Your Nails Have Holes Or Grooves
Up to 80% of people with psoriatic arthritis notice changes in their nails, Zhanna Mikulik, M.D., a rheumatologist at the Ohio State University Wexner Medical Center, tells SELF. You might see shallow or deep holes, known as pitting, in your fingernails and toenails, due to inflammation in the tendons that connect with the roots of your nails. Your nails may also be crumbly or have grooves and ridges on the surface.
Other nail findings include a change shape or turning a yellow-brown color. They can also separate from the nail bed, Mikulik says. That might sound really scary, but the good thing is that doctors can treat these nail-related symptoms with various targeted approaches, according to the American Academy of Dermatology.
Things To Know About Psoriatic Arthritis
Learn more about what it means to have psoriatic arthritis.
1. PsA Is an Autoimmune Disease
2. It Has Ups and Downs, Called Flares
3. It Can Be a Master of Disguise
4. It Has Distinguishing Features
5. It Affects Up to a Third of People with Psoriasis
6. Its Gender Neutral
7. It May be Hereditary
8. Its Not Contagious
9. It Isnt Just About Your Joints
10. You May Not Look Sick
11. Effective Treatment is Available
Quick Links
What To Do About Your Symptoms
If youre experiencing any of the symptoms above and have psoriasis, seek help from your health care provider to consider a possible evaluation with a rheumatologist. Getting treatment early can help you avoid further joint damage and pain.
To find a Banner Health specialist near you, visit bannerhealth.com.
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You Have Pain Or Burning In Your Elbow
A condition called tennis elbow can sometimes show up as a symptom of psoriatic arthritis, even if youve never picked up a racquet. Again, this has to do with the inflammation that happens in spots where your tendons connect to bones, says Dr. Rosenstein. You might notice pain or burning in the external part of your elbow, along with poor grip strength, per the American Academy of Orthopedic Surgeons.
Seeking Help And Getting Through It
I know now that the anger, self-pity, and suicidal thoughts with which I struggled were not just me being dramatic. It was me suffering from disease and going through the cycle of pain and stages of grief.
This was especially heightened during the postpartum depression I experienced after the birth of my son, when my hormones and inflammation were raging uncontrollably. That was when I saw that I needed help from a health care professional.
A clinical social worker was a key component in my health care team and helping me accept my new life. Before my diagnosis I had no idea what mental health care could offer me, and how much I needed that compassion. Not all health care providers who save you are patching up wounds or prescribing medication. Some simply listen to you and help you understand you are not alone.
As I went through medication after medication, I found myself having to stop many because the side effects exasperated my poor mental health state. I learned why some drug commercials say that medications may cause suicidal thoughts and actions or increased depression. It takes time to find the right RA medication that works for your symptoms and doesnt cause too many side effects.
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You Have A Hard Time Moving In The Morning
Psoriatic arthritis can make it incredibly hard to get out of bed when your alarm goes off. The disease can cause inflammation, worn joints, and tightness in the muscles and tendons that can all make you feel really stiff and immobile, especially in the morning after you havent moved around for many hours, says Mikulik.
This symptom can be incredibly wide-reaching some research suggests that morning stiffness affects about 70% of people with psoriatic arthritis.
Youre Having Problems With Your Eyes
The inflammation from psoriatic arthritis can even target your eyes, says Ludmer. In fact, some research says between 7% and 20% of people with psoriatic arthritis appear to develop uveitis, a serious form of inflammation in the tissue of the eye wall that can lead to irreversible vision loss, according to the Mayo Clinic. Early warning signs of this condition include pain and redness in the eyes, light sensitivity, blurred vision, and floaters in your field of vision.
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Osteoarthritis In The Neck
Osteoarthritis in the neck is the degeneration of joints, vertebrae, and discs in the cervical portion of the spine. With less padding between them, vertebrae may rub against each other. That can cause tiny bone fragments to break off and float in the synovial fluid .
Sometimes this process stimulates the growth of bony projections along the edges called bone spurs, or osteophytes. Since the padding is now thinner, the vertebrae become closer to each other. That leaves less room for the spine nerves that stick out from the spinal cord.
Symptoms of neck osteoarthritis range from none to pain, stiffness, and inflammation. Osteoarthritis in the neck pain tends to worsen after activity. Complications such as loss of coordination can happen if the spinal cord becomes pinched.
How Do I Know If I Have Osteoarthritis Or Psoriatic Arthritis
In osteoarthritis, X-rays may show signs like worn cartilage.In psoriatic arthritis, X-rays can show joint damage in later stages of the disease.
Considering this, Is there a link between psoriasis and osteoarthritis? Psoriasis and psoriatic arthritis are related, but they are separate conditions. Psoriasis causes skin cells to renew too quickly, resulting in a red, scaly rash on the skin and characteristic silvery plaques. Psoriatic arthritis causes inflammation in the joints.
What is the difference between arthritis and psoriatic arthritis? So, basically rheumatoid arthritis and psoriatic arthritis are very similar and treatments are generally the same. The biggest difference is the joints involved in the hands and feet and the fact that psoriatic arthritis also involves psoriasis of the skin which is a persistent chronic disease in itself.
Furthermore, What is the difference between rheumatoid arthritis and osteoarthritis and psoriatic arthritis? When you have RA, your immune system attacks the lining of the tissues around your joints. They swell up and become painful. Over time, they can become damaged and deformed. With PsA, your immune system attacks and damages not just your joints, but your skin, as well.
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Can Psoriatic Arthritis Affect Children Too
As many as 12,000 children in the UK are affected by arthritis. It is known as juvenile chronic arthritis , of which there are three main types, stills disease, polyarticular juvenile chronic arthritis and polyarticular onset juvenile chronic arthritis. Psoriatic arthritis is a minor subset of JCA and is uncommon.
If You Have These Symptoms Heres Where To Get Professional Help
Just because you have one of these symptoms doesnt necessarily mean you have psoriatic arthritis. Tons of other things can cause fatigue, for example, like stress, anxiety disorders, and sleep apnea, which makes it difficult to use a list of symptoms alone to figure out if you have psoriatic arthritis. The only way to know for sure is to talk to a doctor and get a proper diagnosis as soon as possible if you need one. Remember: Psoriatic arthritis can lead to permanent joint damage without treatment, not to mention make a big impact on your daily life.
If someone has persistent joint pain or stiffness, especially if accompanied by joint swelling or tenderness, and even more so if its affecting more than one joint simultaneously, this should be brought to the attention of a physician. Most internists or family practitioners can do the preliminary evaluation to determine what condition may be responsible, says Dr. Rosenstein.
Your doctor may need to refer you to a rheumatologist, a dermatologist, or potentially both for diagnosis and treatment. If you realize in your search for care that you have access to a combined rheumatology-dermatology clinic, that can be a really excellent way to land on a treatment plan that collaborates between the two types of care, says Mikulik. The National Psoriasis Foundation can help you find specialist providers and prepare for your first appointment.
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How Is Psoriatic Arthritis Mutilans Diagnosed
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In some cases, people diagnosed with psoriatic arthritis didnt know they had psoriasis. In 85 percent of psoriatic arthritis cases, symptoms of psoriasis are obvious before arthritis is apparent.
To diagnose psoriatic arthritis mutilans, your doctor will first confirm you have arthritis. After checking your joints for signs of swelling or tenderness, youll receive diagnostic testing.
Your doctor may order lab tests to check for inflammation or the presence of certain antibodies. Both can point to arthritis. You doctor will also likely recommend an X-ray or other imaging test to assess joint damage.
Once your doctor has diagnosed you with arthritis, theyll test a blood sample to find out what kind of arthritis you have. For example, if the rheumatoid factor and cyclic citrullinated peptide antibodies are in your blood, you may have rheumatoid arthritis .
At this time, there isnt a lab biomarker for psoriatic arthritis or the psoriatic arthritis mutilans subset. Psoriatic arthritis mutilans is diagnosed by checking the severity of the bone destruction. There are very few conditions associated with such severe bone loss.
It Hurts To Grip A Pen Or Bend Your Toes
Pain and swelling over tendonsa symptom known as tenosynovitisis a common symptom in people with psoriatic arthritis due to that persistent inflammation, says Mikulik. It tends to affect the tendons of the toes or fingers. Depending on how exactly it affects you, it might hurt when you try to rotate your wrist or grasp anything, according to the Mayo Clinic, or you may feel pain or stiffness when trying to move your feet and toes.
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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 on special insoles and good supportive footwear.
Why Does Psoriatic Arthritis Make You So Tired
Studies show close to 80% of people with psoriatic arthritis have some degree of fatigue. When you have this disease, your body makes proteins called cytokines that cause inflammation. They make your joints swell and become painful or stiff. These proteins may also cause fatigue, although doctors arent sure why.
Is rest good for psoriatic arthritis?
Keep your bedroom cool and dark and use sheets made of natural fibers, such as cotton. Quality sleep can help improve many health problems, including psoriatic arthritis, while a chronic lack of sleep can make symptoms worse.
Does psoriatic arthritis hurt all the time? PsA causes painful joint and skin symptoms, which can reduce quality of life and interfere with daily activities. The pain tends to be worse when the condition is active. Doctors may prescribe one or more DMARDs to reduce disease activity and relieve symptoms such as pain.
Can a blood test detect psoriatic arthritis? There is no single blood test that can check for psoriatic arthritis , a chronic, inflammatory disease of the joints that can also cause a skin disorder called psoriasis. Your doctor will order a series of blood tests to check for different signs of psoriatic arthritis.
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Neither Will Taking Deep Breaths Or Meditating
While your well-meaning yogi friend may think the cure for your symptoms is to practice a few asanas, try as you might, yoga is not a cure for psoriatic arthritis. However, it may alleviate stress, and stress can worsen symptoms and bring on a flare. Yoga can also help ease pain and increase mobility, according to the National Psoriasis Foundation . So if you find the practice relaxing and beneficial, go for it!
Psoriatic Arthritis Often Affects People Who Have Psoriasis
Having psoriasis, a disease that often causes inflamed, scaly patches of skin on areas like your knees, elbows, and scalp, puts you at greater risk of getting psoriatic arthritis down the road. The Cleveland Clinic estimates that up to 30% of people with psoriasis get diagnosed with psoriatic arthritis. However, its possible to get psoriatic arthritis even if you dont have psoriasis, and vice versa. Psoriatic arthritis affects people of all genders at relatively equal rates and typically shows up in people between the ages of 30 and 50, says the Cleveland Clinic.
NYU Langone Health explains there are five types of psoriatic arthritis, and depending on which one you have, the disease can show up in very different ways in your body. Around three-quarters of people with the condition have a type called asymmetric oligoarthritis, which impacts up to five joints, though not necessarily the same ones on each side of the body. When the same joints are affected on each side, it may be due to symmetric arthritis, a type of psoriatic arthritis thats similar to rheumatoid arthritis. Theres also spondylitic arthritis, which affects the spine, and distal interphalangeal predominant psoriatic arthritis, which mainly involves the joints near your fingernails and toenails. The rarest form of psoriatic arthritis is arthritis mutilans. Its a severe form of the disease that can destroy the bones in your hands, per the Mayo Clinic.
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What Tests Will I Be Required To Take During My Diagnosis And Treatments
A full case history will be taken, urine and blood tests requested, x-rays, sometimes specialist x-rays, images and scans may also be requested, plus a full examination of your affected parts i.e. back, hands, feet etc.
In summary points to remember when seeing your doctor:
Ask about your medicines:
How Is Psoriatic Arthritis Treated
Treatment will depend on your symptoms, age, and general health. It will also depend on the severity of your condition.
Boththe skin condition and the joint inflammation are treated. Early diagnosis andtreatment helps prevent joint damage. Some medicines used to treat psoriatic arthritisinclude:
- Nonsteroidal anti-inflammatory medicines to ease symptoms
- Corticosteroids for inflammation
- Immunosuppressive medicines such as methotrexate to reduce inflammation if NSAIDs don’t work
- Biologic medicines to ease inflammation
- Vitamins and minerals such as calcium and vitamin D to slow bone deformation
Other treatment may include:
- Obesity
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Rheumatoid Arthritis In The Neck
Rheumatoid arthritis is a chronic inflammatory disease where the bodys immune system mistakenly attacks the lining of the joints. It often starts in the smaller joints of your hands and feet and can spread to other parts of the body like the neck as the disease progresses. This typically doesnt happen until years after the onset of arthritis symptoms.
Neck pain is the primary symptom of rheumatoid arthritis in the neck, with the severity varying from person to person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can make it hard to move from side to side.
The difference between rheumatoid arthritis neck pain and a neck injury is that stiffness and pain from an injury can gradually improve over days or weeks. Rheumatoid arthritis in the neck may not get better it can worsen if left untreated. Even if symptoms improve, inflammation, swelling, and stiffness can return with rheumatoid arthritis in the neck.
You Feel Pain In Your Heel Every Time You Take A Step
Psoriatic arthritis also has a tendency to cause inflammation in sites where tendons insert into bones, such as the Achilles tendon at the back of the heel, and the plantar fascia, causing pain in the sole of the foot and bottom of the heel which often will interfere with walking, says Dr. Rosenstein.
While experts say this isnt the most common psoriatic arthritis symptom, it can make life with this condition even more difficult. If you have heel pain that you cant explain with other reasons , you should get it checked out by a doctor.
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Chair Selection Is Important
It can be extremely difficult to get in different types of seats, depending on their height, width, and design, because of pain or stiffness. Luckily, I was a chemistry teacher, so I had lab stools, which were much easier for me, Dishner says. But outside school I would find myself scanning a room to find the right chair.
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.
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