by What is Psoriatic Arthritis?
Psoriatic arthritis is a type of inflammatory arthritis that occurs in some people who have psoriasis, a chronic skin condition that causes scaling and inflammation. With psoriatic arthritis, the inflammation can involve the joints and tendons or attachments of tendons and ligaments to the bone. Psoriatic arthritis commonly affects the fingers and toes but can also impact other joints like the knees, ankles, lower back and neck.
Signs and Symptoms of Psoriatic Arthritis
The signs and symptoms of psoriatic arthritis can vary greatly from person to person but may include joint pain, stiffness, swelling in or around one or more joints, tender, warm, swollen toes and fingers, Achilles tendinitis and inflammation of the spine. Morning stiffness lasting over 30 minutes is also common. Other symptoms outside of the joints include eye inflammation, pitted or deformed nails. Most people develop psoriatic arthritis a few years after developing psoriasis but it can sometimes precede the onset of skin symptoms.
Non-Drug Treatments for Psoriatic Arthritis
Lifestyle and self-care measures can help manage psoriatic arthritis symptoms. Examples include weight loss if obese, regular low-impact exercise to improve mobility and reduce stiffness, joint protection techniques to prevent further injury, splints, braces or canes for added stability. Heat or cold therapy applied to sore joints. Adequate rest, stress management and good nutrition are also important for overall wellness.
Prescription Medications for Psoriatic Arthritis
For most people, psoriatic arthritis requires both prescription medications as well as non-drug therapies for optimum symptom control. Medications commonly used to treat psoriatic arthritis include:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or prescription NSAIDs are often recommended for milder psoriatic arthritis cases. They work by relieving pain and reducing inflammation.
Disease-modifying antirheumatic drugs (DMARDs): DMARDs are a group of drugs that modify the disease process underlying inflammatory arthritis. Common options for psoriatic arthritis include methotrexate, leflunomide, sulfasalazine. These medications must be used consistently for their full benefits.
Tumor necrosis factor (TNF) blockers: When psoriatic arthritis is moderate to severe, biologic DMARDs known as TNF inhibitors are frequently prescribed either alone or with methotrexate. These include etanercept, adalimumab, infliximab and certolizumab pegol. They block the damaging action of tumor necrosis factor alpha that fuels inflammation.
Interleukin blockers: If psoriatic arthritis flares despite TNF inhibitors, newer interleukin blockers such as secukinumab and ixekizumab may provide additional Psoriatic Arthritis Treatment options. They target other mediators implicated in joint inflammation.
Corticosteroids: Short-term use of oral or injected corticosteroids may help during acute psoriatic arthritis flares if alternate medications require time to work or fail to control active disease.
Complementary therapies may also assist medication Psoriatic Arthritis Treatment. In cases where drug therapy falls short, surgical procedures can help manage joint damage though their use depends on severity and which joints are involved. To learn more, discussing all options with a rheumatologist is advised.
Monitoring Psoriatic Arthritis Progress
For psoriatic arthritis to be effectively controlled long-term it requires close monitoring. Periodic follow-up appointments allow doctors to check symptom changes, evaluate for any side effects, review disease activity through physical exams and lab tests, and adjust or switch treatment as needed. A treatment that succeeds in controlling symptoms and preventing joint damage progression for 6 months or more without significant side effects is generally continued. But flare-ups do happen so management aims to achieve stable low disease activity. With the many medications currently available plus early, proactive management, psoriatic arthritis outcomes have significantly improved in recent decades.
With the understanding that their role is key in managing this chronic disease, through open communication about symptoms and concerns with their rheumatology healthcare providers, people living with psoriatic arthritis have much better chances of feeling well and keeping their joints functioning at full capacity for years to come.
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