Psoriatic Arthritis And Back Pain
Learn more about axial arthritis or spondylitis, which causes back pain and may affect your treatment for PsA.
When you think of psoriatic arthritis , you may imagine skin symptoms or the commonly affected joints, like the fingers, knees, ankles or elbows . However, for many people with the disease, back pain can become a symptom as well. When the spine is affected, its known as axial arthritis or spondylitis. Spondylitis affects the spine and sacroiliac joints, which are located at the bottom of the back.
Who Does Spondylitis Affect?
Many people with PsA have axial arthritis and most of them will have a mix of peripheral and axial arthritis. A much smaller number of people with PsA can have inflammation primarily in the axial area without peripheral symptoms.Axial involvement is usually a late-onset feature of PsA, but not always. Studies show that most PsA patients with spondylitis can have back symptoms for up to 10 years before diagnosis is made.Other symptoms of PsA that people with axial disease may have include inflammation where ligaments and tendons insert into bones inflammation of an entire finger or toe skin disease pitting and lifting of nails from the nailbed eye inflammation and inflammatory bowel disease .Since the treatment for PsA with axial involvement may be different than for PsA with only peripheral symptoms, it is important to know the signs and talk to your doctor about your back pain.
Mechanical Pain vs. Inflammatory Back Pain in PsA
Who Is At Risk For Psoriatic Arthritis
Psoriasis affects 2-3 percent of the population or approximately 7 million people in the U.S. and up to 30% of these people can develop psoriatic arthritis. Psoriatic arthritis occurs most commonly in adults between the ages of 35 and 55 however, it can develop at any age. Psoriatic arthritis affects men and women equally.
It is possible to develop psoriatic arthritis with only a family history of psoriasis and while less common, psoriatic arthritis can occur before psoriasis appears. Children of parents with psoriasis are three times more likely to have psoriasis and are at greater risk for developing psoriatic arthritis. The most typical age of juvenile onset is 9-11 years of age.
Arthritis With Involvement Of The Soft Tissues
It can happen that the inflammatory process present in the joints of the leg extends to the soft tissues, aggravating the present symptomatology .
When this happens, the whole dynamics of the leg is affected and the patient is prevented from engaging in daily living activities.
This type of arthritis is common in those who have overused their joints for example, professional athletes, runners, joggers. Physical injuries can trigger the appearance of this form of arthritis as well.
The inflammatory process can stem from the soft tissues as well, affecting the joints as consequence. In making the diagnosis of arthritis, it is important to diagnose the root of the problem and treat it accordingly.
If the leg pain is severe, involving a large surface and being resistant to medication, the condition one is suffering from might be fibromyalgia.
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Tumor Necrosis Factor Inhibitors
Tumor necrosis factor alpha is a pro-inflammatory cytokine produced by macrophages and lymphocytes. It is found in large quantities in the rheumatoid joint and is produced locally in the joint by synovial macrophages and lymphocytes infiltrating the joint synovium. TNF is one of the critical cytokines that mediate joint damage and destruction due to its activities on many cells in the joint as well as effects on other organs and body systems. TNF antagonists were the first of the biological DMARDS to be approved for the treatment of RA. These drugs began to enter the market for rheumatoid arthritis in 1999 and are now considered a part the ACR recommendations for treatment of RA. There are currently five TNF inhibitors FDA approved for the treatment of RA etanercept , infliximab , adalimumab , certolizumab pegol , and golimumab . Etanercept is a soluble TNF receptor-Fc immunoglobulin fusion construct infliximab, adalimumab, and golimumab are monoclonal antibodies and certolizumab pegol is an anti-TNF antigen binding domain-polyethylene glycol construct. While differing in structure, the efficacy and safety of the drugs is similar across the class in reducing the signs and symptoms of RA, as well as in slowing or halting radiographic damage, when used either as monotherapy or in combination with methotrexate.
What Are Muscle Cramps
Muscle cramps result from an involuntary contraction of the skeletal muscles and are a common symptom of , fatigue, poor circulation, and nerve compression. Muscle from improper conditioning or prolonged exercise is a common cause of muscle cramps. Other common causes include sitting in one place for a long period of time and vascular disorders, both of which decrease blood circulation to the muscles.
, sometimes called charley horses, are sudden and uncontrollable muscle contractions or . They can occur with exercise or while sleeping and usually resolve just as quickly as they came. The pain from muscle cramps can be intense, but can often be relieved with gentle stretching and massage.
Electrolyte depletion in the blood can also lead to muscle cramps. In rare cases muscle cramps can be a symptom of kidney disorders. The endocrine condition may be accompanied by cramping of muscles in the legs and arms, and hypoglycemia, or low blood sugar, can also cause muscle cramps. Depending on the cause, cramping may occur in one muscle or a group of muscles, and it may be accompanied by sharp and a hard visible lump in the muscle.
Muscle cramps may be a sign of dehydration and electrolyte imbalances, which can result in shock or coma and may be life threatening. Seek immediate medical careif you, or someone you are with, have symptoms of severe dehydration, such as loss of consciousness and no urine production.
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Work With A Physical Therapist
If youre not sure how to start exercising, or if psoriatic arthritis symptoms have prevented you from exercising, you may want to work with a physical therapist. These specialists are trained to help you strengthen and lengthen your muscles in ways that should help minimize pain and maximize effectiveness. If you have specific areas of your body that often hurt, the therapist may be able to recommend exercises to address that pain.
Many MyPsoriasisTeam members have shared their experiences with physical therapy. One wrote, I’m still going to physical therapy, and it helps me some.
Another said, Physical therapy got me moving, and my stiffness is better.
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The Worst Drinking Habits For Arthritis Symptoms Say Dietitians
If you suffer from sore, inflamed, arthritic joints , you probably have read that a glass of wine or a margarita might be just what the doctor ordered to ease your pain. Or you might have heard that stopping your drinking habit is the key to making joint aches go away. Or you might have heard both arguments and wondered which is true. After all, there are various studies that have suggested each be the case.
That means you might have to conduct a little experiment on yourself. If you dont drink alcohol, dont start now. But if you do drink, consider eliminating drinking alcohol to see if that behavior helps to remedy your pain. And remember, arthritis, which means joint inflammation, comes in many forms. Common ones include osteoarthritis, a wearing down of cartilage due to aging or injury, gout, caused by the build-up of crystals in the joints, psoriatic arthritis, which affects the skin and joints, and rheumatoid arthritis, where the bodys immune system attacks the joints and bones typically of the hands and feet.
Heres what science and a few registered dietitians have to say about beverage consumption and arthritis, and for more helpful tips, here are the Telltale Signs You Have Arthritis.
So, does alcohol affect arthritis? Are there links between alcohol and arthritis?
In short, yes.
Gout is triggered by certain foods and drinks which contain a chemical called purine, and the amount of purine in alcohol is high.
Treatments For The Arthritis
Non-steroidal anti-inflammatory drugs
NSAIDs, or non-steroidal anti-inflammatory drugs, can reduce pain, but they might not be enough to treat symptoms of psoriatic arthritis for everyone.
Some people find that NSAIDs work well at first but become less effective after afew weeks. If this happens, itmight help to try a different NSAID.
There are about 20 different NSAIDs available, including ibuprofen, etoricoxib, etodolac and naproxen.
Like all drugs, NSAIDs can have side effects. Your doctor will reduce the risk ofthese, by prescribing the lowest effective dose for the shortest possible period of time.
NSAIDs can sometimes cause digestive problems, such as stomach upsets, indigestion or damage to the lining of the stomach. You may also be prescribed a drug called a proton pump inhibitor , such as omeprazole or lansoprazole, to help protect the stomach.
For some people, NSAIDs can increase the risk of heart attacks or strokes. Although this increased risk is small, your doctor will be cautious about prescribing NSAIDs ifthere are other factors that may increase your overall risk, for example, smoking, circulation problems, high blood pressure, high cholesterol, or diabetes.
Some people have found that taking NSAIDs made their psoriasis worse. Tell your doctor if this happens to you.
Steroid injections into a joint can reduce pain and swelling, but the effects do wear off after a few months.
Disease-modifying anti-rheumatic drugs
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Swollen Fingers And Toes
They can get so puffy, they look like sausages. Your doctor may call it dactylitis, or sausage digits. This painful swelling happens to more than a third of people with the disease. It results from joint inflammation and usually affects a few fingers and toes. You might mistake it for gout if it shows up only in your toes. Be sure you get the right diagnosis, because gout and PsA have different treatments.
Risk Factors And Triggers You Can Influence
You do have some power to curb other risk factors and triggers, including:
Sunburn or other skin injury. Wear sunscreen with an SPF of 30 daily. Sunburn is a sign of injury. Skin damage causes inflammation that can set off psoriatic arthritis symptoms. This is the Koebner phenomenon at work. Cuts, scrapes, and other skin injuries can also lead to a flare.
Stress. Inflammation is also part of your body’s response to stress. Too much stress for too long sends stress chemicals in your system.
Everyone has stress. Itâs important to find healthy ways to manage it, such as exercise and meditation. Also, look for different ways to think about or handle the things that cause you stress. Working with a counselor or taking a stress management class can help with this.
Alcohol. Alcohol promotes joint inflammation. Drinking too much might worsen psoriatic arthritis symptoms. Some people with psoriatic arthritis claim that their symptoms improve when they avoid alcohol.
Cigarettes. Smoking both raises the risk for psoriasis and makes the disease worse. Exactly how cigarettes affect psoriatic arthritis isn’t as clear. There is some evidence that people who smoke don’t respond as well to their psoriatic arthritis medicine as nonsmokers.
Food: Foods like these seem to trigger psoriatic arthritis flares in some people:
Obesity. Inflammation may be the link between psoriatic arthritis and obesity.
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Causes Of Psoriatic Arthritis
Almost 1 in 3 people with psoriasis also have psoriatic arthritis.
It tends to develop 5 to 10 years after psoriasis is diagnosed, although some people may have problems with their joints before they notice any skin-related symptoms.
Like psoriasis, psoriatic arthritis is thought to happen as a result of the immune system mistakenly attacking healthy tissue.
But its not clear why some people with psoriasis develop psoriatic arthritis and others do not.
Youre A Serious Germaphobe
You wash your hands religiously, carry sanitizing wipes everywhere, and avoid germ hubs, such as bowling alleys and movie theaters. And with good reason: Anything that can affect your immune system may worsen your symptoms.
Many psoriatic arthritis medications suppress the immune system, leaving you more susceptible to germs, and flare-ups can occur when you get an infection. While vitamins and general attention to hygiene can help ward off sickness, having to skip bowling night with your family to avoid getting sick can still sting even if it does help you avoid a monthlong cold.
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Does Rheumatoid Arthritis Cause Muscle Pain
To work properly, your joints require muscles. Together, they are essential elements to support your movement. Rheumatoid arthritis or RA can affect the muscles in the involved joints, causing muscle pain. The bad news, the pain could be widespread.
Rheumatoid arthritis symptoms how do they progress?
Typically, the symptoms of this autoimmune disorder of arthritis develop gradually. The occurrence can take several weeks until you notice the first symptom.
It usually starts with stiffness in one joint such as wrists, soles of feet, or hands particularly in the morning and will improve by mid-day. This symptom may be vague for a while or may come & go at first, but it will become a regular occurrence as the disease gets worse. It will be followed with other classic symptoms of joint problem such as pain and swelling. Then other joints such as knees, elbows, or ankles could be affected, too.
Another interesting fact, the symptoms of RA tend to affect the joint symmetrically. For instance, once you have it in the left wrist, you are more likely to also have it in your right wrist. See also the differences between RA and OA in this section!
However in a few cases, the occurrence of the symptoms could be slightly different, these include:
And each case can be unique and different. Sometimes RA is off for several months or even years, but in a few cases it can be constantly progressive.
What Are Options For Pain Management
Minor pain and stiffness of mild PsA can be alleviated with non-steroidal anti-inflammatory drugs . In addition, injections of corticosteroids may be used.5
For moderate to severe disease, treatments that target joint disease in PsA frequently can reduce symptoms and prevent disease progression. Recommended treatments include disease-modifying anti-rheumatic drugs .
The first step for treatments is usually DMARDs such as methotrexate, leflunomide, or sulfasalazine. Other treatments include medicines that target tumor necrosis factor , a chemical that produces a wide range of inflammation in PsA.
Examples of TNF blockers include etanercept , adalimumab , infliximab , golimumab , and certolizumab pegol . Other DMARDs that have proven effective in clinical trials include ustekinumab Stelara), and secukinumab .1
The FDA has also recently approved Inflectra , a biosimilar to infliximab, for the treatment of psoriatic arthritis.7Physical and occupational therapy can be critical treatment approaches to both protect the involved joints and maintain function.5
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How Is Arthritis Diagnosed
Its important to find out if you have arthritis and what type it is because treatments vary for each type. Early diagnosis and treatment are important to help slow or prevent joint damage that can occur during the first few years for several types.
Only a doctor can tell if you have arthritis and what type it is. When you see your doctor for the first time about arthritis, expect at least three things to happen. Your doctor will ask questions about your symptoms examine you and take some tests or X-rays.
You can help your doctor by writing down information about your symptoms before your appointment. Bring your answers when you see your doctor.
Arthritis may limit how far or how easily you can move a joint. Your doctor may move the joint that hurts or ask you to move it. This is to see how far the joint moves through its normal range of motion. Your doctor may also check for swelling, tender points, skin rashes or problems with other parts of your body.
Finally your doctor may conduct some laboratory tests. These may include tests of your blood, muscles, urine or joint fluid. They also may include X-rays or scans of your body. The tests will depend on what type of arthritis your doctor suspects. They help confirm what type of arthritis your doctor suspects based on your medical history and physical exam and help rule out other diseases that cause similar symptoms.
Can Children Suffer From Arthritis Leg Pain
The answer is yes. In fact, there are many different types of arthritis that affect both children and adolescents, causing leg pain among other symptoms.
It is important to identify these symptoms at an early stage, in order to pursue a correct course of treatment and prevent the respective joints from becoming permanently damaged.
Among the most common types of arthritis that can cause leg pain, there are: rheumatoid arthritis, chronic arthritis and idiopathic arthritis.
All of these are juvenile forms of arthritis and, apart from the pain and inflammation, they can cause a reduced range of motion in the affected joints.
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