Many people have heard the term “arthritis” used in a general sense but are less familiar with psoriatic arthritis. This type of arthritis impacts the skin and joint tissues and continues to progress over time, with waxing and waning periods of inflammation and remission. [1]
Psoriatic arthritis can impact all parts of the body and may vary in intensity from mild to severe. It can impact just one or both sides of the body. This disease has several potential causes, but genetics tend to play a strong role. Individuals with family members who have psoriasis or psoriatic arthritis are at greater risk of getting the disease compared to those without this family history. [2]
Additionally, psoriatic arthritis can be caused by the body’s immune response to an infection in which the immune system attacks the body. This is more likely to occur in people who have a genetic predisposition to the disease compared to those who don’t. [2]
How do you know if you have psoriatic arthritis? It is important to monitor any symptoms you are experiencing that could be related to the disease, and your doctor can perform a series of tests to help rule out other possibilities. [2]
Symptoms of Psoriatic Arthritis
While each person’s experience will likely be different, there are overarching symptoms associated with psoriatic arthritis that are important to discuss with your medical provider. These symptoms can vary in terms of severity over time. Some typical symptoms include:
- Issues with joints and tendons—While this can occur anywhere within the body, it is common to have pain in the ankle, knee, finger, toe, and back areas. These body parts may feel “warm” and are often most painful when you first get up.
- Swelling—Almost half of the individuals diagnosed with psoriatic arthritis experience swelling of the fingers and toes. This is a result of tendon inflammation and can make the hands and feet look much bigger than their typical sizes.
- Nail damage—This can occur with both fingernails and toenails. Individuals with psoriatic arthritis can experience dislodgment of the nail from the nail bed and may notice changes in the coloring of the nails.
- Exhaustion—Since psoriatic arthritis is an inflammatory disease, it often comes with the common symptom of fatigue. Individuals with this disease may feel like they have the flu, even when they are not fighting a new illness.
- Eye/vision issues—People with psoriatic arthritis may experience changes in their vision or inflammation of the eye and surrounding areas as a result of the disease.
- Pain in lower back— This pain is related to inflammation of joints near the spinal area and the pelvis (hip area). [1-2]
Additionally, some patients with psoriatic arthritis notice pain in the chest or difficulty breathing, though this is less common than the other symptoms mentioned above. Overall, the most prominent symptoms include joint pain, stiffness, and swelling. [1-2]
Risk Factors for Developing Psoriatic Arthritis
As noted previously, genetics are frequently a factor in getting psoriatic arthritis. Having a family history of the disease will unfortunately place you at a greater risk of developing it as well. There are also instances in which people with genetic predisposition have gotten the disease through their immune responses to outside diseases. [1]
Furthermore, individuals who have a psoriasis diagnosis are also at significantly increased risk of getting the disease. Psoriasis is a condition that impacts the skin, and it is often observed prior to symptoms of psoriatic arthritis. In fact, psoriasis is the most significant risk factor in getting psoriatic arthritis. [2]
Age also plays a role in the development of the disease. A majority of patients with psoriatic arthritis are diagnosed between the ages of 30 and 50; however, it is important to note that people who fall outside of this age group can also get the disease. [2]
Diagnosing Psoriatic Arthritis
Psoriatic arthritis can be challenging to diagnose, as there is not a single assessment utilized for diagnosing the disease. This is one of the reasons why it is important to keep a record of your symptoms so that your physician can examine you and order the appropriate diagnostics. In many cases, it takes ruling out other possible etiologies of your symptoms in order to diagnose psoriatic arthritis. [2]
At your appointment, your doctor will likely take a look at your hands, feet, and potentially other parts of your body, assessing for any changes in fingernail presentation as well as signs of swelling or increased sensitivity to touch. [2]
Additionally, your doctor may order imaging to assess the joints and tissues of your body either in the form of an X-ray or magnetic resonance imaging (MRI). The X-ray examines joint changes that are consistent with psoriatic arthritis, while the MRI provides refined imaging of hard and soft tissues, thus making it an effective tool for examining tendons and ligaments. [2]
Other assessments may include drawing blood or fluid from the body. For example, you may be asked for blood to assess for rheumatoid factor, which is an antibody that is linked to people with rheumatoid arthritis. This antibody is generally not associated with psoriatic arthritis, which is helpful for narrowing down your diagnosis. Additionally, a joint fluid test may be utilized to assess for gout versus psoriatic arthritis. [2]
Treating the Disease
Unfortunately, there is not a cure for psoriatic arthritis currently, but there are interventions that can be implemented to help slow the progression and reduce pain by easing inflammation. [1-2]
Patients with this disease are often treated with oral medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). While NSAIDs (such as ibuprofen) help with pain, DMARDs are medications that help to reduce the rate of progression of the disease. [2]
Additionally, your doctor may recommend several types of therapy to address your symptoms, including physical therapy, occupational therapy, massage therapy, and light therapy (using UV lights). For very severe cases, some patients may be recommended to undergo surgery to replace a joint. [1-2]
Living with Psoriatic Arthritis
Although a diagnosis of psoriatic arthritis may not be ideal, there are ways to manage the disease and lifestyle factors that can be modified to help reduce inflammation. For example, diet modifications to reduce inflammatory foods (such as refined sugar, dairy, and red meat) may help with discomfort. Some foods that help to reduce inflammation are fruits, vegetables, fish, olive oil, pumpkin seeds, and flaxseeds. [1]
Another way to help decrease inflammation is to be sure you are exercising regularly. This can help improve your strength and flexibility, both of which are important for maintaining healthy joints. Keeping a healthy weight is also important for reducing the impact of weight of the body on the joints and for improving overall energy. [1-2]
As always, it is important to be kind to yourself and to listen to your body. Take rest breaks as needed and pace yourself throughout the day to help improve your energy levels. Remember that psoriatic arthritis can be managed effectively and that patients with this disease can still live fulfilling lives. [2]
References:
[1] https://www.activebeat.com/your-health/7-common-symptoms-of-psoriatic-arthritis/
[2] https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076