Every Day Is Different And I Dont Know What Body I Will Wake Up To
Some days I feel fine other days its a struggle just to get out of bed. A psoriatic arthritis flare doesnt just mean painful joints, for me it also includes brain fog, fatigue, psoriasis flares, difficulty moving, and tender, swollen fingers and toes. This can have a huge impact on my mental health and self-esteem as every day is different, and I dont know what body I will wake up to.
Simple tasks become difficult during flares, and I can lose my train of thought mid-sentence, which makes me feel really self-consciousespecially at work. I worry that people take this as me being rude and not concentrating, but really its just the psoriatic arthritis brain fog and fatigue kicking in. Jude D., 28
You Know That Youre Incredibly Resilient
Sure, trying to conceal your swollen joints when you ask for help opening your toothpaste in the morning or covering up your limp while picking up your groceries isnât exactly glamorous or sexy.
But you know more than anyone that going through life with chronic pain makes you incredibly tough and resilient.
While some days are worse than others, you know deep down that every small accomplishment, every sweaty yoga class, and every particularly strenuous home-cooked meal means a little bit more to you because you donât take your strength for granted.
Article originally appeared on April 5, 2021 on Bezzyâs sister site, Healthline. Last medically reviewed on April 6, 2021.
What Are The Types Of Psoriatic Arthritis
Generally speaking, there are five different types of PsA. These are:
- Asymmetric oligoarticular: Asymmetric oligoarticular PsA involves only a few joints on one side of your body. It affects about
- between 7% and 32% of people with PsA.
- Arthritis mutilans:Arthritis mutilans is the most severe type of PsA. In this type of PsA, inflammation is very severe and can lead to joint deformation, particularly in your hands and feet. Less than 5% of people with PsA have this type.
Its possible to have more than one type of PsA. For example, you can have asymmetric oligoarticular PsA that also occurs with spondylitis PsA.
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Unpredictable Flares Can Make Planning Hard
One of the biggest challenges of dealing with psoriatic arthritis is not being able to anticipate when flares will strike. These unwelcome episodes can affect both your personal and professional life.
In a study presented at the 2018 Annual Perspectives in Rheumatic Diseases Conference, researchers found about 80 percent of participants with psoriatic arthritis said they were partially or totally unemployed due to their condition.
More than half of respondents reported having difficulty spending time with friends.
I never know, day to day, what Im going to feel like or what my body will be able to do, Donaldson says.
The erratic nature of the disease can make planning problematic.
The hardest part of living with this disease is the unpredictability, Covert agrees. How many naps will I need? Will I even need a nap, or will I be able to get out of bed? Will I be able to walk today? And if so, how long and how far?
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 treatment
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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Youre Just Being Lazy
My family has told me on many occasions to stop being so lazy. They just dont understand. Many people mistake fatigue for laziness but psoriatic arthritis fatigue is very real. I am sure all psoriatic arthritis sufferers would love to trade places with someone who doesnt suffer for one day and shop till I drop or go hiking. If we could have a psoriasis and arthritic-free life, we would defiantly not sit in the house. Sometimes sitting on the couch and watching a movie is a challenge.
Key Points About Psoriatic Arthritis In Children
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Psoriatic arthritis is a rare form of arthritis or joint inflammation that affects both skin and joints. It can occur in people who have the skin disease psoriasis.
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It is most common in adults ages 30 to 50. But it can start in childhood.
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This condition causes inflamed, swollen, and painful joints. It also causes eye pain and fatigue.
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Treatment may include medicines, heat and cold, splints, exercise, physical therapy, and surgery.
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Early treatment can help the disease go into remission. Delayed treatment may lead to long-term disability.
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Pregnancy Fertility And Breastfeeding
Psoriatic arthritis wont affect your chances of having children. But if youre thinking of starting a family, its important to discuss your drug treatment with a doctor well in advance. If you become pregnant unexpectedly, talk to your rheumatology department as soon as possible.
The following treatments must be avoided when trying to start a family, during pregnancy and when breastfeeding:
- leflunomide
- retinoid tablets and creams.
Theres growing evidence that some other drugs for psoriatic arthritis are safe to take during pregnancy. Your rheumatology department will be able to tell you which ones.
It will help if you try for a baby when your arthritis is under control.
Its also important that your arthritis is kept under control as much as possible during pregnancy. A flare-up of your arthritis during pregnancy can be harmful for you and your baby.
Psoriasis and psoriatic arthritis can run in families. If you have either condition, you could pass on genes that may increase your childrens risk though its difficult to predict.
As treatments continue to improve, people with psoriatic arthritis in years to come can expect a better outlook. If you have any questions or concerns, talk to your doctor.
Keep The Lines Of Communication Open
From there, its truly about self-awareness of symptoms and keeping the lines of communication open and honest with your healthcare provider, according to Ruderman.
When you have any chronic disease its important to seek out a physician you can communicate with, he says. You need to be able to communicate and say, This is working, or, This isnt, and why. Its a marriage, if you will. You have to let them know whats going on. You dont want to go into an office visit and say, I didnt want to bring it up because you didnt feel comfortable sharing.
Dr. Orbai recommends creating a personalized checklist that covers things such as checking your skin, checking your joints for inflammation, evaluating sleep and overall mood, and evaluating how well the medication seems to be working. All of those things are important to look at when determining whether or not you need to change your treatment plan, she says.
During any doctors visit, discuss the coordination of treatment plans with other specialists who may also be working with you, such as a dermatologist overseeing a treatment plan for psoriasis, Ruderman advises.
Its important that whoever oversees your primary care is also able to engage with your other physicians about your treatment plans otherwise its easy to miss things, he notes.
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How Is Psoriatic Arthritis Diagnosed
There is no single test to diagnose psoriatic arthritis. Healthcare providers make the diagnosis based on a patient’s medical history, physical exam, blood tests, and X-rays of the affected joints. Magnetic resonance imaging is generally not needed except in unusual circumstances.
Laboratory tests that may be helpful in diagnosis or used to monitor disease activity include:
- Rheumatoid factor and anti-CCP – types of blood tests to help diagnose rheumatoid arthritis.
- HLA-B27 – blood test to help diagnose, may also be indicated with a family history of psoriasis or psoriatic arthritis.
- Sedimentation rate and C-reactive protein – may indicate inflammation.
X-rays are not usually helpful in making a diagnosis in the early stages of the disease. In the later stages, X-rays may show changes that are more commonly seen only in psoriatic arthritis. One such finding is called the “pencil-in-cup,” which describes the finding where the end of the bone gets whittled down to a sharp point. This finding indicates more severe inflammatory changes to joints, which may require more aggressive treatment.
Psoriatic Arthritis Is Not The Same As Arthritis
Many community members shared that others fail to understand that PsA is not the same as osteoarthritis or rheumatoid arthritis. Too often, friends and family dismiss the significance of PsA with flippant comments about their own arthritis symptoms. The lack of understanding can be frustrating and emotionally draining.
Very difficult, particularly when they say, Oh, I have arthritis too, but I do not let it slow me down.
Usually it is hard to explain. My neighbors see me limping at the beginning of a walk, then half an hour later I am walking at a slow but normal pace. I say arthritis. They assume it is osteo.
When someone starts in about how much their finger hurts when it gets cold, I flat out stop talking.
They do not understand. They think it just makes you ache a bit but you are fine.
No, because people think it is normal arthritis aches and pains. When you try to describe flares, people glaze over it.
It is very difficult. People say, Oh yeah, I have arthritis too!
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Symptoms Inside And Out
Got joint pain? Pitted nails? What about red, scaly rashes? These are common symptoms of psoriatic arthritis . This form of the disease is similar to rheumatoid arthritis. It strikes about 30% of people with the skin condition psoriasis. It can affect several different body parts, along with your emotions.
The Importance Of Keeping A Record Of Your Symptoms
Experiencing new or worsening symptoms is one sign you may need to change your treatment. But teasing out the difference between your usual, everyday symptoms and those that may be new can be challenging.
With all forms of inflammatory arthritis, it can be really hard for both the patient and the doctor to distinguish mild flares of a patients disease from new or worsening symptoms, explains Dr. Lusa.
Keeping a regular record or log of your symptoms can help, says Eric Ruderman, MD, associate chief of rheumatology at Northwestern Medicine in Evanston, Illinois.
I often encourage patients every week or so to stop, take stock, and ask, Am I feeling better? Or: What symptoms am I feeling or what symptoms have dissipated? he notes. Sometimes its more granular than that. Asking yourself, What is it that I want to be able to do? Is it going on a run? Is it that its really important that I can take a walk with my spouse? You want to be able to see movement in the right direction, and that involves keeping track of how youre feeling.
Things that are critical to think about, according to Dr. Ruderman, are whether or not youre experiencing new or worsening symptoms, if older symptoms that were once gone have reemerged, or if your daily activities are impacted negatively. Or it may be simply that youre dissatisfied with how your current treatment plan is working, he says.
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At This Point You Know More About Managing Inflammation Than Most Doctors
While you know that no diet or lifestyle change will illuminate the root of your psoriatic arthritis, youâve still read up on every little detail on maintaining an anti-inflammatory lifestyle.
You probably take a turmeric supplement and avoid nightshade vegetables and sugar. Maybe youâve even cut out gluten and alcohol or started meditating to reduce stress.
Whatever lifestyle changes youâve decided to commit to, chances are youâve impressed your doctor or rheumatologist with the sheer amount of knowledge youâve acquired doing your own research.
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 Is Psoriatic Arthritis In Children
Psoriatic arthritis is a rare form of arthritis or joint inflammation that affects both skin and joints. Psoriasis is an ongoing condition that causes a red, scaly, itchy rash. It also causes nails to become thick and pitted with tiny holes.
Psoriatic arthritis causes painful joint pain and swelling, along with skin rashes. It most often affects finger and toe joints. But it can also affect wrists, knees, ankles, and the lower back.
This condition is most common in adults ages 30 to 50. But it can start in childhood. In many cases, the skin disease starts before the arthritis.
Early diagnosis and treatment helps to ease pain and prevent joint damage from getting worse.
Scalp Psoriasis And Psoriatic Arthritis
Scalp psoriasis is a common skin disorder that leads to red patches on the scalp.
Moreover, it may affect your entire scalp and also spread over the forehead.
No one knows the exact cause of the disorder but you cant catch it from anyone else.
Moving on, there is also a term called psoriatic arthritis nodules that is the complication of psoriatic arthritis.
Moreover, the nodules develop lumps under the skin but not more people are affected by the disorder.
Now, it may be hard for you to make someone understand from which pain you are suffering.
Additionally, people take these things lightly so here are some of the tips to tell your family about your chronic disorder.
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How To Explain Psoriatic Arthritis To Family
The first time when youre diagnosed with the disorder you are also shocked.
Subsequently, not many people are recognized with the disorder except the doctors or the person who is suffering from it.
So, one thing you should do is have a calm conversation with your family and make them understand the pain you are suffering from.
Tell them you need their support and make them recognizable with every term of the disorder.
Moreover, if you also want to understand whether you are affected by the disorder or not before going to the doctor then you can also go for psoriatic arthritis MCQ online.
In addition, the quiz will help you in spotting your condition.
Moving further suffering from the miserable disorder you may opt for some of the best treatments.
So, read below to apprehend some of the preeminent treatments for taming psoriasis and psoriasis arthritis.
What Are The Symptoms Of Psoriatic Arthritis In A Child
The skin condition psoriasis may start before or after the arthritis. Psoriasis causes a scaly, red, itchy rash on the knees, elbows, scalp, face, and the folds of the buttocks. It can also cause pitting of fingernails or toenails.
Each childs symptoms may vary. Symptoms of psoriatic arthritis may include:
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Inflamed, swollen, and painful joints, usually in the fingers and toes
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Morning stiffness in the joints
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Reddened skin over the affected joints
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Sausage-like swelling of fingers and toes, plus swollen wrists
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Deformed joints from chronic inflammation
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Symptoms in the spine or sacroiliac joint
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Lack of energy
The symptoms of psoriatic arthritis can seem like other health conditions. Make sure to see your childs healthcare provider for a diagnosis
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Signs And Symptoms Of Psoriatic Arthritis
For most people, psoriatic arthritis develops years after psoriasis. Contact your dermatologist if you have psoriasis and any of these signs or symptoms:
- A very noticeable swollen finger or toe
- Swollen and tender joints
- Stiffness when you wake up or sit for hours that fades as you move
- Nails that are pitted
- Nail separating from nail bed
- Lower back pain
Psoriatic Arthritis Symptoms Can Take Many Forms
Although the most common psoriatic arthritis symptoms are pain and swelling in the fingers and toes, it can manifest in many different ways. In Carman’s case, for example, symptoms first appeared in her lower back and neck.
Jody Quinn, 58, an office manager for a construction company, started feeling pain in her elbow in the early 1990s. Even though she’d been diagnosed with psoriasis several years earlier, her condition was mild and only affected her scalpso she never imagined she might also have psoriatic arthritis. Her primary care doctors didn’t suspect it, either: “They kept sending me to orthopedic specialists,” Quinn says. “They would say, ‘You have tennis elbow.'”
It isn’t uncommon for doctors to first suspect other joint problems, Dr. Ogdie explains. Doctors often think a patient has tennis elbow, Achilles tendinitis, or plantar fasciitis, inflammatory conditions that affect the heel or bottom of the foot.
It wasn’t until a dermatologist noticed that one of Quinn’s fingernails had fallen offpeeling, pitting nails is a symptom of psoriatic arthritisthat the diagnosis finally became clear. When she was told that she had psoriatic arthritis, Quinn was surprised. “Now, I know more about it than I ever thought I would.”
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