What Are The Treatment Options For Psoriatic Arthritis
The aim of treatment for psoriatic arthritis is to control the disease and relieve symptoms. Treatment may include any combination of the following:
- Splinting.
- Surgery.
Choice of medications depends on disease severity, number of joints involved, and associated skin symptoms. During the early stages of the disease, mild inflammation may respond to nonsteroidal anti-inflammatory drugs . Cortisone injections may be used to treat ongoing inflammation in a single joint. Oral steroids, if used to treat a psoriatic arthritis flare, can temporarily worsen psoriasis. Long-term use of oral steroids should be avoided when possible due to the negative effects on the body over time.
DMARDs are used when NSAIDs fail to work and for patients with persistent and/or erosive disease. DMARDs that are effective in treating psoriatic arthritis include: methotrexate, sulfasalazine, and cyclosporine.
Biologic agents are an important consideration when disease control is not being achieved with NSAIDS or DMARDs. Biologics have been utilized for the treatment of psoriatic arthritis since 2005 and are highly effective at slowing and preventing progression of joint damage. Your healthcare provider will complete additional laboratory tests and review safety considerations before initiating a medication regimen. Gaining good control of psoriatic arthritis and psoriasis is important to avoid increased systemic risks, particularly heart disease.
Exercise
Heat and cold therapy
Splinting
Surgery
Loss Of Significant Joint Mobility
For example, you were able to flex your wrist 60 degrees, and two years later, you lost 50 percent of that range of motion. Its possible to feel okay and still experience loss of range of motion, says Dr. Domingues. But the idea is to prevent joint damage and to make you have less pain. If you have less pain and are still progressing, that means your treatment could be working better.
Psoriatic Arthritis Signs And Symptoms
Early symptoms with psoriatic arthritis are important. People will complain of pain and swelling in their joints hands, feet, wrists, etc. They may have a small patch of psoriasis or have psoriasis covering many areas of the body. There may be complaints of stiffness and fatigue. For example, studies in Toronto showed the year before they were diagnosed, people had reported joint pain, fatigue, and stiffness. Early in the disease, people will often have episodes of worsening of the psoriatic arthritis and then episodes of improvement.
Don’t Miss: How Do I Know If I Have Knee Arthritis
How Successful Are The Treatments
Anti-inflammatory drugs can help to reduce pain, swelling and stiffness. Unfortunately, however, they can make skin symptoms worse in some people. Steroid injections to joints may give relief. Disease-modifying drugs such as methotrexate can damp down both skin and joint symptoms, as can targeted biologic agents.
In some cases, surgery to remove a thickened synovial membrane , realign a joint or to fuse a joint may stop pain which results from movement.
Sometimes it is possible to remove the painful end of a bone .
Remember: All treatments may have unwanted side effects or require special precautions . Always make sure you have all the information before embarking on any course of therapy this includes reading the patient information leaflets provided with your medicines.
What Does Psoriatic Arthritis In The Feet Feel Like
When your feet are affected by psoriatic arthritis, you may have pain, tenderness, and swelling in your foot. This occurs when the membranes that line the joints, tendons, and connective tissue in the foot become inflamed. Similar to other forms of inflammatory arthritis, such as rheumatoid arthritis, joints may feel may warm to the touch, and stiffness may be worse in the morning or after periods of inactivity.
Symptoms may also flare, then go into periods of remission. Heres more information about coping with psoriatic arthritis flares.
But unlike with rheumatoid arthritis where symptoms typically occur in the same joints on both sides of your body , PsA is usually asymmetrical. You can have psoriatic arthritis in the ankle joint of one foot and the toe of another, explains Dr. Kor, who also serves as spokesperson for the American Podiatric Medical Association.
Specific foot problems caused by PsA include:
Read Also: Does Cold Weather Affect Psoriatic Arthritis
How To Keep Your Feet Healthy With Psoriatic Arthritis
Psoriatic arthritis is a chronic condition that can get worse over time. A small percentage of people with PsA develop arthritis mutilans, which is a severe and painful form of the disease that can lead to deformity and disability. Though theres no cure for psoriatic arthritis, you can take steps to manage symptoms, control inflammation, and protect your joints. To help keep your feet healthy:
1. Stick to your PsA treatment plan. Your rheumatologist may prescribe nonsteroidal anti-inflammatory drugs to relieve pain and reduce inflammation, disease-modifying antirheumatic drugs to help slow the progression of psoriatic arthritis, or biologics, which are complex, targeted DMARDs that act on certain immune system pathways, to manage psoriatic arthritis symptoms and help prevent disease progression.
2. Lose weight if you need to. Maintaining a healthy weight reduces the amount of stress on the joints in your feet, which can help relieve pain and improve your walking gait. Excess body weight can also increase inflammation, and potentially make arthritis symptoms worse. Check out these weight loss tips that are especially helpful when you have arthritis.
Stretching exercises, especially ones that are focused on the source of your foot pain, such as the plantar fascia or Achilles tendon, can help relieve pain. Talk to your doctor or podiatrist about exercises that are safe for you.
Psoriatic Arthritis Prognosis And Outlook
What is the prognosis for individuals who experience PsA? Some of it depends on the pattern of PsA you have. But, overall, the sooner you are diagnosed and begin treatment, the better your prognosis and pain will be.
While PsA is a chronic, yet progressive disease, in that it tends to get worse over time, you may have a milder form that doesnt cause too much pain and decreased mobility. For example, the most common type of PsA, asymmetric oligoarticular, tends to come with the mildest symptoms. In contrast, the rarest form, yet the most debilitating form, arthritis mutilans, can cause severe deformities.
Whatever the type of PsA you have, the sooner you receive treatment and the more vigilant you are in making lifestyle changes, the less pain and better quality of life you will experience.
Read Also: What Are The Effects Of Arthritis
Seeing My Doctor For Leg Pain And Swelling
I already had experience in the past of letting my pain go too long before I said anything. My reward for that was it caused permanent joint damage in my back. I was not about to wait so long this time. My next visit with my primary care doctor I told her of the pain I was experiencing in my left towards my ankle. She examined my leg. She did not see anything that looked unusual. She then looked at my ankle. She did notice that it was very swollen. I explained to her that it swells a lot along with my other ankle but I was not having the pain in the right ankle. She looks in my chart and notices psoriatic arthritis noted there. She said that the psoriatic arthritis was putting pressure on my joints in my foot causing them to swell. That swelling was causing shooting pain as a reaction.
Medication Options For Psa
For moderate to severe disease, treatments that target joint disease in PsA 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 , brodalumab , and secukinumab .6 The FDA has also recently approved Inflectra , a biosimilar to infliximab, for the treatment of psoriatic arthritis.8
Read Also: Why Does Psoriatic Arthritis Hurt So Bad
Six Symptoms You Shouldnt Ignore
The symptoms of psoriatic arthritis can vary in severity, from person to person and can even come and go . Here are six symptoms you should watch out for.
1. Its hard to move in the morning
Psoriatic arthritis can make getting up in the morning a challenge, especially after you havent moved around for a while. It can cause stiffness and pain in one or more joints, from your toes to your fingers. It can even cause pain and swelling in the tendons and surrounding structures that connect to your bone, a condition called enthesitis.
2. Your fingers look like warm sausages
About 30 to 50 percent of patients with psoriatic arthritis will experience the symptoms of dactylitis, or extreme swelling in their fingers and toes, Dr. Aquino said. This is when the entire fingers and toes swell to resemble sausages.
You may notice your swollen joints feel warm to the touch because inflammation and swelling cause heat.
3. You have lower back pain
When you think of psoriatic arthritis, you typically think about skin symptoms, but many people experience lower back pain as well. About 20 percent of those with psoriatic arthritis will develop a subtype called spinal involvement or psoriatic spondylitis, which may result in pain and stiffness in the back and hips, Dr. Aquino said.
4. Your nails have grooves and ridges
5. You experience eye problems
6. Youre always tired
What Foods Can Help With Swelling In Psoriatic Arthritis
ANSWER
Psoriatic arthritis causes swelling. So do certain foods, like fatty red meats, dairy, refined sugars, processed foods, and vegetables like potatoes, tomatoes, and eggplants. Avoid them and choose fish, like mackerel, tuna, and salmon, which have omega-3 fatty acids. Those have been shown to reduce inflammation. Carrots, sweet potatoes, spinach, kale, and blueberries are good choices, too.
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “What Is Psoriatic Arthritis?”
National Psoriasis Foundation: “Diet and Nutrition” “Researchers study how diets affect psoriatic disease.”
Celiac Disease Foundation: “What Can I Eat?”
Barrea, Luigi. Journal of Translational Medicine, published online January 2015.
Arthritis Foundation: “The Ultimate Arthritis Diet.”
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “What Is Psoriatic Arthritis?”
National Psoriasis Foundation: “Diet and Nutrition” “Researchers study how diets affect psoriatic disease.”
Celiac Disease Foundation: “What Can I Eat?”
Barrea, Luigi. Journal of Translational Medicine, published online January 2015.
Arthritis Foundation: “The Ultimate Arthritis Diet.”
This tool does not provide medical advice. See additional information.
Other Answers On:
Also Check: Is Arthritis And Autoimmune Disease
How To Manage Psa In The Feet
People cannot take direct action to prevent PsA from developing, but they can take some steps to limit flare-ups and the impact of this condition on their lives.
For example, people may find it helpful to work with a doctor or podiatrist to help them find the right sort of footwear for their condition. Using shoe inserts may provide symptom relief and make it easier to walk.
Strengthening exercises and stretches may also prevent more severe symptoms. Doing exercises that involve slow, gentle, strength building movements, such as yoga and tai chi, can be safer for the joints than higher impact exercises such as running.
Trying physical therapy can also help build strength, work through stiffness, and maintain mobility in the feet.
When a person is experiencing pain, treatment can help them feel more comfortable, slow down the progression of the condition, and prevent joint injury.
The sections below look at some treatments and home remedies in more detail.
Symptoms Of Psoriatic Arthritis
The severity of the condition can vary considerably from person to person. Some people may have severe problems affecting many joints, whereas others may only notice mild symptoms in 1 or 2 joints.
There may be times when your symptoms improve and periods when they get worse .
Relapses can be very difficult to predict, but can often be managed with medicine when they do occur.
You May Like: Does Krill Oil Help Arthritis
What Are Medications And Treatment Options For Psoriatic Arthritis
The medical treatment of the arthritis aspects of psoriatic arthritis is described below. The treatment of psoriasis and the other involved organs is beyond the scope of this article.
Generally, the treatment of arthritis in psoriatic arthritis involves a combination of anti-inflammatory medications and exercise. If progressive inflammation and joint destruction occur despite NSAIDs treatment, more potent medications such as methotrexate , corticosteroids, and antimalarial medications are used.
Exercise programs can be done at home or with a physical therapist and are customized according to the disease and physical capabilities of each patient. Warm-up stretching, or other techniques, such as a hot shower or heat applications are helpful to relax muscles prior to exercise. Ice application after the routine can help minimize post-exercise soreness and inflammation. In general, exercises for arthritis are performed for the purpose of strengthening and maintaining or improving joint range of motion. They should be done on a regular basis for best results.
Treatment For Psoriatic Arthritis
Treatment for psoriatic arthritis aims to:
- relieve symptoms
- slow the condition’s progression
- improve quality of life
This usually involves trying a number of different medicines, some of which can also treat the psoriasis. If possible, you should take 1 medicine to treat both your psoriasis and psoriatic arthritis.
The main medicines used to treat psoriatic arthritis are:
- non-steroidal anti-inflammatory drugs
- biological therapies
Also Check: What To Do For Arthritis In The Shoulder
Impact Of Psa In The Shoulder
MyPsoriasisTeam members describe psoriatic arthritis pain in the shoulder and the way it affects their lives.
One noted, I hurt like hell. My hip and shoulder make life a struggle, but I’m still here. Another shared that they have PsA pain in their shoulders and between their shoulder blades: Im in agony with it. I need some relief. Its hard to lie down.
As this member pointed out, PsA pain in the shoulder can also affect your ability to sleep, as putting pressure on the joint can be painful. Another member shared their experience with this: Im having a terrible time using my arm and shoulders and trying to sleep on my sides. The pain is killing my shoulder. Another wrote, My shoulder is in agony. Its hard to lie down.
Effects On The Immune System
PsA is an autoimmune condition, which means that it influences the way that the immune system works. The immune system fights pathogens, such as bacteria and viruses. In someone with an autoimmune condition, it mistakenly attacks healthy cells.
In a person with PsA, the immune system attacks the joints, tendons, and the insertion points of tendons and ligaments. If a person also has psoriasis, it also affects the skin.
Researchers do not fully understand why this happens. They think that some bacterial infections, including strep throat, may trigger PsA. In addition, if a person has a genetic susceptibility, they may develop PsA as a result of severe stress, a physical injury, or an event that causes the immune system to react strongly.
720% of people with psoriasis develop uveitis, and it is more common in people who have PsA than in those who have psoriasis alone.
Uveitis is a group of diseases related to eye inflammation. Without treatment, it can lead to vision loss. People with PsA should have regular eye exams for this reason.
Read Also: Does Rheumatoid Arthritis Cripple You
When Psoriatic Disease Strikes The Hands And Feet
We take many common movements and activities for granted â until they become difficult or impossible to do. Get a grip on whatâs happening.
Our hands and feet are ultra-sensitive. Sensory neurons, which trigger pain sensations in the brain, cluster at the fingertips. The complex anatomical structure of hands and feet â with many joints, tendons and ligaments packed tightly together â gives us an acute sense of touch and lets us do precision movements. Our hands, particularly when used for communication through gesture, draw attention.Our feet are so important for our balance and mobility.
Thatâs why psoriatic disease, when it strikes the hands and feet, has an outsize effect. The symptoms can be more intense and more upsetting. Fingernail psoriasis, for instance, is often immediately noticeable and can make something as basic as a handshake feel uncomfortable. Pain and other symptoms of psoriasis and psoriatic arthritis in the hands and feet can make other routine tasks hard to accomplish.
Gary Bixby, who lost all his fingernails and toenails to severe psoriasis , says psoriatic nail disease makes it painful to chop fuel for his wood-burning stove, a frustrating problem during winters at his home in Blair, Wisconsin.
âIt was affecting more fingernails, then my toenails and large areas on my arms, legs and trunk,â says Bixby. âThatâs when I went to a podiatrist, who thought I had psoriasis, and then to a dermatologist, who confirmed it.”
What Causes Psoriatic Arthritis In The Shoulder
Researchers are not sure exactly what causes psoriatic arthritis, whether in the shoulder or elsewhere. They do know that PsA, like rheumatoid arthritis, is a form of chronic inflammatory arthritis. These types of arthritis occur when the body mistakenly attacks its own healthy tissues. This attack leads to inflammation, which causes the pain that people with PsA experience. Most people with psoriatic arthritis develop psoriasis on the skin and are later diagnosed with arthritis.
Also Check: How To Cure Arthritis In Shoulder
Diagnosis And Treatment Of Finger Psa
When diagnosing PsA in the fingers, doctors will begin by taking a medical history.
If an individual already has psoriasis or if their family has a history of the condition, this may help determine the cause of finger pain and swelling.
Next, doctors may examine the hand. They will look for:
- inflammation and swelling in the joints
- inflammation in places where tendons attach to bones
- difficulty moving the fingers, including trigger finger
- nail changes
- skeletal disorders in other parts of the body
Doctors may also order imaging tests, such as radiography, ultrasonography, and MRI scans.
Treatment for PsA may entail:
Doctors choose treatments based on the severity of a persons symptoms. Some people may only need NSAIDs or to take medications during flare-ups, while those with more advanced PsA may need more intensive treatment.
In some cases, surgery may be necessary to address damage.
Not all of these drugs are suitable for everyone. That is why doctors will take into account any other medical conditions a person has, any medications they are taking, their individual response to different treatments, and risk of side effects.
Living with PsA can be challenging, particularly if it inhibits movement in the hands.
People can look after the health of their joints and manage the symptoms of PsA by trying:
It is also advisable to protect the skin if a person has psoriasis on the affected joint. People can do this by: