Janice was feeling a little off. Her psoriasis was flaring up again, but this time was different.
She felt exhausted. Her elbows hurt and when she looked at her throbbing fingers, they reminded her of breakfast sausages. The pain made it hard to type, cook, or fold laundry.
Janice was suffering from the onset of psoriatic arthritis.
Psoriatic arthritis is a painful autoimmune disease that affects the joints. It is often accompanied by a painful skin rash called psoriasis.
The autoimmune condition can also cause:
• Morning stiffness
• Finger or toenail changes, like a fungal infection
• Red and painful eyes
During a psoriatic flare-up, the body’s immune system attacks healthy cells. When the attack involves skin cells, the result is a red, painful rash with silver-looking scales. These same flare-ups can also trigger inflammation in the joints.
What are the symptoms of psoriatic arthritis?
The symptoms of psoriatic arthritis are like other types of arthritis:
• Mild to severe joint pain
• Joint stiffness
• Loss of motion
• Joints, warm and tender to the touch
Psoriatic arthritis can affect every joint in the body.
When psoriatic arthritis attacks the joints in the fingers and toes, they take on a sausage-like appearance. In severe and rare cases, psoriatic arthritis leads to arthritic mutilans, a disabling disorder that destroys the small bones in the hand and fingers, causing deformities in the hand.
Spinal inflammation caused by the psoriatic autoimmune response can cause spondylitis and lead to neck or back pain.
When psoriasis attacks the sacral joint between the spine and the pelvis, it can cause sacroiliitis.
Psoriasis also can impact the connective tissues of the tendons and ligaments in the feet and lower legs, resulting in Achilles tendonitis or plantar fasciitis.
Joint pain and swelling experienced with abnormalities in your fingernails, or tenderness in the soles of your feet or near the heels, may indicate psoriatic arthritis.
Diagnosing and treating psoriatic arthritis when symptoms first occur can help relieve pain and prevent progression.
Don’t ignore joint pain; it’s the body’s warning sign. If you experience pain, make an appointment to see an orthopedic specialist.
How is psoriatic arthritis diagnosed?
Like many autoimmune conditions, there’s no conclusive diagnosis for psoriatic arthritis. It’s often diagnosed through a process of elimination when tests for similar conditions have negative results.
During the diagnosis phase, your healthcare provider may use X-rays, MRIs, and joint-fluid tests to rule out other conditions such as rheumatoid or osteoarthritis.
If these tests do not show another condition and psoriatic symptoms are present, treatment can begin.
How is psoriatic arthritis treated?
Unfortunately, there’s no cure for psoriatic arthritis.
But you and your health care provider can design a treatment plan to prevent further joint damage by lengthening the time between flare-ups.
Treatment may include medications, such as
• Nonsteroidal anti-inflammatory drugs (NSAIDs), to decrease inflammation
• Disease-modifying antirheumatic drugs (DMARDs), to slow the progression
• Immunosuppressants, to manage your body’s immune response
• TNF alpha inhibitors, which mimic the body’s natural reaction to pain and swelling
• Steroid injections
If pain is severe, joint replacement surgery may be an option.
Are you at risk for psoriatic arthritis?
Your risk of psoriatic arthritis may be higher if you have one or more of the following factors.
• You were diagnosed with psoriasis.
• One of your family members has been diagnosed with psoriasis.
• You experienced significant physical trauma or a severe viral or bacterial infection.
• You’re between 30 and 50 years old.
What are some things you can do to care for yourself?
If you suffer from psoriatic arthritis, take it easy on your joints.
Some simple—and some not-so-easy—lifestyle changes can help you relieve symptoms.
In your home
• Avoid straining your joints. Place things you use every day in convenient easy-to-reach locations.
• If psoriatic arthritis affects your hands, make life in your kitchen a little easier.
o Use jar openers
o Use grips for picking up things
o Cook with utensils that have oversized handles
o Prepare vegetables in a food processor
o Purchase pre-chopped veggies
• There are devices that can help you in other areas of your home, too.
o Use a dressing stick
o Purchase touch lights
o Use voice-controlled remotes or voice-activated online assistant devices.
• Secure throw rugs or remove them to reduce your risk of falling.
• Install railings and grab bars in bathrooms, along walkways, and steps.
• Install raised toilet seats.
In your daily life
• Maintain a healthy weight.
• Exercise regularly to help lubricate your joints. See a physical therapist who can give you exercises that are best for your condition.
• Pace yourself during flare-ups to help reduce the negative impact of the symptoms.
• Keep a health-and-food journal. Over time, the relationship between life events, foods, stress, and flare-ups will become apparent. Don’t forget to include environmental or other health conditions such as infections, wounds, stress, cold weather, heavy-alcohol use, or medications in your journal for a complete picture.
• Watch what you eat. Seeds, fish, and other foods rich in omega-3 fatty acids along with fresh turmeric and garlic can help prevent or curb inflammation.
• Be aware of foods that trigger the autoimmune response. Some common culprits are red meat, dairy, sugar, gluten, processed foods, nightshade vegetables such as eggplant and tomatoes, and alcohol. Some triggers will be immediate; others may take a few days or a week.
• Don’t smoke.
• Don’t drink alcohol.
• Practice meditation to reduce stress.
• Avoid high heels and constricting clothing.
• Practice good sleep habits. Aim for 7 to 8 hours of sleep each night.
• Psoriatic arthritis may affect your sleep, especially during a flare-up. Clear your sleeping area of distractions, shut off the television and hand-held electronic devices. Check your mattress to make sure it is giving you comfortable support.
• Buy a programmable thermostat. People sleep better in cooler environments. But the same temperature that helps you sleep can make your joints feel stiff. A programmable thermostat allows you to increase the temperature a few degrees an hour or so before you get out of bed. The warmer temperature will make it easier to get moving.
Remember, psoriatic arthritis affects people physically and mentally.
People who suffer from psoriatic arthritis also report feelings of anxiety and are twice as likely to experience depression. Many withdraw from social situations during flare-ups.
Sometimes, people feel out of control because of the unpredictability of their condition.
The National Psoriatic Foundation offers a free eKit that includes an eBook and a flare tracker to help you monitor and understand your triggers.