Look For More Symptoms
I have named a few red flags of a flare-up, but there are many others, as well. You may have joint pain in your jaw, elbow, or shoulders. You may experience digestive issues, anxiety, or any number of symptoms. Its important to always be cognizant of your body and take the time to check in. If you can get ahead of a flare before it gets worse, youll be better off in the long run! Be prepared and get a game plan in place for if you run into any of these 10 red flags.
Psoriatic Arthritis Treatment Types
There are a number of ways to treat active psoriatic arthritis. And while thereâs no cure for it, medication may help reduce the signs and symptoms of psoriatic arthritis.
Here are examples of some treatment types for active psoriatic arthritis.
Corticosteroids, also known as steroids, are used on a short-term basis to help with inflammation.
How they are prescribed: Pill or an injection into a muscle or directly into an affected joint
Nonsteroidal anti-inflammatory drugs are used to help with joint pain and inflammation.
How they are prescribed: Pill
Disease-modifying antirheumatic drugs work to reduce the body’s overactive immune and/or inflammatory processes that cause psoriatic arthritis symptoms such as joint pain and swelling.
The DMARD family can be classified as the following:
Traditional nonbiologic DMARDs, like methotrexate, are often prescribed at the time of diagnosis. Oral synthetic small molecules are another class of nonbiologic DMARDs.
One of the options available includes the Janus kinase inhibitors. JAK inhibitors work by blocking JAK enzymes located within cells.
How they are prescribed: Injection or pill
XELJANZ/XELJANZ XR is a JAK inhibitor and available as an oral pill.
Biologic DMARDs are proteins manufactured using recombinant DNA technology .
Types of biologic DMARDs include tumor necrosis factor inhibitors and non-TNFis.
How they are prescribed: Injection or infusion
What Are Other Symptoms
Fatigue People with PsA often experience generalized fatigue. Fatigue may appear as extreme tiredness, difficulty keeping eyes open, or flu-like symptoms. Patients also reported symptoms such as lack of motivation and loss of appetite in conjunction with fatigue. Fatigue can be experienced very differently depending on the person. No two individuals experiences are the same, even for people that have the same underlying health condition, like PsA.
Eye Problems – People with PsA are somewhat are significantly more likely than the average person to develop eye problems . Of the eye problems that people with psoriasis develop, the most common is Uveitis, which is an inflammatory disease process internal to the eyes . Uveitis refers to a group of inflammatory diseases of the eye from various causes that produce swelling and destroy eye tissue. Symptoms of uveitis include vision loss which can range from slight to severe loss of vision.
Early treatment is important to reduce the risk of complications, and patients with eye pain, severe light sensitivity, or any change in vision should immediately see an ophthalmologist for examination.
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What Can I Do
If you feel tired all the time, tell your doctor, as it is important to rule out any other causes of fatigue. Sometimes you may need to have your medication changed or take tests so that your GP can fully understand what is happening.
With or without medical intervention, there are a number of lifestyle changes that may help you feel generally less exhausted.
How Arthritis Medications Affect Gi Problems
Yes, GI problems are common side effects for many drug classes used in the treatment of inflammatory arthritis, says Justin Owensby, PharmD, PhD, research pharmacist with the department of clinical immunology and rheumatology at the University of Alabama at Birmingham. In fact, most GI problems in RA patients are related to their medications, says Dr. Huffstutter. Side effects for RA drugs range from minor, such as nausea, to severe, like GI bleeding. They depend on the specific drug, dose, duration of therapy, and other meds youre taking, says Dr. Owensby.
Arthritis meds that can cause GI symptoms include:
NSAIDs: Nonsteroidal anti-inflammatory drugs reduce compounds called prostaglandins, which protect the lining of the stomach, explains Jared J. Vanderbleek, PharmD, pharmacist at the Kirklin Clinic at the University of Alabama at Birmingham. If the lining of the stomach is exposed to stomach acid, irritation or an ulcer may occur. The most common complication associated with NSAIDs are gastritis and peptic ulcer disease, says experts. If you take steroids along with these meds, or take NSAIDs for a long period of time, you may be at an increased risk of side effects, adds Dr. Vanderbleek.
DMARDs: Disease-modifying antirheumatic drugs such as methotrexate have been shown to cause diarrhea and nausea, as well as abdominal pain, indigestion, and vomiting.
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Asymmetrical Joint Pain And Swelling
With psoriatic arthritis, stiffness, pain and throbbing of your joints is par for the course. Typically psoriatic arthritis will present asymmetrically in your joints: one joint may flare up but not the other. For instance, my left sacroiliac joint and knee and my right wrist and elbow are most commonly affected. Each psoriatic arthritic patient will have different joints affected, so be on the lookout for which of your joints are your main culprits.
The Link Between Psoriatic Arthritis And Migraines
Psoriatic arthritis is an inflammatory form of arthritis. About 30% of people with psoriasis, an autoimmune skin disease that causes skin cells to build up and form plaques, also have PsA. Symptoms of psoriatic arthritis can include joint pain and swelling, skin lesions, back pain, and nail deformity.
Recent research has linked psoriasis and psoriatic arthritis to migraines. People with the two conditions are believed to be at higher risk of new-onset migraines.
Migraines can be moderate-to-severe headaches accompanied by nausea and sensitivity to light and sound. More research is needed to better understand the relationship between PsA and migraines.
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How Are Autoimmune Diseases Diagnosed
Diagnosing an autoimmune disease usually takes healthcare providers longer than it does to diagnose other diseases. This is because many autoimmune diseases have similar symptoms with each other and with other diseases. You can help your healthcare provider with the diagnosing process by bringing the following to your appointment:
- A detailed list of any symptoms and how long youve had them.
- A record of your familys health history. Note if anyone in your family has an autoimmune disease.
In addition to interviewing you about your symptoms, your healthcare provider may do some blood tests to check for autoimmune diseases, including:
- Antinuclear antibody test .
Specific symptoms combined with specific blood markers may prove that you have an autoimmune disease.
Does Ankylosing Spondylitis Cause Nausea
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There are many unwelcomed symptoms of ankylosing spondylitis . The fatigue, brain fog, and pain are enough to cope with. But many people living with AS also live with digestive issues, too – these can include stomach upset, nausea, loss of appetite, and sometimes more serious conditions such as inflammatory bowel disease .
However, some of our community members are not diagnosed with IBD but still live with daily nausea and gut problems. Some studies have estimated that up to 60% of people living with AS have gut inflammation1, which could be a possible cause of nausea and other stomach distress.
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Connecting The Inner Ear
There are a variety of health conditions related to psoriatic arthritis. Studies have shown that people living with a psoriatic disease can suffer from damage to their inner ears.
For some, this damage can appear as hearing loss. However, it can also cause other issues including dizziness and vertigo.
Spine Shoulders And Hips
PsA that affects the spine is called axial psoriatic arthritis. It can cause bony growths and inflammation in various parts of the spine that affect the back, shoulders, and hips.
Over time, spinal inflammation may affect the joints between the vertebrae, which are the small bones in the spine. This is caused spondylitis.
PsA that affects the sacroiliac joints between the spine and the pelvis is called sacroiliitis. This is often felt at the bottom outside of your back near your hip. It can also cause pain further into the lower back, hips, or buttocks.
The back pain caused by axial PsA is different from common back pain in that it gets better with exercise and worse when sedentary. The pain may wake you up in the middle of the night and be worse the first 30 minutes after you wake up.
Over time, you may experience chronic joint pain and stiffness, which may make it hard for you to bend your spine. You may also experience decreased range of motion.
Spinal involvement usually comes later in the progression of PsA, but not always. Early treatment can often help prevent your spine from becoming affected.
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Seek Help From A Doctor
If you’re experiencing vertigo, it’s essential to seek help from a doctor. It may mean it’s time to adjust your treatment plan, including adding the option of more physical therapy.
It can also mean new medications such as Dramamine to reduce the spinning sensation or muscle relaxers. Even if you feel sure that your dizziness is brought on by PsA, you should still check in with your doctor.
What This Means For Patients On Methotrexate
Patients tell us all the time that nausea and fatigue are part of their experience taking methotrexate. This study adds to the body of literature that shows that these side effects are clinically meaningful for patients, says Louis Tharp, executive director of GHLF. Data like this can help support patients reports that these are not just inconvenient side effects and need to be part of the provider-patient conversation.
It may also be reassuring to patients on methotrexate that these side effects are what researchers called temporal that they are related to timing. You may feel more nausea and fatigue immediately after taking methotrexate, but it is important for patients to know that these symptoms typically subside over time and wont necessarily last all week long.
This data may help doctors and patients have a better discussion about what to expect when starting methotrexate for inflammatory arthritis, says W. Benjamin Nowell, PhD, director of Patient-Centered Research at GHLF. Patients can be more prepared for side effects they may encounter and how to better manage or offset them.
You and your doctor may discuss taking some of the following steps to reduce the side effects from taking methotrexate:
Take methotrexate after meals, which may reduce the risk of stomach upset. Your doctor may also consider prescribing other medication to help treat symptoms like nausea and vomiting.
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Triggers Of Psoriatic Arthritis Flares
Every person has their own unique experience with psoriatic arthritis flare-ups. Something may cause a flare-up in one person but not in another. Thats why its important to track and log the triggers that set off your symptoms. Show the log to your doctor. Finding a link or pattern between certain activities and your psoriasis flare-ups can help control your outbreaks.
Common psoriatic arthritis triggers include the following.
Skin trauma or injury: This might include cuts, bumps, bruises, scratches, scrapes, or infections. Prevent injuries by being careful when cooking, gardening, nail trimming, and shaving. Wear gloves and long sleeves when doing an activity that could potentially cause injury.
Dry skin: Dry skin can cause a flare-up. Aim to keep skin hydrated with moisturizing lotions and creams.
Sunburn: While sunshine is good for psoriasis, getting sunburned is not. Always carry a hat and sunscreen.
Stress: Relaxation and stress reduction tactics such as yoga and meditation can alleviate stress and anxiety. Consider joining a psoriasis support group.
Alcohol: In addition to potentially causing flare-ups, alcohol can interfere with the effectiveness of certain medications.
Excess weight: Extra pounds can stress joints. Additionally, psoriasis plaques can develop in skin folds. People with psoriasis are at a higher risk of cardiovascular disease, which can be triggered by an unhealthy weight. Talk with your doctor about a diet and exercise plan.
Theme : Improved Prognosis
In addition to focusing on alleviating symptoms and their impact in the immediate- and short-term, participants discussed the importance of treatment providing an improved prognosis in the medium- and long-term.
Slowing down or halting disease progression A factor influencing many participants treatment decisions was the potential for medications to slow down or halt future joint damage. This was important for those participants who expressed anxiety about their PsA worsening over time.
They said it will stop your disease activity so it wont, your bones wont fall to bits effectively
The worry is always there that this is going to get worse and worse
Enabling independence to be maintained Increased disability in the future concerned those participants who placed a high value on maintaining their independence.
If I could have anything it would be independence, it would be to be able to be as fast as everybody else, it will be able to drive my own car, go out when I wanted to go out, come in and lock my own front door and not have somebody to come in to help with the shower
I live alone and I want to keep my independence
I have got a shorter life because of the amount of drugs that I take, I know that it is going to restrict my lifestyle. I have always said I want a good quality even though it is short I dont want to live until I am 90 and be curled up in a ball somewhere, I dont want that, I would rather keep taking the injections and keep going
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How Are Autoimmune Diseases Treated
There are no cures for autoimmune diseases, but symptoms can be managed. Everyones immune system, genetics and environment are different. That means that your treatment must be unique.
Some examples of medications used to treat autoimmune diseases include:
- Limiting processed foods from your diet.
Tips For Vertigo Management
It’s hard to live with vertigo. While you’re waiting to get help, try to avoid getting into dangerous situations like driving, standing on public transportation, or riding a bike.
Stabilize yourself by sitting or lying down during a dizzy spell. Lean on a wall, shopping cart, or something stable if you are unable to sit. I know these things aren’t always practical. We all have busy lives and can’t take the time to stop, but safety should always be your priority.
Don’t be afraid to ask for help and let others know what’s going on. Many people have experienced vertigo or know someone who does and understand how dangerous it could be. In my experience, others have expressed empathy when I’ve needed accommodations.
I’m thankful for how much others have helped me they’ve been my rock while my world was spinning. Or, at least helped me dodge all the people at the train station.
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What To Expect During Treatment
Migraines may not be a quick and easy fix. Due to the range of symptoms and underlying conditions, a mix of therapies may be required to target and reduce migraines and symptoms adequately.
Its important to mention all symptoms to your PsA doctor, so further exploration can be done to determine if there is a direct link and if treatments can overlap.
How to prepare for a visit with a headache specialist:
- Keep a migraine journal.
- Write down questions.
Progression Of Psoriatic Arthritis Symptoms
In some cases, people with PsA may experience only stiffness and pain initially without any other symptoms. The pain and stiffness may be intermittent, brief flare-ups of symptoms might appear to go away. Many people may think that their joint symptoms spontaneously have resolved.
PsA often begins in the distal joints, those farthest away from the core of the body, such as the joints in the fingers and toes. Musculoskeletal symptoms are often slow to develop and hidden. A rapid onset of PsA symptoms is also possible and is reported in about one-third of people with PsA.
The symptoms of PsA, which vary from person to person, can change in severity. Skin symptoms typically appear before the joints become involved, sometimes up to 10 years before any joint symptoms are noticed. The fact that joint symptoms sometimes unfold over time, can make PsA not only difficult to diagnose, it also masks the damage that the chronic inflammation is causing in your body. Without treatment, many of these symptoms can lead to progressive, permanent joint damage. Arthritis mutilans, the most severe form of PsA, occurs in approximately 5% of people with PsA. The shortening of fingers and toes, deformity, and loss of function characterizes arthritis mutilans.
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Availability Of Data And Materials
Celgene is committed to responsible and transparent sharing of clinical trial data with patients, healthcare practitioners, and independent researchers for the purpose of improving scientific and medical knowledge as well as fostering innovative treatment approaches. For more information, please visit .
For Many Patients Side Effects Worsened Right After The Mtx Dose
As a first-line treatment for rheumatoid arthritis and also commonly used in psoriatic arthritis, methotrexate is well-known among inflammatory arthritis patients. While methotrexate is effective for a great number of patients and helps many achieve low disease activity or even remission, the medication sometimes gets a negative reputation for potential side effects, including fatigue, nausea, hair loss, mouth sores, and others.
The Global Health Living Foundation and CreakyJoints studied patients experience with MTX side effects and presented research last year that found that 58 percent of current methotrexate users and 79 percent of people who had taken methotrexate but stopped experienced at least one or more side effects.
Nausea and fatigue were among the most commonly reported side effects, so our research team decided to study these further.
While nausea and fatigue can be bothersome enough to make a medication intolerable for some patients, understanding how these side effects occur in relation to timing of when methotrexate is taken is important. For arthritis patients, the medication is typically given once a week . Are side effects worse right after taking the MTX dose? Do they improve afterward?
In research presented during ACR Convergence 2020, the annual meeting of the American College of Rheumatology, researchers looked at data from 91 patients who had either rheumatoid arthritis or psoriatic arthritis and were currently taking oral methotrexate for it. .
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