We Cant Say It Enough: Get Your Omega
Research links omega-3 consumption with anti-inflammatory benefits, especially for your joints. Theres some debate about whether supplements or whole food sources of omega-3s are best.
Most studies use higher levels of omega-3s than are found in single servings of fish or other foods rich in omega-3s, but some suggest the body can better absorb omega-3s from food than from capsules.
Our take? Eat a diet with a healthy mix of omega-3-rich foods salmon, tuna, avocado, flax and chia seeds, olive oil and on the days youre not in the mood to cook, pop a supplement.
How To Avoid A Psoriatic Arthritis Relapse
There’s no cure for PsA. Anti-rheumatic drugs don’t change the underlying fact that you’re affected by the disease. There may be places in your body where it still lingers even when your joints don’t feel painful or swollen.
Remission as a result of taking anti-TNF biologics or other medicines is drug-induced, so your doctor will likely recommend you stay on your medication. Three out of 4 people who stopped taking their disease-fighting medication in one small study had symptoms return within 6 months. Fortunately, starting their medication again restored remission.
Although some people can stay in psoriatic arthritis remission without drugs, it’s not common. If you want to try a lower dose or to stop taking a medicine once you’ve reached remission, you’ll need to work with your doctor closely. As soon as symptoms begin, you’ll need your medication again.
Changes in how you handle things in your daily life can also help prevent some PsA symptoms from returning. Some arthritis medications can cause fatigue, so pace yourself and stop to rest before you get tired. Protect your joints, keep your weight in check, and make regular joint-friendly exercise such as walking, swimming, or biking part of your routine.
What Is Psoriatic Arthritis
Psoriatic arthritis is a form of inflammatory arthritis characterized by joint pain, swelling, and morning stiffness. It is associated with having psoriasis or a family history of psoriasis. Both psoriasis and psoriatic arthritis are chronic autoimmune diseases meaning, conditions in which certain cells of the body attack other cells and tissues of the body.
Psoriatic arthritis can vary from mild to severe, it can present in the following ways:
- Oligoarticular, affects four or fewer joints in the body.
- Polyarticular, affecting four or more joints.
- Spondylitis, less common and affecting the spine, hips, and shoulders.
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Employ Some Life Hacks
Crow also advises taking shortcuts that can make living with PsA flares easier. These life hacks can help minimize fatigue or joint pain, she says. If your joints hurt, you can change the stuff you are using in your daily life for example, if your hands hurt, you can use a wide-grip fork while eating. You can also change how you interact with stuff, such as choosing to have grocery delivery rather than exerting the energy required to go to the store and bag all the items yourself.
How To Prevent Psoriatic Arthritis Flare
At this time, theres no way to prevent psoriatic arthritis. As researchers begin to look into ways to prevent the condition, you can take action to help prevent flare-ups or sudden worsening of your symptoms.
- Take your medication as directed. When they feel better, sometimes people will take less medication or stop taking it, Dr. Haberman says. But a lot of times this causes them to develop flares again. If you wish to come off of or change your medication, talk to your provider first. A slow taper is often better than stopping completely, Dr. Haberman says.
- Maintain a healthy weight. People who are obese are more likely to develop psoriatic arthritis and less likely to respond to treatment, Dr. Haberman says. It may be that, since medications dont come in different doses, these people dont get as much medication. Or it may be that, because adipose tissue is inflammatory, the medications have to overcome inflammation from psoriatic arthritis and obesity, Dr. Haberman explains. A healthy weight also reduces stress on the joints and can lead to less pain.
- Be active. Doing so will help keep your joints flexible and the surrounding supporting muscles strong. Consider walking, swimming, biking, or yoga, which are gentle on the joints.
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You May Rethink Your Career Choices After A Psoriatic Arthritis Diagnosis
For Paige Meleney, 29, a small animal veterinarian in Cleveland who learned she had psoriatic arthritis in elementary school, living with this condition meant rethinking the career she had always envisioned for herself.
My goal was to do musical theater and to sing on Broadway someday, and I performed throughout middle school, high school, and college, explains Meleney, who chronicles life with her condition on . I remember when I finally had to have the big conversation with my parents.
She knew a career in musical theater would not only be physically demanding, requiring a lot of dancing and late nights, but could also be financially unstable. Although there was a chance that I could have fulfilled that dream, the reality was because of my arthritis I needed to pursue a career where I could have health insurance to maintain my disease and pay my bills, she explains.
Accepting a new vision of yourself and reinventing your dreams can help build your resilience and open the door to new possibilities. While Meleney decided to pursue a degree in biology instead of musical theater, she looked for a way to keep pursuing the things she loves.
I ended up finding an a cappella group in college that I loved and sang with 24/7. That kept me sane while I got my biology degree, she says. I use music in different ways its just not my career. I do love my job as a veterinarian though, so I cant complain.
How Can I Find The Appropriate Care I Need
Initially your GP is the first point of contact, who then should refer you on to a dermatologist/rheumatologist, if this is not already the case. If you are not happy with the advice you receive, remember you are always entitled to seek a second opinion. Remember, If you are seeing a dermatologists for your psoriasis and a rheumatologists for your arthritis make sure each is aware of this, so they can liaise and provide you with appropriate care for both conditons.
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What Causes Psoriatic Arthritis
The genes you inherit from your parents and grandparents can make you more likely to develop psoriatic arthritis. If you have genes that put you at risk of this condition, the following may then trigger it:
- being overweight
There is also an element of chance, and it might not be possible to say for certain what caused your condition.
Psoriasis and psoriatic arthritis are not contagious, so people cant catch it from one another.
How Do You Get A Timely And Accurate Diagnosis
If you suspect PsA, youre probably eager to find out for surebecause the sooner youre diagnosed, the sooner you can get treatment for your pain. Plus, leaving PsA untreated can lead to permanent joint damage. So how do you get the correct diagnosisfast? It often comes down to whether your doctor is knowledgeable of PsA.
Its important that dermatologists and primary care physicians caring for patients with psoriasis ask about joint pain, morning stiffness, nail changes, and evidence of dactylitis and refer them early to rheumatologists to avoid a delay in diagnosis, Dr. Ward says.
Make sure your rheumatologist is well-versed in PsA, too: Seeing a rheumatologist who is familiar with psoriatic arthritis and seronegative spondyloarthropathies can help with making a timely and accurate diagnosis, says Dr. Kohler.
A doctor who is thorough is also more likely to help you get a fast, accurate diagnosis. Once you get in the room with a good rheumatologist, theyll likely collect your medical and family history and do a physical exam, blood tests, and imaging tests to diagnose you. For example, your doctor should ask you questions regarding any skin issues that could indicate psoriasis if youre not already diagnosed, Creaky Joints says. Taking time to check you for things like nail symptoms, including yellowing or brittleness, that can be easy to miss is also a good sign.
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Is It Actually A Symptom Of Psa
It took some time, but eventually, I was diagnosed with psoriatic arthritis and my temperature swings got pushed to the side in favor of more pressing and painful symptoms. But they continue to persist.
When I feel my worst and find myself in a PsA flare, I seem to actually run a low-grade fever and the swings from hot and cold begin to worsen. I hadnt actually noticed it until I started doing a better job of recording my symptoms and side effects. And I noticed the swings between cold and hot become much more pronounced and last much longer.
However, I do want to be clear that my doctor has never officially attributed these swings in body temperature to my psoriatic arthritis. They still continue to just be a random symptom that I also experience.
It is only my opinion that the temperature swings are linked with my PsA. And Ive even attempted a deep dive into Google, and other than patients sharing personal experience, I havent been able to find many relevant medical studies.
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Focusing On People With Psoriasis
Most people with psoriatic arthritis have psoriasis first. For a small percentage of patients, psoriatic arthritis occurs before psoriasis, although most often they will have a first-degree relative with skin psoriasis, notes Dr. Haberman. Still, others have no skin psoriasis or dont notice the psoriasis hidden in areas like the scalp, umbilicus, and gluteal fold.
Read more about the connection between psoriasis and PsA.
Up to 30 percent of patients with psoriasis will go on to develop psoriatic arthritis, says Dr. Haberman. The majority of cases begin with the skin condition and then progress to joint pain within seven to 10 years. Recent studies have found that patients with psoriasis who develop severe fatigue, heel pain, and joint pain without overt swelling are more likely to develop PsA.
While we dont yet know which individual patients with psoriasis will go onto develop PsA, researchers have identified a few potential risk factors for the progression of PsA, including:
- Family history of psoriatic arthritis
- Psoriasis that affects the scalp and groin
- Nail involvement in psoriasis, such as nail pitting
- Being overweight or obese. PsA is worse in patients who are overweight and often biologics may not work as effectively in people who are overweight, says Dr. Haberman.
- Exposure to certain infections
- Physical trauma
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What Can Blood Tests Tell Me Or The Doctor
To make a diagnosis of psoriatic arthritis most doctors would require you to have psoriasis, or a history of psoriasis in a close relative, together with arthritis and inflammation in at least one joint. If several joints are affected the doctor would expect to find a pattern of joints involved which matches one of the patterns usually seen in psoriatic arthritis. Blood tests for rheumatoid arthritis are usually negative but often blood tests of general inflammation in the blood are positive. These latter bloods are called the erythrocyte sedimentation rate C-Reactive protein or plasma viscosity all are measures of inflammation and abnormal, if the value exceeds a certain level.
Will Drug Treatments For Psoriatic Arthritis Make My Psoriasis Worse
Some drug treatments may make psoriasis worse, but then again, some can also make it better too. Before you start any treatments offered, discuss this both with your dermatologist and rheumatologist. DONT FORGET to politely request that both consultants let each other know of your treatment regimes, this helps both of them evaluate your treatment and any side effects that you may be likely to experience. Some people find that when their psoriasis is bad their arthritis is also bad and as one improves, so does the other. This most often occurs when the skin and joint disease start simultaneously. Some of the arthritis treatments also help the skin and this is can help the doctors decide which is the best drug to use.
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Maintain A Healthy Weight To Lower Your Psoriatic Arthritis Risk
In a recent review in the March 2021 issue of the Journal of the American Academy of Dermatology, researchers looked at whether lifestyle factors affected risk of developing psoriatic arthritis among people with psoriasis. Interestingly, the study suggests that making certain changes, such as losing weight if you are overweight or obese, could make a difference.
Participants in the study who were overweight or obese were found to have an increased psoriatic arthritis risk and the higher their body mass index, or BMI, the higher their risk. According to a review published in June 2020 in Rheumatology and Therapy, this is likely because fat tissue plays a role in inflammation throughout the body.
There is no question there is a link between obesity and psoriasis, and that there is a higher link in those with obesity of developing psoriatic arthritis on top of psoriasis, says Eric Ruderman, MD, a rheumatologist and professor of medicine in the division of rheumatology at Northwestern University Feinberg School of Medicine in Chicago.
Maintaining a healthy weight plays a vital role in lowering psoriatic arthritis risk, says Modi. Not only can weight loss decrease inflammation in your body if youre overweight or obese but it can also relieve stress on your joints and tendons, Modi adds. Extra weight leads to higher demands on the joints and tendons, which can cascade into increased inflammation, she says.
Can You Prevent Psa
PsA is an autoimmune disease in which the immune system malfunctions and attacks healthy tissues. The immune systems attacks in PsA focus on the joints, entheses, and skin cells. Autoimmune diseases are generally not preventable, although reducing risk factors like stress, smoking, and toxin exposure might help.
Experts do not know of any ways to prevent PsA. There are no treatments available for people with psoriasis that guarantee they will not develop PsA down the road. Because some people will have PsA and never have psoriasis, or they will develop PsA first, it is difficult to identify who might be at risk for PsA.
One 2019 medical review looked at the challenges healthcare providers experience trying to prevent PsA in people with psoriasis. The reviews authors noted the difficulty in identifying triggering events in people with psoriasis that might cause them to have PsA.
In time, there will be conclusive ways to prevent PsA. In the meantime, healthcare providers place their focus on managing symptoms and disease progression in people with psoriasis. They also advise people to speak up if they experience symptoms of PsA, including joint pain, morning stiffness, swollen fingers and toes, and low back pain.
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Who Can Diagnose And Treat Psoriatic Arthritis
If you have painful, swollen joints and other symptoms, start with your primary care doctor, says Dr. Parody. They may refer you to a rheumatologist, who specializes in diagnosing and treating arthritis and other diseases that affect the joints, muscles and bones.
Some psoriatic arthritis treatments will also help calm skin symptoms. But if you have bothersome psoriasis symptoms, it can be helpful to see a dermatologist, too .
When To Get Medical Advice
See a GP if you have persistent pain, swelling or stiffness in your joints even if you have not been diagnosed with psoriasis.
If you’ve been diagnosed with psoriasis, you should have check-ups at least once a year to monitor your condition. Make sure you let the doctor know if you’re experiencing any problems with your joints.
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Can You Prevent Psoriatic Arthritis
Curated by Claudia Shannon / Research Scientist / ishonest
Waiting for a psoriatic arthritis diagnosis can feel a bit like the opening scene of Jaws. One minute, youre splashing around in crystal clear waters the next, a big-a** shark is threatening to strike.
And while the term psoriatic arthritis can induce the same level of dread as those two deep notes that signaled the shark was near, were here to remind you that you dont need to let fear of a PsA diagnosis interfere with your life.
Unfortunately, theres no evidence that PsA can be prevented but there are plenty of things you can do to promote good joint health and manage psoriasis symptoms.
Who Will Be Responsible For My Healthcare
Youre likely to see a team of healthcare professionals.
Your doctor, usually a rheumatologist, will be responsible for your overall care. And a specialist nurse may help monitor your condition and treatments. A skin specialist called a dermatologist may be responsible for the treatment of your psoriasis.
You may also see:
- A physiotherapist, who can advise on exercises to help maintain your mobility.
- An occupational therapist, who can help you protect your joints, for example, by using splints for the wrist or knee braces. You may be advised to change the way you do some tasks to reduce the strain on your joints.
- A podiatrist, who can assess your footcare needs and offer advice onspecial insoles and good supportive footwear.
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