Psoriatic Arthritis

Psoriatic arthritis is a form of arthritis affecting some people with the skin condition psoriasis, causing joint pain, stiffness, and swelling, especially in the fingers and toes.
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The basics

Psoriatic arthritis is a chronic inflammatory condition that affects the joints, skin, and nails. It is a type of autoimmune arthritis that can occur in people with psoriasis, a skin condition that causes red, scaly patches on the skin.

Psoriatic arthritis can affect any joint in the body, but is most commonly found in the fingers, toes, spine, and sacroiliac joints. It can also be challenging to diagnose, as it shares symptoms with other forms of arthritis. Treatment options include medication, physical therapy, and lifestyle changes to manage symptoms and prevent joint damage. Early diagnosis and treatment are important for the best outcome, as untreated psoriatic arthritis can lead to long-term joint damage and disability.

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Symptoms

The presentation of psoriatic arthritis can vary greatly from person to person. Some people may have only mild joint pain and stiffness, while others may experience more severe symptoms that affect multiple joints and other parts of the body. Some common symptoms of psoriatic arthritis include:

  • Joint pain and stiffness, especially in the fingers, toes, and lower back
  • Swelling and warmth in the joints
  • Fatigue and general malaise
  • Nail changes, such as pitting or separation from the nail bed
  • Eye inflammation, such as conjunctivitis or uveitis
  • Skin rash or patches of red, scaly skin
  • Inflammation in other parts of the body, such as the heart, lungs, or kidneys.

These symptoms can come and go, and may worsen during periods of stress or illness.

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Therapies & treatments

Physiotherapy

A physiotherapist can work with individuals to develop a personalized exercise program aimed at improving mobility, flexibility, and strength while minimizing pain and discomfort. In addition to exercises that target the affected joints, such as the hands, feet, and spine, a physiotherapist may also utilize modalities such as heat, ice, or electrical stimulation to reduce pain and inflammation. Education on proper posture and body mechanics can also be beneficial in reducing stress on affected joints and preventing further damage.

Occupational Therapy

Occupational therapy (OT) can be an important component of a comprehensive treatment plan for individuals with psoriatic arthritis. OT focuses on helping individuals improve their ability to perform daily activities and live independently despite their condition. This may involve working with a therapist to develop strategies for managing pain and fatigue, modifying the home or work environment to reduce stress on the joints, and learning new ways to perform tasks that may be difficult or painful due to joint stiffness or limited mobility. OT may also involve the use of assistive devices such as splints, braces, or adaptive equipment to help individuals with psoriatic arthritis maintain their independence and quality of life.

Medications

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs such as ibuprofen or naproxen can help reduce inflammation and alleviate pain associated with psoriatic arthritis. These medications should be used as directed and under the supervision of a healthcare provider due to potential side effects.

Disease-Modifying Antirheumatic Drugs (DMARDs)

DMARDs such as methotrexate or sulfasalazine can help slow or halt the progression of joint damage caused by psoriatic arthritis. These medications can take several weeks to months to start working and require regular monitoring for potential side effects.

Biologic Medications

Biologics such as TNF inhibitors or IL-17 inhibitors can help reduce inflammation and slow or halt the progression of joint damage caused by psoriatic arthritis. These medications are typically given via injection or infusion and require regular monitoring for potential side effects.

Procedures

Steroid Injections

Steroid injections can help reduce inflammation and alleviate pain in specific joints affected by psoriatic arthritis. These injections should be used sparingly and under the guidance of a healthcare provider due to potential side effects.

Joint Replacement Surgery

In severe cases of psoriatic arthritis, joint replacement surgery may be necessary to alleviate pain and improve joint function. This is typically a last resort option after other treatments have been unsuccessful.

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Self-care strategies

Exercise

Regular low-impact exercise, such as walking, swimming, or yoga, can help improve joint flexibility, reduce inflammation, and maintain overall physical health.

Rest

Balancing activity with rest is important to avoid overexertion and further damage to the joints. It is important to listen to your body and take breaks when needed.

Heat and cold therapy

Applying heat to stiff joints can help to reduce pain and increase mobility, while applying cold to inflamed joints can help to reduce swelling.

Maintain a healthy diet

A healthy diet rich in fruits, vegetables, lean proteins, and omega-3 fatty acids can help to reduce inflammation and promote overall health and well-being.

Stress management

Stress can trigger psoriatic arthritis symptoms, so it is important to learn stress management techniques such as meditation, deep breathing, or progressive muscle relaxation.

Get enough sleep

Getting enough sleep is crucial for managing psoriatic arthritis symptoms, as it helps reduce inflammation and promotes overall physical and mental health.

Avoid smoking and excessive alcohol consumption

Smoking and excessive alcohol consumption can worsen inflammation and increase the risk of other health problems, so it is important to avoid these habits.

Stay informed

Staying informed about the latest research and treatments for psoriatic arthritis can help you work more effectively with your healthcare team to manage your symptoms.

Seek support

Joining a support group or talking to others with psoriatic arthritis can provide emotional support and practical advice for managing the condition.

Work with your healthcare team

Working closely with your healthcare team, including your doctor, rheumatologist, and physical therapist, can help you develop an effective treatment plan and manage your symptoms over time.

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