Psoriatic arthritis is a particular kind of arthritis that often afflicts individuals who have psoriasis.
Psoriasis is a skin disorder characterized by itchy red blotches capped with scales. Most often, individuals first develop the skin condition and then later on are diagnosed with the condition of psoriatic arthritis.
On the other hand, in some cases, the joint issues appear before the skin lesions do.
Some of the primary symptoms of psoriatic arthritis include the following:
- Stiffness of the joints
- Pain in the joints
- Swelling of the joints
The symptoms of this condition can affect any joints in your body, including those in your spine and fingertips. As with most other conditions, these signs and symptoms can be fairly mild to excruciatingly severe.
In addition, with psoriatic arthritis as well as psoriasis itself, you may have periods of what we know as flares- where your symptoms are present- and periods of time where you have little to no symptoms at all- known as remission.
You should be aware that there is no cure for this condition at all at this point, so the main focus in treatment is controlling the signs and symptoms, while preventing any major damage to your joints. Without any treatment at all, this condition could be disabling.
Signs and Symptoms of Psoriatic Arthritis
Both of these conditions- psoriasis and psoriatic arthritis are chronic diseases, that is they will become worse over time. As mentioned, you will most likely have periods of time where your symptoms will seem to clear up and even go away.
However, there will also be times when your signs and symptoms will flare up and become worse.
This condition can affect the joints on both sides of your body or just one side. In many cases, the signs and symptoms of this condition are very much like those of rheumatoid arthritis.
In both of these conditions, the joints will become swollen, painful, and warm to the touch.
In addition to the above signs and symptoms, psoriatic arthritis is also characterized by the following:
Swollen toes and fingers: the condition of psoriatic arthritis can result in sausage-like swelling of your fingers and toes that is extremely painful.
In addition, you may have some deformities and swelling in your feet and hands before any other significant joint symptoms develop.
Pain in your feet: the condition of psoriatic arthritis can also result in pain where your tendons and ligaments are attached to your bones- especially in the sole of your foot (this is referred to as plantar fasciitis), and the back of your heel (this is referred to as Achilles tendinitis).
Pain in your lower back: some individuals with the condition of psoriatic arthritis will also develop a condition that is known as spondylitis.
This condition results in inflammation of the spinal joints as well as the joints between your pelvis and spine (this condition is referred to as sacroilitis).
When Should You See Your Physician?
If you have the skin condition of psoriasis, you should be sure to speak with your physician if you develop any type of joint pain.
The condition of psoriatic arthritis can be sudden onset or can develop slowly. No matter how it comes on, if you do not seek treatment for it, it can result in some pretty significant damage to your joints.
Causes of Psoriatic Arthritis
The condition of psoriatic arthritis happens when your body’s natural immune system begins to attack the healthy tissues and cells.
This abnormal immunity response results in joint inflammation and an overabundance of skin cells.
Scientists are not exactly clear on the reason why the body’s natural immune system turns on the healthy tissue, but it seems as though it is due to a combination of environmental factors and genetics.
In most cases, individuals who suffer from this condition also have a family history of psoriasis, psoriatic arthritis, or a combination of both. Some research has uncovered specific genetic markers that do seem to be associated with this condition.
In addition, it’s possible that something in the environment or even physical trauma such as a bacterial or viral infection could trigger this condition in those that have a genetic tendency towards it.
Risk Factors for Psoriatic Arthritis
There are several things that can increase an individual’s risk of developing this condition, including the following:
Having the skin condition of psoriasis could is the greatest risk factor for developing this condition. Individuals who have lesions on their fingernails are much more likely to develop the condition of psoriatic arthritis.
Most of the time, individuals with this condition also have a family member- especially a sibling or parent- that also suffers from this condition.
While it is true that age does not specifically determine risk for psoriatic arthritis, it has been proven that it occurs most commonly in adults between the ages of 30 to 50.
Complications with Psoriatic Arthritis
A very small percentage of individuals with the condition of psoriatic arthritis also develop a condition known as arthritis mutilans, which is a very painful, severe, and even disabling form of this condition.
Over time, arthritis mutilans will actually destroy the small bones in your hands, especially your fingers, which results in permanent disability and deformity.
Getting Ready to See Your Physician
Chances are you will start by discussing your symptoms with your general practitioner. Then, he/she will probably refer you to a physician that specializes in treating arthritis and related conditions. This specialist is known as a rheumatologist.
What to Do to Prepare
Since time is so short during an appointment, you’ll want to take the time to consider some answers to common questions your physician may ask, such as:
- What types of signs and symptoms are you experiencing?
- When did these signs and symptoms begin?
- Do you or does anyone in your immediate family have psoriasis?
- Does anyone in your immediate family have psoriatic arthritis?
- What medications and supplements are you currently taking?
You may also want to consider bringing along a close friend or family member to the appointment to help you remember what is said about your condition.
It can be difficult to process all of the information you’ll be given, and they may be able to remember something that you miss.
At your appointment, your physician is likely to ask some of the following:
- Which of your joints are affected with the pain, inflammation, and swelling?
- Is there anything you do that makes your symptoms worse?
- Is there anything you do that makes your symptoms better?
- Which treatments have you already tried?
- Have any of the treatments helped at all?
Being ready to answer these questions will help the appointment to run more smoothly, plus it can open up time for more discussion if you need it.
Testing and Diagnosing Psoriatic Arthritis
During the examination, your physician will most likely do the following:
- Look closely at your joints for signs of tenderness and/or swelling
- Check your fingernails for any abnormalities such as flaking, pitting, and more.
- Press on the bottom of your feet and around your heels to search for areas that are tender.
There is truly no single test that can confirm a diagnosis of psoriatic arthritis. However, there are some tests that can rule out other possible causes of your joint pain such as gout or rheumatoid arthritis.
Imaging Tests for Psoriatic Arthritis
There are a couple of different imaging tests that can be used to determine the presence of psoriatic arthritis including:
X-rays: just a plain x-ray will be able to reveal any changes in your joints that occur as a result of psoriatic arthritis, but do not occur in other types of arthritis.
MRI: this imaging test uses radio waves and a strong magnetic field to produce detailed images of the soft and hard tissues in your body. This test can be used to look for problems related to the tendons and ligaments in your lower back and feet.
Laboratory Tests for Psoriatic Arthritis
In addition to the above imaging tests, your physician is likely to perform a couple of laboratory tests to confirm the diagnosis of psoriatic arthritis. These include:
Rheumatoid Factor, or RF: Rheumatoid factor, is an antibody that is typically present in the blood of those individuals suffering from rheumatoid arthritis, but not in the blood of those with the condition of psoriatic arthritis.
Therefore, this is one of the best ways for a physician to determine whether you have one or the other.
Joint Fluid: your physician can use a long needle and take out a very small sample of joint fluid from one of your affected joints.
In most cases, it’s fluid from the knee that is tested. If your physician finds uric acid crystals in your joint fluid, it could be an indication that you are suffering from gout instead of psoriatic arthritis.
Treating Psoriatic Arthritis
Since there is no cure for this condition, treatment primarily focuses on gaining control of the inflammation in the affected joints in order to prevent pain and disability.
Medications for Psoriatic Arthritis
Most of the time, treatment starts with controlling the pain and inflammation with medications. Some of the most common medications used to treat this condition include the following:
NSAIDs: these can help to relieve both pain and inflammation. OTC medications often work quite effectively, but if you need something stronger, your physician can write you a prescription for something.
There are some side effects that accompany these medications, including heart problems, liver and/or kidney damage, and stomach irritation.
DMARDs: these are also known as disease modifying antirheumatic drugs and can slow the progression of this condition.
By slowing the progression, the joints and other tissues are saved from permanent damage. These also come with some side effects including severe lung infections, bone marrow suppression, and even liver damage.
Immunosuppressants: this class of medications work to suppress your immune system because it is out of control in the condition of psoriatic arthritis. However, since your immune system is being suppressed, your susceptibility to infection is greatly increased.
TNF-Alpha inhibitors: TNF-Alpha, or tumor necrosis factor- alpha is an inflammatory substance that is naturally produced by your body. These medications work to reduce pain levels, tender/swollen joints, and even morning stiffness.
Again, these come with some side effects including risk of serious infections, hair loss, nausea, and diarrhea.
Surgical Treatments for Psoriatic Arthritis
If the above treatments do not work for you, there are some surgical and other procedures that can be done to control your symptoms including:
Steroid Injections: in this procedure, a corticosteroid will be injected into your joints, which will help to quickly reduce inflammation. However, these are short-term treatments, the pain and inflammation will return.
Joint Replacement: if you have a joint that has been severely damaged by this condition, your physician can replace it with a joint that is made of plastic and metal.
Lifestyle and Home Remedies for Psoriatic Arthritis
These days, people are turning more towards natural treatments and away from the medical world for treating their conditions.
They want something that doesn’t necessarily bring along side effects that are sometimes worse than the condition itself.
Following are some of the self-care treatments that can be used to treat psoriatic arthritis.
Protect joints: simply making a change in the way that you perform everyday tasks can make a huge difference in the way that you are feeling.
Maintain a healthy weight: this will help to place less strain and stress on your joints, which will result in reduced pain levels and increased mobility and energy levels. The best way to do this is to eat foods such as whole grains, fruits, and veggies.
Get plenty of exercise: while it’s true that you may not feel like exercising when you’re in pain, the best way to keep your muscles strong and your joints flexible is to get plenty of exercise. The best exercises for joints are walking, biking, and swimming.
Use hot/cold therapy: since cold numbs, it can help to dull the pain. You can use cold packs several times each day for 20 to 30 minutes at a time. Using heat can help to relieve pain and relax tense muscles.
Pace Yourself: dealing with inflammation and pain can be exhausting. In addition, there are some medications that can result in fatigue.
You shouldn’t just stop being active but make sure that you rest before you reach the point of exhaustion.
Try to divide work and/or exercise into shorter segments and make sure that you’re finding the time you need to relax during the day.
More Natural Treatments for Psoriatic Arthritis
Following are some of the natural therapies that can be quite effective when used along with the more conventional therapies.
Fish Oil- it is thought that fish oil could result in a reduction in the proteins that result in inflammation.
Eskimo populations get lots of this vitamin/mineral and it should be noted that they tend to have lower occurrences of both psoriatic arthritis and rheumatoid arthritis.
While it’s true that genetics do play a role in this condition, it is also possible that their diet plays a role.
Acupuncture- studies around this particular treatment are conflicting, at best. In some cases, it is very effective at controlling the symptoms, but in other cases, it has no effect at all.
However, this treatment does continue to be used for all types of arthritis and is best used on isolated areas instead of widespread.
Turmeric- this is a member of the ginger family and is thought to provide relieve of the symptoms of this condition.
The reason is that this herb seems to have an effect on the production of inflammatory protein production in the body.
However, the effects are usually very mild and therefore can be difficult to measure. Many times, people say that though they do get some benefit, it’s usually so minimal that they don’t continue it.
Willow Bark- this if often called an “herbal aspirin” because it contains a substance called salicin which is very similar to acetylsalicylic acid which is the active ingredient in aspirin.
It’s possible that this could be beneficial for treating the symptoms of psoriatic arthritis.
Vitamin D- one study revealed that individuals with this condition typically have a deficiency of Vitamin D.
On the other hand, that same study revealed that the presence or absence of Vitamin D really doesn’t have much effect on the activity of the condition.
Vitamin K- while this vitamin has not specifically been studied for the treatment of psoriatic arthritis, there is one report that reveals low levels of this vitamin are associated with severe cases of osteoarthritis. Still, it’s not clear if this vitamin can improve symptoms, one thing is clear- it can’t hurt.
L-carnitine – L-carnitine is found naturally in the body and generally, healthy people produce enough of their own and don’t require supplementations.
There have been some indications that it could help individuals with psoriatic arthritis, but that hasn’t been proven as of right now.
Vitamin B12 – One study revealed that deficiencies in Vitamin B12, just like Vitamin D, are much more common in those with psoriatic arthritis than those who are healthy.
However, it doesn’t seem to be considered a primary option for treatment. Again though, it can’t hurt to get extra Vitamin B12 in your diet.