joints, contributing to lessened pain and inflammation. In addition to reducing the amount of strain on your joints, maintaining a healthy weight can also contribute to increased mobility.

hand pain

Regular exercise: Regular exercise is an important part of every day life when you are living with psoriatic arthritis. Exercise loosens joints, decreases pain, and increases your mobility. All of these things contribute to your quality of life. If you are having trouble exercising while living with psoriatic arthritis because of the strain on your joints, engage in exercises that are gentle to your joints (e.g., swimming and biking).

Protecting your joints: When your joints are already inflamed and painful, try to reduce the introduction of any additional stress to your joints. When opening a jar, use a jar opener to assist. When pushing a door open, use your body weight to push the door open instead of your fingertips.

Pacing your activities: Fatigue is a very real part of psoriatic arthritis. When you are already fatigued, it’s best to split your tasks up into multiple segments so as not to put undue stress on your joints when you’re already tired. Relax several times during the day to conserve your energy.

 

Living with Psoriatic Arthritis

Living with psoriatic arthritis is all about maintaining the right treatment plan. With the right treatment plan in place, you can live a life free of pain and inflammation. Most doctors prescribe a combination of therapies to patients with psoriatic arthritis. This can include drug therapies, home remedies, and lifestyle changes to increase mobility, treat psoriasis symptoms, and minimize joint pain.

Even though psoriatic arthritis is a lifelong, chronic, autoimmune disorder, this does not have to impact your quality of life. Get diagnosed early, have your doctor develop a treatment plan, and stick to it. These are the keys to living a healthy life with psoriatic arthritis.