Is Insomnia A Symptom Of Psoriatic Arthritis
As if thats not enough, chronic pain can also make it hard to sleep. While psoriatic arthritis does not directly cause insomnia, the tendon, ligament and joint pain can interrupt your sleep and lead to restless nights. Whats more, psoriatic arthritis is associated with an increased risk of other illnesses that are linked to sleep disturbances or fatigue, including:
Work And Psoriatic Arthritis
Having psoriatic arthritis may make some aspects of working life more challenging. But, if youre on the right treatment, its certainly possible to continue working.
Help and support is available, and you have rights and options.
The Government scheme Access to Work is a grant that can pay for equipment to help you with activities such as answering the phone, going to meetings, and getting to and from work.
The 2010 Equality Act, and the Disability Discrimination Act in Northern Ireland makes it unlawful for employers to treat anyone with a disability less favourably than anyone else. Psoriatic arthritis can be classed as a disability if its making every-day tasks difficult.
Your employer may need to make adjustments to your working environment, so you can do your job comfortably and safely.
You might be able to change some aspects of your job or working arrangements, or train for a different role.
In order to get the support youre entitled to, youll need to tell your employer about your condition. Your manager or HR department might be a good place to start.
Other available support might include:
- your workplace occupational health department, if there is one
- an occupational therapist. You could be referred to one by your GP or you could see one privately
- disability employment advisors, or other staff, at your local JobCentre Plus
- a Citizens Advice bureau particularly if you feel youre not getting the support youre entitled to.
How To Treat Psoriatic Arthritis
The main goals in managing PsA are to stop disease progression, reduce inflammation, treat skin symptoms, relieve pain, and keep your joints moving as much as possible.¹¹ A dermatologist and rheumatologist should coordinate your treatment plan. A physical therapist may also be helpful to help increase your flexibility and strength.¹¹
For those people with psoriatic arthritis and psoriasis, your doctor will design a treatment plan that addresses both conditions.
The foundation of PsA treatment includes medications that control inflammation in the body and reduce pain. Medications may include the following and are usually recommended based on the severity of your PsA symptoms.
Mild Disease: The goal of treating mild PsA is primarily to ease pain and reduce inflammation. A number of anti-inflammatory drugs may be recommended, such as:
Nonsteroidal anti-inflammatory drugs : NSAIDs include drugs like ibuprofen and naproxen sodium that can be purchased over-the-counter as well as prescription-grade NSAIDS, such as celecoxib or diclofenac.
Corticosteroids: These are more powerful anti-inflammatory drugs that are prescribed by a doctor and can be taken either by mouth or injected in the doctors office. These medications are only used for brief periods of time for disease flare-ups because of their adverse long-term side effects.
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Work Out At Times When You Feel Your Best
You might try to schedule your workouts first thing in the morning before life has a chance to interfere with your plans. But working out when you feel your best is usually more doable when you have psoriatic arthritis, according to Dr. Iversen.
For many people, exercising is easier later in the afternoon because theyre too sore and stiff in the morning, Dr. Iversen says. You may be more motivated to exercise when your body feels its best, plus you can focus on your form when youre not distracted by any pain. Some individuals find that light movement in the morning, such as stretching, can help ease tightness. Dr. Iversen suggests doing some gentle movements before you even get out of bed, then doing a little more while youre standing under warm water if you shower in the morning.
How Is Inflammatory Arthritis Diagnosed
Inflammatory arthritis can be difficult to diagnose as other conditions can have the same symptoms. Your GP may ask you about your symptoms and how long you’ve had them. They will also examine your affected joints. They may want to rule out other conditions such as septic arthritis and gout.If your doctor suspects you have inflammatory arthritis, or is concerned about your symptoms, they may suggest you have some blood tests. You may also have joint X-rays to see if your joints are being damaged by your arthritis. An MRI scan may be done to look at your joints in more detail.You are likely to be referred to a rheumatology specialist to confirm the diagnosis.
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How Can I Care For Myself If I Have Inflammatory Arthritis
Although there’s no cure for inflammatory arthritis, there are many things you can do to reduce pain and stiffness and to help prevent joint damage and disability.
- Have regular check-ups with your GP. Your doctor can advise you on treatment options and other things you can do to help reduce pain, swelling and inflammation. Your doctor will monitor you after you start on preventative maintenance treatment, and you’ll need to have regular blood tests.
- Try some non-drug treatments, such as physiotherapy, hydrotherapy and occupational therapy. Ask your GP or rheumatologist about these options, and how you can access them.
- Stop smoking as this can increase your risk of inflammatory arthritis.
What Foods Should I Eat
When it comes to psoriatic arthritis, many of the foods on the good list are the same types found on other types of healthy diet lists such as for heart health, diabetes, and cancer. Many of these foods have the effect of decreasing inflammation. Naturally, since joint inflammation is a major symptom of psoriatic arthritis, these types of foods are beneficial for people who have this disease.
What should you eat to decrease inflammation? As a starting base, your diet should include:
When cooking, use healthy oils, such as extra virgin olive oil or avocado oil. Great herbs to use include ginger and turmeric, which are also noted for their anti-inflammatory properties.
Many of the foods listed for helping to improve psoriatic arthritis are ones with anti-inflammatory and antioxidant properties. The following list of foods are known for just that.
- Avocado: This fruit is one of the best healthy fats out there. Avocados are high in potassium, beta-carotene, and Vitamins C, E, and K.
- Greens: Leafy greens, including collards, spinach, kale, Swiss chard, and beet greens are great anti-oxidant and Vitamin K boosters.
- Fatty fish: Anti-inflammatory omega-3 fatty acids are the key in fatty fish. Try trout and salmon as part of your psoriatic arthritis diet.
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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
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.
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What Are The Symptoms Of Psoriasis
There are different types of psoriasis. The most common is chronic plaque psoriasis. This causes patches of red, raised skin, with white and silvery flakes.
It can occur anywhere on the skin, but most commonly at the elbows, knees, back, buttocks and scalp.
Psoriasis can cause small round dents in finger and toe nails, this is known as pitting. Nails can also change colour, become thicker and the nail may lift away from your finger.
What Are The Symptoms Of Inflammatory Arthritis
The symptoms of inflammatory arthritis are:
- joint pain, tenderness and swelling
- stiffness when getting up in the morning or after periods of inactivity
- other symptoms not related to the joints, eg, tiredness, skin changes and weight loss.
However, these symptoms can also occur in other forms of arthritis and other diseases.
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Managing Psoriatic Arthritis Muscle Pain
Muscle pain is not one of the most common symptoms of psoriatic arthritis . However, some people diagnosed with the condition experience muscle aches and pain related to their diagnosis, in addition to the more common joint pain.
Understanding how muscle pain can be tied to psoriatic arthritis is important. That knowledge can help you recognize what is going on with your body and make sure you get the necessary treatments to keep doing your daily activities and to maintain your well-being and quality of life. Heres what you need to know about managing muscle pain with psoriatic arthritis.
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:
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.
Heat and cold therapy
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The Power Of Epsom Salts
Epsom salts are known to help reduce swelling, so it makes sense that many in the community use them to help with foot pain. A hot salt water bath can feel soothing, and the magnesium found in Epsom salts helps relax muscles and relieve pain.
I soak my feet in a warm Epsom salt water bath.
Hot bath soak with Epsom and bath salts.
Managing Psoriatic Arthritis Flares
When Julie Cerrone developed psoriatic arthritis , she didnt know what it was. Shed had knee problems and chronic pain for years but wasnt diagnosed with PsA until she was in her late 20s. Even after the diagnosis, she didnt immediately connect the profound fatigue she sometimes felt with flaring PsA.
Its a bone-chilling fatigue that has me in bed all day, says Cerrone, a health and wellness consultant in Pittsburgh. Walking up my front steps feels like Im hiking Mount Everest.
Flares for Cerrone can also mean painful, swollen joints and widespread discomfort. It may start in my hands but can travel up my forearm, and all the way to my neck, she says. “Its like my bones hurt.
More than Skin and Joints
Although Cerrones symptoms arent unusual, rheumatologist Philip Mease, MD, says flares can vary widely.
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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:
Reduce Stress And Pace Yourself
Relaxing your muscles is important to ease the pain of psoriatic arthritis. People who have chronic pain tend to tense their muscles, which can actually tighten the joints and make pain worse. Deep, abdominal breathing and guided imagery like closing your eyes and imagining a relaxing place can be an effective way to help quiet your muscles. Balancing your life from day to day is also important rushing to get as much done as possible on a “good” day may only cause you more pain later on.
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Try Gentle Stretching And Strengthening Exercises
If you’re less active because of psoriatic arthritis pain, your muscles can start to weaken. And tight, weak muscles can put extra pressure on your joints, which can make pain worse, says Katie Lawton, MEd, an exercise physiologist at the Cleveland Clinic in Ohio. Stretching and strengthening exercises can increase your range of motion and build muscle to help take pressure off of your joints.
The key is to determine which muscles to work and how much to work them, says Lawton. If you have chronic pain, start by stretching to a tolerable limit and then gradually increasing the stretch over time. Strength training, which includes exercising with free weights, resistance bands, or your own body weight, is also beneficial, but its important to understand your limitations. You may want to consider working with a physical therapist or personal trainer, who can help you develop a workout plan thats right for you.
Listen To Your Body And Scale Back When You Need To
Paying careful attention to your bodys signs and symptoms is critical, Dr. Iversen says. Overexercising can result in tendon inflammation, or enthesitis, a condition associated with psoriatic arthritis. Using a perceived exertion scale to measure your effort can help you determine how difficult your workout feels, according to the Centers for Disease Control and Prevention5. If youre using a 010 scale to do this, working out at a 5 or below will help keep you from overtraining, according to Dr. Iversen.
Keeping a workout diary to track how you feel after your workouts can also be helpful, according to Dr. Bilsborrow. For example, if you notice that you experience any pain thats worse on one side of your body or a sharp increase in joint pain or swelling during a particular workout, thats a good sign you need to slow down or try something new, Humphrey says.
Dr. Iversen recommends avoiding high-impact or very strenuous workouts if you have a flare-up of symptoms. You could still do some light aerobic exercise such as walking, aquatics, or walking in the pool, just to keep things going, she says.
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Psa Does Not Define Who We Are
So, I have concluded that chronic pain is the kind of pain that affects the quality of your life and lasts for more than six months. Stress is a major cause of pain, so it makes sense to find a way of reducing stress. The major causes of stress include family, work, and of course money.
Be mindful even if you have a chronic illness you can still enjoy all the blessings of life. It took me years to learn the art of managing stress and be positive. Remember that this disease we call PsA does not define who we are.
When To Get Medical Advice
See a GP if you have persistent pain, swelling or stiffness in your joints even if you have not been diagnosed with psoriasis.
If you’ve been diagnosed with psoriasis, you should have check-ups at least once a year to monitor your condition. Make sure you let the doctor know if you’re experiencing any problems with your joints.
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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.
Do Certain Foods Trigger Psoriatic Arthritis Flares
There is no substantial evidence that diet impacts PsA disease or symptoms. If you wish to change what you eat and see if it helps, see .
1. CDC. Psoriasis overview. 2018. Available at: www.cdc.gov/psoriasis/index.htm. Accessed July 25, 2020.
2. National Psoriasis Foundation. Psoriatic arthritis , an inflammatory form of arthritis, affects about 30 percent of people with psoriasis.2020. Available at: www.psoriasis.org/about-psoriatic-arthritis. Accessed July 25, 2020.
3. NIH. Psoriatic arthritis.2020. Available at: https://ghr.nlm.nih.gov/condition/psoriatic-arthritis. Accessed July 25, 2020.
4. Jadon DR, et al. Axial Disease in Psoriatic Arthritis study: defining the clinical and radiographic phenotype of psoriatic spondyloarthritis. Ann Rheum Dis. 2017 76:701.
5. ACR. Psoriatic Arthritis. www.rheumatology.org
6. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriatic Arthritis. Available at: www.niams.nih.gov/health-topics/psoriatic-arthritis#tab-symptoms. Accessed July 30, 2020.
7. Alexis AF, Blackcloud P.Psoriasis in Skin of Color: Epidemiology, Genetics, Clinical Presentation, and Treatment Nuances. J Clin Aesthet Dermatol. 2014 7:16-24
8. FitzGerald O, Haroon M, Giles JT, et al. Concepts of pathogenesis in psoriatic arthritis: genotype determines clinical phenotype. Arthritis Res Ther. 2015 17**.
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