A form of arthritis that develops in conjunction with existing Psoriasis.
Psoriatic arthritis is a type of arthritis that affects individuals who already have psoriasis, which is a skin disease that features rashes of red patches and silvery scales.
A combination of genetics, environment and immunity are believed to cause the disease, but there is no certifiably known cause. Psoriatic arthritis, much like other forms of arthritis, is a response to a disorder where immune cells attack healthy cells. Joint pain and swelling and the overproducing of skin cells are the results of this condition.
An individual will most likely be diagnosed with psoriasis before being diagnosed with psoriatic arthritis, but joint pain and swelling can occur before the rash appears. Psoriatic arthritis most commonly develops in individuals aged 30-50 who also have psoriasis.
There is no cure for psoriasis or psoriatic arthritis. Treatment is focused on alleviating discomfort, pain management, and reducing joint damage.
Psoriatic Arthritis Symptoms
The symptoms of Psoriatic Arthritis range from pain and swelling to nail changes and exhaustion.
Symptoms of psoriatic arthritis resemble symptoms of rheumatoid arthritis, such as joint pain, stiffness and swelling.
Psoriatic arthritis symptoms resembling rheumatoid arthritis symptoms include:
- General tiredness
- Pain and swelling in the tendons
- Redness of the eye
- Reduced range of motion; painful and difficult motion
- Stiffness, especially in the morning
However, psoriatic arthritis also causes:
- Foot pain
- Nail changes (mimics fungus infections, separates from the nail bed, etc.)
- Lower back pain
- Swollen fingers and toes
There are five different types of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis and arthritis mutilans.
Symmetric psoriatic arthritis acts like a milder form of rheumatoid arthritis in that it affects the body equally on both sides.
Asymmetric psoriatic arthritis affects joints unequally – or both sides of the body’s joints are not affected symmetrically.
DIP affects the distal joints of the fingers and toes.
Spondylitis is an inflammation of the spinal column, causing stiffness in the neck, lower back, or spinal vertebrae.
Arthritis mutilans is the most severe form of psoriatic arthritis, deforming and destructive of the body’s smaller joints.
Symptoms of both psoriasis and psoriatic arthritis often alternate between flare ups and remission and also often occur in conjunction with each other.
Psoriatic Arthritis Causes
Causes of Psoriatic Arthritis include family history and environment.
Psoriatic arthritis occurs when the immune system’s immune cells attack healthy cells and tissues – much like what occurs with rheumatoid arthritis, an autoimmune disease.
An individual’s genetics and immune system are believed to cause psoriatic arthritis. Environmental factors can also be at play for causing psoriatic arthritis. Consider such events as a virus or type of bacteria, or some sort of trauma to the skin like an infection or extreme scratching, which are believed to bring on psoriatic arthritis. A family history of the disease notes a genetic predisposition for developing psoriatic arthritis.
That said, no single cause for the disease is currently known.
Psoriatic Arthritis Treatment
Common prescription and over-the-counter drug treatments for psoriatic arthritis.
An individual suffering from joint pain, stiffness and swelling in conjunction with a skin rash should contact a medical professional, as those are symptoms of psoriatic arthritis. Early diagnosis and treatment of psoriatic arthritis are needed to reduce joint pain and prevent further joint damage, although there is no cure.
A combination of prescription and over-the-counter medication, physical therapy, regular exercise, rest, and sometimes surgery can be used to treat psoriatic arthritis, or rather manage the disease.
A doctor might prescribe the following medications:
- Nonsteroidal anti-inflammatory drugs, also known as NSAIDs, to reduce joint swelling and pain. These can include Advil, Motrin, Aleve, Anaprox,
- Disease-modifying antirheumatic drugs, also known as DMARDs. These can include Methotrexate (Trexall) or sulfasalazine (Azulfidine).
- Tumor necrosis factor-alpha (TNF) inhibitors might be prescribed to individuals with severe arthritis or psoriatic arthritis symptoms. These drugs can include Adalimumab (Humira), Etanercept (Enbrel), Golimumab (Simponi), or Infliximab (Remicade).
- Immunosuppressants will suppress the very immune system that is attacking healthy cells, as we see occur in psoriatic arthritis patients. Common drugs would include Azathioprine (Imuran, Azasan), Cyclosporine (Sandimmune, Neoral), Leflunomide (Arava).
Both DMARDs and TNF inhibitors prevent joint damage.
As with any prescription drugs, thoroughly review your medications with your doctor and pharmacist to ensure you are being prescribed properly for your individual case. Be sure to ask about drug interactions, side effects, and allergies as many of these drugs come with serious and sometimes life-threatening effects.
A non-medicinal and more holistic approach to managing psoriatic arthritis.
For those not interested in traditional, medicinally-treated management of psoriatic arthritis, there are a homeopathic or natural approaches that are quite common. Although, it’s important that there is no cure for psoriatic arthritis, whether you treat in a traditional or alternative manner.
Moderate exercise is important for individuals with psoriatic arthritis because it alleviates joint pain and swelling by maintaining weight, increasing range of motion, and strengthening muscle tissue surrounding joints. Applying heat might be required for an individual with psoriatic arthritis before exercise to relax the muscles, and applying ice is usually necessary after exercise to reduce soreness.
A water therapy program consisting of pool exercises is another treatment option because there is zero impact and it reduces the body weight on the joints, which allows less pain and greater range of motion.
Yoga for arthritis is another natural treatment for psoriatic arthritis. This low- to no-impact activity allows for moderate exercise that benefits the symptoms of psoriatic arthritis. The different yoga poses and positions will gently strengthen the muscles around the joints to slow the disease’s progression but also make movement much less painful. Yoga can alleviate and manage symptoms like soreness and stiffness.
Splinting the joints, especially the fingers and wrists, can reduce joint inflammation and help with problems associated with joint alignment and stability. Splints can be worn at night or during work or exercise, but should not be worn at all times.
Properly fitted shoes or orthopedic shoes can help alleviate some of the pain associated with swelling of the toes and feet, a common symptom for individuals with psoriatic arthritis.
Other alternative treatments for arthritis, not specifically psoriatic arthritis, have included:
- Plant oils with gamma-linolenic acid (GLA)
- Fish oils
- Acupuncture
- Transcutaneous electrical nerve stimulation (TENS)
- Tai Chi (Chinese martial arts)
Psoriatic Arthritis Prevention
There is no way to prevent psoriatic arthritis because of its environmental and genetic causes.
At this time, there is no known way for psoriatic arthritis to be prevented, because of its causes like genetic and environmental factors. However, when symptoms can be identified for an early diagnosis, treatment can begin immediately for management of the psoriatic arthritis symptoms, which can include pain management.
Psoriatic Arthritis Resources
Look on the web for resources and more information about psoriatic arthritis.
Mayo Clinic – http://www.mayoclinic.com/health/psoriatic-arthritis/
National Psoriasis Foundation – http://www.Psoriasis.org