Psoriasis and arthritis are not widely considered related, but there does exist a disease affecting about 1.5 million Americans that draws a direct line between the two. Psoriatic arthritis (PsA) is a chronic autoimmune disease that often begins with a diagnosis of psoriasis. Just as psoriasis is thought to be caused when the autoimmune system mistakenly attacks otherwise healthy skin cells – with the familiar itchy, scaly results – PsA affects joints in the same manner.
According to the Johns Hopkins Arthritis Center, “About one in three people with the skin disease psoriasis, will get PsA. It affects the joints as well as the tendons, and it may also affect the spine.” The cause of PsA is unknown and there is no cure. Although you can be diagnosed with PsA without first experiencing psoriasis, if you have psoriasis, the probability of you later developing PsA is much greater. “In fact, a medical history of psoriasis should be an alert that any pain or swelling in the hands or feet may be symptoms of PsA. Patients diagnosed with psoriasis should be on the alert for signs and symptoms of arthritis,” writes RheumotoidArthritis.org.
Psoriatic Arthritis Symptoms
Psoriatic arthritis is typically first diagnosed for people between the ages of 30 and 55. Hallmark symptoms include joint pain and inflammation. If left untreated, PsA can result in permanent joint and tissue damage. As such, it’s important to treat PsA early and aggressively.
In most cases, a skin rash will precede joint pain and discomfort. This can be good news in some cases, as it may help doctors reach a diagnosis earlier. Some patients won’t experience skin issues until later – or perhaps never.
According to the National Psoriasis Foundation, if you experience any of the following symptoms, you should see your physician.
- Tenderness, pain and swelling over tendons
- Swollen fingers and toes that sometimes resemble sausages
- Stiffness, pain, throbbing, swelling, and tenderness in one or more joints
- A reduced range of motion
- Morning stiffness and tiredness
- Nail changes — for example, the nail separates from the nail bed or becomes pitted, mimicking fungus infections
- Redness and pain of the eye (uveitis)
Life with Psoriatic Arthritis
Because there’s no definitive test for PsA, you may be referred to a rheumatologist who will consider your symptoms and family history. Medical researchers continue to explore the role genetics play in PsA. According to Medical News Today, “More than 40 percent of people with PsA have a family member with the condition.”
Additionally, you will be subject to blood tests, MRIs and X-rays. Your doctor will need to know if you show signs of certain proteins and antibodies, which are associated with either PsA or related conditions.
Once a diagnosis is confirmed, you will be prescribed oral anti-inflammatory medication. Depending on the severity of your case, you may also be treated with medication designed to mitigate joint damage. Steroid injections are often used to quickly reduce inflammation and provide pain relief. If irreversible joint damage has been identified, your doctor will explore the option of joint replacement surgery.
Regular exercise and a healthy lifestyle are key to living successfully with PsA. Just as with psoriasis of the skin, triggers play a role in PsA. The key to successful management of PsA is to prevent flareups by avoiding common triggers including:
- Cigarette smoke
- Prescription drugs that cause adverse reactions for people with PsA
- Irritating foods
It will likely take time for you to develop a clear understanding of which triggers are the most problematic for you. Each patient and each case behaves and reacts differently. Keep a food journal so that you can monitor patterns and share the data you collect with your doctor.
Alternative medicine provides additional tools to reduce pain and the effects of PsA. Many patients have benefited from acupuncture and meditation. Yoga is very popular among PsA patients as it combines stretching, strength building, and meditation.
As tough as it may be to hear, attitude makes a difference, too. Even the National Psoriasis Foundation stresses the importance of a positive mindset. Under the care of your doctor, learning how to live with PsA successfully is attainable. For additional support, the Arthritis Foundation provides a resource for connecting adults with PsA through local groups and events. And broader statistics and information about psoriasis can be found here.