What If Youre Not Satisfied With Your Doctor
McIlwain says that if youre not feeling better after a few months of treatment, you should consider reevaluating your medical team.
There is very good treatment available for psoriatic arthritis, and most patients should begin to feel some improvement within a month or two,” he says. But if you arent getting better, talk openly and honestly with your doctor to make sure youre on the right track and if youre not, find another physician.
You Wish More People Understood What Youre Going Through
Because psoriatic arthritis is not a particularly common condition , it can be hard to find someone else who’s going through the same thing you are. It took 12 years after my diagnosis to meet someone else with psoriatic arthritis, Dishner says. That means its important to create your own support system. Keeping your friends and family involved in your experiences with psoriatic arthritis and your treatment plan, says Markenson, may help them to better understand what you’re going through and how to help you.
Tests To Diagnose Psoriatic Arthritis
These tests can help confirm psoriatic arthritis and rule out other conditions, like rheumatoid arthritis.
- Erythrocyte sedimentation rate : Gives a rough idea of how much inflammation is in your body, which could be caused by psoriatic arthritis. But higher levels can come from other autoimmune diseases, an infection, a tumor, liver disease, or pregnancy, too.
- Rheumatoid factor and anti-CCP antibody: These tests can rule out rheumatoid arthritis. People with that condition may have higher levels of these in their blood.
- HLA-B27: More than half of people who have psoriatic arthritis with spine inflammation will have this genetic marker. You can get tested to find out if you do.
- Iron tests: People with psoriatic arthritis may have mild anemia, or not enough healthy red blood cells.
These can show cartilage changes or bone and joint damage that suggests arthritis in your spine, hands, or feet. Psoriatic arthritis usually looks different on X-rays than rheumatoid arthritis does.
Bone Density Scan
Because psoriatic arthritis may lead to bone loss, your doctor may want to measure your bone strength. You could be at risk for osteoporosis and fractures.
Joint Fluid Test
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What To Expect At The Doctors Office
You may be seeing various health care providers during your journey to figure out whats causing your symptoms. Its common for people to see their internist/general practitioner, a dermatologist to treat their psoriasis, or other types of doctors to manage specific areas that are causing pain, such as a podiatrist to treat foot pain. However, if you or any of the health care providers you are currently seeing suspect it could be psoriatic arthritis, ask for a referral to a rheumatologist. These doctors specialize in arthritis and have the training to determine whether your joint symptoms are due to PsA or could be something else.
Psoriatic arthritis can be challenging to diagnose for a number of reasons, including:
What If I Want To Get Pregnant
Some psoriatic arthritis treatments can be harmful to fetuses, so if you hope to get pregnant, its important to tell your doctor so you can work together on this goal. Elizabeth says that at the time of her psoriatic arthritis diagnosis, she was a little embarrassed to talk about her sexual health with her physician. I was diagnosed as a teenager and had questions regarding how psoriatic arthritis would affect my ability to have children in the future, but I felt too awkward to ask. Thankfully, that was a discussion my doctor brought up as I got older, so eventually I got answers, she says. Alyssa A., 32, immediately asked her physician how psoriatic arthritis could affect pregnancy when she was diagnosed in the spring of 2021. Alyssas rheumatologist wasnt as helpful as she hoped, but her ob-gyn thoroughly answered her questions. If youre in a similar situation and are able to get a second opinion, it may offer more clarity and reassurance.
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As Can The Words Youre Too Young To Have Arthritis
When you say the word arthritis, every older person you meet has it, too, Dishner says. While well-meaning people may sympathize by comparing their own ailment with yours, psoriatic arthritis is a much different form of arthritis and does not develop because of aging. It can occur at any age but typically begins to cause symptoms among those between 30 and 50 years old, according to the NPF.
Access To Care Challenges
Serious racial disparities exist when it comes to access to care, both when it comes to psoriatic arthritis and in general.
Studies show differences in psoriatic arthritis based on skin color and race. For example, Black people tend to have more severe:
- Skin involvement
Despite that, they’re less likely than White people to be put on immunosuppressive drugs.
Furthermore, according to 2021 research, psoriatic arthritis is diagnosed less often in:
- Black people
- People of Asian descent
- Latinx people
People in these groups who have psoriatic arthritis often have a higher disease burden and lower quality of life because of disparities in care.
Some studies show implicit, often unconscious biases against people of color throughout the healthcare community. This is believed to have negative effects when it comes to treatment decisions and outcomes.
Some facilities have looked at disparities in their own patients. They found that poverty plays a role. But when comparing Black and White people of the same socioeconomic status, it became clear that outcomes remained worse for Black people.
Researchers call for more investigation into the impacts and disparities caused by bias in the medical profession and better education aimed at eliminating these issues.
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Youre Always On The Search For The Next Best Thing
In recent decades, there have been more advances in medications and studies confirming the benefits of certain therapies for psoriatic arthritis than ever before. Doing your own research and following up on it with your rheumatologist will help you and the doctor find and maintain the best treatment plan. Says Dishner, Its important to understand your options and to never give up hope.
How Can I Stop My Psoriatic Arthritis From Getting Worse
This was the first question Jennifer R., 35, asked her doctor when she was diagnosed in 2015. At the time she was in a lot of pain and wanted to know if she would feel that way forever. My doctor did say the condition was lifelong, and the idea was to stop the diseases current progression, she tells SELF. I learned that if I found medications that worked, I would be in less pain. Knowing that bit of information helped because I had hope. My doctor made sure I knew it was going to be a process, and having a realistic outlook helped me move forward, she says.
Similarly, Elizabeth wishes she had asked how controlling her psoriatic arthritis could affect her overall health. Everyone talks about joint damage, which is a serious risk. But I wish I knew to bring up items like heart healthwhich can be affected by the inflammation from psoriatic arthritis, she says. Knowing this, Elizabeth says she would have spent more time thinking about ways to care for herself that didnt just focus on her joints.
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Physical Therapists And Other Healthcare Providers
Depending on a persons particular needs, their healthcare team may involve other healthcare professionals, such as:
- Physical therapists: These professionals can teach a person special exercises and stretches that help with pain management and joint mobility.
- Occupational therapists: Occupational therapists provide customized treatment plans to enable people to perform daily activities and better manage their physical limitations and pain. Part of their work may include adapting a persons environment or tasks to fit their needs.
- Chiropractors: These practitioners manually adjust the spine, muscles, and joints. They use special hands-on techniques to restore joint mobility, which may help improve joint function in addition to reducing pain.
Physical Exam For Diagnosing Psoriatic Arthritis
The next step in diagnosing psoriatic arthritis is a thorough physical exam, which can involve a number of steps, including the following:
- Looking for signs of psoriasis in usual spots such as elbows and knees, as well as less visible places including the scalp, belly button, intergluteal cleft , palms of hands, and soles of feet
- Checking the nails of fingers and toes for abnormalities
- Applying pressure to joints for tenderness and swelling, as well as looking for redness
- Checking for tendon and ligament issues, including plantar fasciitis and Achilles tendonitis
- Checking for back mobility
- Checking for pain and inflammation along the sacroiliac joints, which is where the spine connects with your pelvis
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You Might Avoid Wearing Short Sleeves On A Hot Day If You Have Psoriasis Too
As if psoriatic arthritis wasnt enough, many people with the condition also have psoriasis, which produces patches of thick, red skin and silvery scales. Even when the temperature is 80 degrees and climbing, sleeveless shirts arent an option for many. My psoriasis is mainly on my elbows, so I would never dream of wearing a sleeveless dress, Dishner says. Three-quarter sleeves are my best friends.
What Are Foods That Trigger Psoriatic Arthritis Symptoms
Now that you know what you should be eating, lets talk about what you should be avoiding if you are living with psoriatic arthritis. While the above list of foods are noted for their anti-inflammatory properties, there are foods that are known for just the opposite. That is, they are known to cause inflammation. Naturally, these are just the types of foods you should avoid if you are living with psoriatic arthritis.
Saturated fats, sugar, alcohol, and simple carbohydrates are all triggers for psoriatic arthritis symptoms to flare up. Theyre also key factors in weight gain and obesity. As your weight increases, the stress on your joints also increases, so it goes hand in hand that keeping your weight down is beneficial for managing psoriatic arthritis.
Whats on the bad food list for individuals living with psoriatic arthritis?
- Processed meats
- Fried foods
Similarly, the foods on this list are ones that you would find on many lists for foods to avoid. It is only natural that our bodies do well with more nutrient-dense foods than ones that are processed, enriched, and full of sugar.
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What Are The Complications Of Psoriatic Arthritis
- Psoriatic arthritis can lead to obesity because movement/exercises become restricted due to pain. This leads to increase stiffness in joints.
- Research has shown that the chances of developing diabetes is more than 40% in patients with psoriatic arthritis.
- Many patients with psoriatic arthritis can develop arthritis mutilans, which is very painful. Arthritis mutilans destroy the finger bones leading to permanent deformity.
- Eye problems such as recurrent uveitis can develop in patients with psoriatic arthritis. Uveitis causes pain and redness in eyes and can even affect your eyesight.
- People with psoriatic arthritis have a high chance of developing cardiovascular diseases such as stroke or heart attacks if left untreated due to ongoing inflammation.
- Psoriatic arthritis can lead to severe joint pain, which can make you less mobile. This affects your daily routine and work. The inability to move and work can lead to stress and depression.
- Psoriatic arthritis patients are prone to get Inflammatory Bowel Syndrome or IBD.
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
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:
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Research Progress Related To Psoriatic Arthritis
The NIAMS supports translational and clinical research at universities and other organizations throughout the country that are studying psoriatic arthritis. Researchers are continuing work to understand what causes the disease, which may help them identify new treatment strategies. Following are some examples of the types of studies that are ongoing.
Youre A Serious Germaphobe
You wash your hands religiously, carry sanitizing wipes everywhere, and avoid germ hubs, such as bowling alleys and movie theaters. And with good reason: Anything that can affect your immune system may worsen your symptoms. Many psoriatic arthritis medications suppress the immune system, leaving you more susceptible to germs, and flare-ups can occur when you get an infection. While vitamins and general attention to hygiene can help ward off sickness, having to skip bowling night with your family to avoid getting sick can still sting even if it does help you avoid a monthlong cold.
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What Are My Treatment Options
There are numerous psoriatic arthritis medications, but they generally aim to control inflammation and minimize your pain and potential joint damage, according to the Cleveland Clinic. The exact type of treatment your doctor prescribes depends on the severity of your condition, but discussing your priorities with your physician and how medications can help you tackle them allows you to have some control over your medical condition.
When Gemma H., 35, was diagnosed with psoriatic arthritis in 2012, she found it comforting to learn about potential treatments, including what would happen if one didnt work for her. Asking about medications allowed me to research and understand things before I started taking them, Gemma tells SELF. Discovering that there are many different medications she could try if one didnt work helped relieve some of the anxiety she felt about running out of treatment options.
Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.
All About Psoriatic Arthritis
- Psoriatic arthritis can cause swelling, stiffness and pain in and around your joints/tendons.
- It generally affects those who have already have the skin psoriasis, which causes patches of red, raised skin with white and silvery flakes associated with itching.
- Sometimes people have arthritis symptoms before they are even diagnosed with skin psoriasis. In some rare cases, people have psoriatic arthritis and may never show any obvious patches of psoriasis.
- Both psoriasis and psoriatic arthritis are autoimmune conditions. Our bodys immune system protects us against infection and illness. In autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body, in this case skin and joints.
- Both conditions can affect individuals of any age.
- It is projected that around 1 in 5 people with psoriasis may develop psoriatic arthritis.
- Psoriatic arthritis is categorized under spondyloarthropathy. These are a group of disorders with some similar manifestations.
- Psoriatic arthritis is completely treatable condition. Early diagnosis and appropriate treatment in timely manner can prevent joint deformities and long-term disability. Psoriatic arthritis can occur in any part of the body, including spine and the fingertips.
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Living With Psoriatic Arthritis
Just like psoriasis, psoriatic arthritis can have periods where its flaring up and periods where its more in remission. Thats why so much advice tends to focus on how to avoid future flares. Try to keep a daily log and see if there is anything that could be triggering your symptoms likediet, high stress levels, or lack of sleep.
Having psoriatic arthritis can also put you at risk for other health complications. Weve found that theres a strong connection between psoriatic arthritis and both depression and metabolic syndromebecoming overweight or obese, having high cholesterol, having insulin resistance, says Dr. Efthimiou. The exact reasons for these links arent fully understood, but it could have to do with the high levels of inflammation in your body when you have psoriatic arthritis.
While being diagnosed with psoriatic arthritis can be a shock, there are a lot of treatment options that can help you go on to live a full, active life.
You will also want to do whatever you can to put less pressure on your joints. While it can be hard to lose weight, dropping a few pounds can both reduce the strain on your joints and make some medications more effective. Instead of focusing on the number on the scale, work on adding movement in as much as you can. Doing joint-friendly exercises like biking, swimming, yoga, and walking are a great way to feel your best.