How Often Should You See Your Doctor
It depends on your condition and how long youâve been on your current treatment. At first, your doctor may want to see you every few months. If they put you on a biologic drug, theyâll want to see you more often. You may need to check in every 6-12 weeks. Once your psoriasis is under control, you may only need to go in every 6 months.
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.
Have You Been Hit By A Double Whammy
Take the short quiz below to find out if you have symptoms or a family or medical history that may be associated with psoriatic arthritis . Share the results with your rheumatologist.
Please note: This quiz is not meant to diagnose patients with PsA. Talk to your rheumatologist about your results.
About 1 in 3 people with psoriasis may develop PsA.
Sources: 1. Gottlieb A, Merola JF. Psoriatic arthritis for dermatologists. J Dermatolog Treat. 2019 1-18. doi: 10.1080/09546634.2019.1605142. 2. Psoriatic arthritis. American College of Rheumatology. Updated March 2019. Accessed August 10, 2020. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis.
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Questions The Psoriasis Doctor May Ask You
Psoriasis can cause other physical or mental health problems. To get you the best treatment, your doctor may want to know:
- How much does psoriasis affect your daily life?
- Do you have anxiety or depression?
- Are you tired a lot?
- Do you have trouble using your hands and feet?
- Do you have joint pain?
- How well do you sleep at night?
- Have your symptoms changed or gotten worse?
What Do Rheumatology Doctors Do
Rheumatologists are experts in the treatment of inflammatory autoimmune disorders. These conditions, such as lupus or rheumatoid arthritis, involve the patients immune system attacking its own healthy body tissue rather than invading external disease agents. Your primary care provider may refer you to a rheumatologist if you experience joint pain, especially if there was no prior injury. If your joint pain is accompanied by fatigue, fever, rash, or stiffness, it could also indicate an inflammatory disorder. Sometimes abnormal blood test results can also indicate a rheumatic illness.
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How Arthritis In The Hands Is Treated
If youre diagnosed with an inflammatory form of arthritis, you have more treatment options than someone with OA. While nonsteroidal anti-inflammatory drugs can help manage the pain of both types of arthritis, the development of disease-modifying antirheumatic drugs and biologics has vastly improved the prognosis of those with inflammatory forms of arthritis by reducing inflammation and preventing further joint damage.
Cortisone injections can be useful for those with OA and conditions such as RA, though theyre usually used in patients whose inflammatory arthritis is limited to just one or two joints, Dr. Byram says. Injections of hyaluronic acid can be helpful for those with OA , but these are better for managing pain in larger joints like the knees rather than the hands.
What To Look For In A Health Professional
- Experience treating your condition. The more experience your doctor has with your condition, generally, the more adept he will be at recognizing and treating it. For example, a doctor who has little experience with fibromyalgia might not be as quick to make a diagnosis and prescribe effective treatment as one whos spent a lot of time with such patients.
- Up-to-date knowledge. Arthritis research advances continuously. Make sure your doctor is on top of the latest studies so he can provide the best care.
- Accessibility. A doctor who cant see you for weeks or return calls when youre in the midst of a medication reaction or a flare can make you feel like a second-rate patient.
- Willingness to fight. A good doctor will go to bat for you with your insurance company if they dont want to cover a specialist referral, surgical procedure or prescribed medication.
- A solid office staff. Your doctor may be wonderful, but if her staff loses your phone messages, deletes your e-mail, fails to do what they say they will or treats you rudely when you call or visit, consider looking elsewhere.
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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:
How Does Psoriatic Arthritis Treatment Work
Your rheumatologist may prescribe non-steroidal anti-inflammatory drugs for pain management and to reduce inflammation. Additionally, corticosteroids may be taken by mouth or injection to help reduce inflammation.
Conventional Disease-Modifying Anti-Rheumatic Drugs such as methotrexate may be used to reduce the damage from inflammation. The newest biologically-based, targeted medicines can dramatically reduce the underlying components which cause inflammation at the cellular level.
Psoriatic arthritis is a chronic disease which requires ongoing management by a licensed specialist. Partnering with a smart team of doctors will help you to manage the twists and turns diseases like this can take.
Make sure you get the highest level of Psoriatic arthritis treatment. Contact ARBDA today or visit one of our six offices in New Jersey for more information about our psoriatic arthritis treatment options.
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When Should I See A Rheumatologist
It is important to see a rheumatologist as soon as possible when you notice signs of psoriatic arthritis . Common symptoms can include stiffness, pain, swelling and tenderness in the joints, tendons or ligaments. You may also experience swelling, fatigue and changes in the nails . Untreated PsA can cause permanent joint damage.
Early diagnosis and treatment can help slow the disease and control symptoms. It can help keep your joints healthy, improve your range of movement, reduce your pain and tiredness, and prevent permanent joint damage.
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.
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What Are The Symptoms
Psoriatic arthritis can affect any joint in the body and symptoms can vary from person to person. It can develop slowly with mild symptoms, or come on quickly and be severe. The most common symptoms are:
- pain, swelling and stiffness in one or more joints
- pain and stiffness in the buttocks, lower back or neck
- pain in tendons, such as at the back of the heel or sole of the foot
- changes in nails, such as thickening, colour change or separation from the skin
- pain and redness in the eyes.
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.
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What Did You Look For In Your Rheumatologist
I looked for a gentle, confident, wise, reassuring bedside manner, says Seth D. Ginsberg, cofounder and president of the Global Healthy Living Foundation, an advocacy group for people living with chronic illnesses.
I was interested in someone I could relate to, have a conversation with, and explain my situation to in broader terms than just my aching joints. My wife came with me during the first visit and joined us in the exam room. Her opinion mattered, too, says Ginsberg.
Udell agrees that one of the first things to consider is the doctors personality and how well it meshes with yours especially if your disease is a serious, chronic one such as rheumatoid arthritis.Thats because your relationship with the rheumatologist could be a very long one, which is one reason I went into this specialty, Udell says.
And, he notes, the doctor-patient relationship should be nurtured as time goes on. If thereâs an issue that the patient and physician donât see eye-to-eye on, for example, they need to discuss it.
Or you might want to be more aggressive about treatment options while your doctor wants to be less aggressive this is also something you two must discuss, he says.
How Is Psoriatic Arthritis Diagnosed
A single medical test is not available to diagnose psoriatic arthritis. To find out whether you have psoriatic arthritis, your doctor will do the following:
Look at your medical records.
Ask you specific questions. This usually includes questions such as whether any of your blood relatives have psoriasis or psoriatic arthritis.
Examine your joints. This examination includes looking at your body to see whether you have swollen joints. Your doctor will gently press on the skin around certain joints to find out whether the area is tender.
Send you for medical testing. This may include x-rays and a blood test.
Before giving you a diagnosis, your doctor considers your test results and everything he or she learned while meeting with you. In case youre wondering, the result from your blood test cannot tell whether you have psoriatic arthritis. It tells your doctor whether you have inflammation throughout your body. People who have psoriatic arthritis have body-wide inflammation. Many other diseases also cause body-wide inflammation. Inflammation is a piece of the puzzle.
Because psoriatic arthritis can look like other types of arthritis, patients often see a dermatologist or rheumatologist for a diagnosis. A rheumatologist is a medical doctor who specializes in diagnosing and treating arthritis and other diseases of the joints, muscles, and bones. Rheumatologists and dermatologists generally have the most experience diagnosing and treating psoriatic arthritis.
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What Is Psoriatic Arthritis Video
Psoriatic arthritis can cause pain, swelling and stiffness in and around your joints.
It usually affects people who already have the skin condition psoriasis . This causes patches of red, raised skin, with white and silvery flakes.
Sometimes people have arthritis symptoms before the psoriasis. In rare cases, people have psoriatic arthritis and never have any noticeable patches of psoriasis.
Psoriatic arthritis and psoriasis are autoimmune conditions. Our immune system protects us against illness and infection. In autoimmune conditions, the immune system becomes confused and attacks healthy parts of the body.
Both conditions can affect people of any age.
Its estimated that around one in five people with psoriasis will develop psoriatic arthritis.
Psoriatic arthritis is a type of spondyloarthritis. These are a group of conditions with some similar symptoms.
Laboratory Tests For Diagnosing Psoriatic Arthritis
Your rheumatologist will likely order a series of laboratory tests, the results of which will help check for other conditions or point to psoriatic arthritis. These studies will examine factors such as the following:
- Complete blood count
- Erythrocyte sedimentation rate and C-reactive protein , which are inflammatory markers that might be elevated in PsA but should not be elevated in wear-and tear osteoarthritis or arthritis
- Rheumatoid factor and anti-cyclic citrillunated peptide , which are antibodies often present in cases of rheumatoid arthritis, but not commonly found in cases of PsA
- Blood urea nitrogen, creatinine, uric acid, and urinalysis
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Caspar Criteria For Diagnosis
Diagnosing psoriatic arthritis relies on markers in an established system called the Classification Criteria for Psoriatic Arthritis .
The criteria are each assigned a point value. Each one has a value of 1 point except for current psoriasis, which has a value of 2 points.
The criteria are as follows:
- current psoriasis outbreak
- personal or family history of psoriasis
- swollen fingers or toes, known as dactylitis
- nail problems, like separation from the nail bed
- bone growths near a joint that are visible on an X-ray
- absence of rheumatoid factor
A person must have at least 3 points based on the CASPAR criteria to be diagnosed with psoriatic arthritis.
Things You Only Understand If You Have Psoriatic Arthritis
Pain, anxiety, and fatigue are just a few of the symptoms of psoriatic arthritis. Heres what its really like to live with the condition.
Psoriatic arthritis is much more than just a few body aches. From pain and stiffness to severe fatigue, the condition comes with an array of symptoms that pose daily challenges for those who live with it. For those who dont have it, the mental and physical toll of psoriatic arthritis can be difficult to understand. Here are 15 statements only those who have psoriatic arthritis are familiar with. If you dont have the condition but know someone who does, this list can help you start deepening your understanding of psoriatic arthritis.
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You Can Have Psoriasis And A Different Kind Of Arthritis That Is Not Psa
People with psoriasis can develop different types of arthritis including rheumatoid arthritis, gout, osteoarthritis, and reactive arthritis so diagnosing PsA involves ruling out those other conditions.
Its often difficult to say in a first visit whether a patient definitely has psoriatic arthritis or another type of arthritis that just co-exists with psoriasis, says Dr. Kumar. PsA can take a long time to diagnose because a patient can delay seeing the doctor, then confirming PsA can require multiple labs and imaging tests.
The good news is that the diagnosis process for psoriatic arthritis is improving. Whereas PsA wasnt even recognized as a distinct condition decades ago , doctors are now better equipped with improved lab tests and imaging studies that help identify this disease so more patients can find relief.
Finding The Right Doctor For Psoriatic Arthritis
Once you’re diagnosed with psoriatic arthritis, it becomes a part of your lifefor the rest of your life. Finding a doctor you trust to help you manage the condition is critical. In fact, it may be one of the most important decisions you make.
Psoriatic arthritis is a complex condition affecting many parts of your body. Most patients do best with help from a whole team of health experts. A study published in the Archives of Dermatological Research found those who got help from both arthritis and skin doctors got a more accurate diagnosis and better targeted medications.
The right team can help you make smart treatment choices, understand your rights as a patient, and control your condition so you can continue to enjoy life.
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Q: What Side Effects Do You Need To Worry About With The Medications That Treat Psoriatic Arthritis
With methotrexate, the concern has always been liver damageâscarring and cirrhosis. We know that monitoring closely can help identify early signs of that before it gets bad. There is some uncertainty as to whether people with psoriasis and psoriatic arthritis might be more susceptible to liver disease, but it has not been sorted out. We worry about blood counts, because the drug can affect bone marrow. So we monitor that closely. Both methotrexate and biologics target the immune system, so there is a significant concern about infections. Common bacterial infections, such as pneumonia or sinusitis, as well as less common infections, such as tuberculosis and fungal infections, can occur more frequently. We have to be attuned to those.
With methotrexate, regular laboratory monitoring is important. With biologics there are no specific guidelines for testing. But usually a physician will follow you closely and make sure things are going well. These are not drugs where we say, “OK, here’s a prescription for the next year.” We like to see people at a minimum of every three to four months. We want to be on top of it if something goes wrong.
What Is Psoriatic Arthritis
Psoriatic arthritis is an autoimmune disorder, meaning the immune system misreads healthy joints, tendons, pelvic joints, or the spine as a potential threat that needs to be attacked. This process can cause inflammation, pain, swelling, and/or stiffness3, most commonly in the hands, feet, ankles, wrists, or knees4. One of the major risk factors of developing psoriatic arthritis is having psoriasis, a skin condition most commonly characterized by patches of scaly skin that has dead skin cells on top. Of the approximately 7.5 million people in the U.S.5 who have psoriasis, between 20% and 30% will go on to develop psoriatic arthritis6. That said, psoriasis does not cause psoriatic arthritis, and having the skin condition doesnt mean youll automatically develop psoriatic arthritis.
Psoriatic arthritis usually shows up after about 7 to 10 years of living with psoriasis, although a small minority of patients will develop psoriatic arthritis before ever seeing any skin evidence of psoriasis7. And the severity of someones psoriasis doesnt determine whether they will develop psoriatic arthritis. Someone can have a horrible skin disease but no joint problems, and vice versa, Samar Gupta, M.D., an associate professor at the University of Michigan Medical School and the chief of VA clinical rheumatology and medical education, tells SELF.
Other psoriatic arthritis risk factors include8:
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