Psoriatic Arthritis

Psoriatic Arthritis

Article by Shane Armfield

What is Psoriatic Arthritis?

Psoriatic arthritis causes painful inflammation in and around your joints. It usually affects people who already have psoriasis, a skin condition that causes a red, scaly rash, especially on your elbows, knees, back, buttocks and scalp.

However, some people develop arthritic symptoms before psoriasis, while others will never acquire skin conditions.

Your joint hurts for two reasons:

  • Your nerve endings are irritated by the chemicals produced by the inflammation.
  • The swelling stretches the capsule in your joints.

When the inflammation goes down, the capsule remains stretched and can’t hold your joint in its proper position. This can make your joint unstable and painful.

What are the Symptoms of Psoriatic Arthritis?

Symptoms of psoriatic arthritis can include:

  • pain and stiffness in and around your joints
  • swollen fingers or toes (dactylitis), caused by inflammation both in joints and tendons
  • buttock pain, a stiff back or a stiff neck (spondylitis)
  • pain and swelling in your heels
  • pain in other areas where tendons attach to bone (enthesitis), such as your knee, hip and chest
  • pitting, discolouration and thickening of your nails
  • fatigue, which can be caused by the activity of the disease or the emotional effects of living with a long-term condition.

What Causes Psoriatic Arthritis

Researchers have not identified a specific infection. We don’t yet precisely know what triggers the inflammation, although a particular combination of genes and infection makes some people more likely to develop psoriasis and psoriatic arthritis. Sometimes arthritis can follow an accident or injury, mainly if it affects a single joint. People who are overweight are more susceptible to both psoriasis and arthritis associated with this.

How Is Psoriatic Arthritis Diagnosed?

Due to the variety of symptoms experienced by patients, diagnosing Psoriatic Arthritis can be complex. Doctors will confirm the diagnosis based on your symptoms, a physical examination and the results of x-rays, scans and blood tests. Your doctor may also refer you to a specialist (Rheumatologist) to confirm the diagnosis and receive treatment.

Blood tests, in this case, are used to measure inflammation. You may have one of these tests:

  • Erythrocyte Sedimentation Rate (ESR)
  • C-reactive protein (CRP).

Both of these may show a high value when inflammation is present. These tests may be repeated from time to time to help monitor your arthritis.

Psoriatic Arthritis Treatment

Your Doctor or Rheumatologist will use a combination of skin treatments and medication to treat your condition. The medications prescribed will depend on the severity of your symptoms.

Treatments for your Skin

Your skin’s treatment will usually involve a variety of ointments. These may vary from tar-based lotions, dithranol based ointments, steroid-based creams, vitamin D-like ointments and vitamin A-like (retinoid) gels such as tazarotene.

If the creams and ointments don’t help your psoriasis, your doctor may suggest light therapy or retinoid tablets.

Many of the DMARDs used for psoriatic arthritis will also help your skin condition. Similarly, some of the treatments for your skin may help your arthritis.

Medication and Drugs

The three main groups of drugs used to treat the pain and inflammation caused by Psoriatic Arthritis are:

  • analgesics
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • disease-modifying anti-rheumatic drugs (DMARDs)
  • steroids

Your doctor or rheumatology specialist is the best person to discuss these drugs with and will manage the use of these medications carefully.

Physical Therapies for Psoriatic Arthritis

Looking after your joints and managing your symptoms is very important in the treatment of Psoriatic Arthritis. Your physiotherapist can suggest several different therapies that may help ease your symptoms and reduce the impact of Psoriatic Arthritis on your life.

The following treatments m help patients with Psoriatic Arthritis.

  • Therapeutic Exercise
  • Heat/Cold Therapy
  • Education
  • Pain Management
  • Acupuncture
  • Splinting advice
  • Fatigue management
  • Manual techniques
  • Hydrotherapy

Surgery

Surgery is occasionally needed for Psoriatic Arthritis. These may include injections, tendon surgery or, in extreme cases, joint replacement. Outcomes for these procedures are successful.

What Can You Do For Yourself?

Understand Your Condition and How it Affects You

“Knowledge is power”. Educating yourself on the condition will help you manage your inflammation better and empower you to talk to others (Rheumatologist, GP, family etc.) about your situation.

Understanding how your behaviour and activities influence your symptoms can help you reduce the pain and suffering caused by Psoriatic Arthritis. Speaking to a health professional can help you identify aspects of your life that may be aggravating your Psoriatic Arthritis and help address them.

Keep Moving to Pain and Swelling

  • Exercise helps to lessen your pain in the long run by maintaining muscle strength and optimising joint health.
  • Inflammation can lead to muscle weakness and stiffness in your joints. Exercise is vital to prevent this and to keep your joints working correctly.
  • Well-designed activity programs can increase your range of movement, reduce fatigue and help you feel better overall. Appropriate low-impact aerobic activities like hydrotherapy, cycling, Tai chi, pilates and walking can help improve your general health and manage your symptoms.
  • A strength-training program called progressive resistance training (PRT) has improved physical function in rheumatoid conditions.
  • Your physiotherapist is an expert in the assessment and prescription of Psoriatic Arthritis exercises. Would you please ask them what is best for you?

Relaxation Techniques

  • Managing stress and anxiety with muscle relaxation techniques, distraction, guided imagery, and other techniques can help improve your general health and control painful symptoms.
  • Activities such as Tai Chi, Pilates and Yoga are a great way to relax and de-stress while conditioning the muscles and joints in the body.

Aids and Equipment

  • Supports such as walking aids and specialised cooking utensils reduce joint strain and help you manage pain and fatigue. Your therapist can give you advice on aids.

Heat and Ice Therapy

  • Heat – heat works to reduce muscle tension and stimulate blood circulation. You may find that applying something warm before getting up in the morning or during the day helps reduce discomfort and stiffness in your joints.
  • Ice – Ice helps reduce inflammation in muscles and joints by constricting blood vessels and preventing fluids from leaking into surrounding tissues. It would help if you tried icing your joints after any significant activity or at the end of the day.

Activity Pacing

  • Being aware of how your daily habits and activities influence your symptoms is very important. Learning about activity pacing through diaries and activity management strategies can help you achieve what you want, but with less pain or discomfort.

Sleep Health

  • Poor sleep patterns, sleeping environment, and sleeping position can significantly impact your pain and symptoms. Most people are unaware of the factors that can influence sleep health, so addressing these factors can help you manage your symptoms.

Treat Your Muscles

  • A quality remedial massage may be just the relief your muscles need. Treat yourself to a good rub down with someone you trust. The benefits vary from person to person but may include decreased pain and muscle stiffness associated with your arthritis, increased circulation, and an improvement in your sleep and immune functions. Mentally, massage can also decrease stress and depression. Besides all that, massage feels good!

Psoriatic Arthritis Products

Heat packs are often a fantastic way of easing away stiffness and pain associated with Psoriatic Arthritis.

Please attain specific advice from your physiotherapist or doctor.