Get Informed About Psoriatic Arthritis
Psoriatic arthritis is a condition that ranges from mild, occasional flare-ups in some people to more continuous symptoms for others. The condition occurs most often in sufferers of skin psoriasis, a disorder that causes red, scaly patches on the skin. It's estimated that 30 percent of those with skin psoriasis will develop the arthritis associated with the disorder. However, it can occur without psoriasis, especially for those with a family history of the disorder. Like other types of arthritis, psoriatic arthritis is inflammatory and can affect any joint in the body. It is an autoimmune disease and occurs when the immune system erroneously attacks any healthy tissue such as the skin and joints. Research shows that when left untreated, constant inflammation can damage joints severely. Fortunately, treatments are available that most people will find effective for their symptoms.
Causes of Psoriatic Arthritis
Doctors don't know exactly what causes psoriatic arthritis. They believe heredity may play a role since 40 percent have a family member with either psoriasis or arthritis. Psoriatic arthritis may also be caused by an infection such as a streptococcal throat infection that triggers the immune system. Environmental factors may also have a role in the cause. Symptoms can be brought on by infection, injury, or exposure to certain triggers. These triggers are specific and cause symptoms to worsen, or flare up when exposed to them. Common triggers include:
- skin wounds and infections
- cold weather
- severe stress
- heavy use of alcohol
- exposure to cigarette smoke
- certain medications, prescribed or over the counter
It's important to identify what triggers symptoms. This can be done by keeping a journal to record what happened just before the flare-up.
Signs and Symptoms of Psoriatic Arthritis
Symptoms most often appear in adults aged 30 to 50, but they can also begin in childhood. Arthritic symptoms may or may not appear before skin psoriasis. There's no difference in risk between men and women. The disorder affects the large joints mainly in the lower extremities, finger and toe joints, and in the back and pelvis. One joint or multiple joints may be affected. Fingers and toes may look like sausages. Children can develop uveitis, an inflammation of the eye's middle layer. If pain and stiffness occur in the spine, it's known as spondylitis. There may also be tender spots in ligaments and tendons. Called enthesitis, it may result in pain in the heels, the soles of the feet, or around elbows.
Treatment of Psoriatic Arthritis
An early diagnosis is important to prevent joint damage. A rheumatologist will look for painful, swollen joints and patterns of arthritis. They will make note of any skin or nail changes associated with psoriasis. X-rays may be taken to determine the extent of joint damage. An MRI, ultrasound, or CT scan can detect the damage in more detail. A blood test will rule out other types of arthritis with like symptoms such as osteoarthritis, rheumatoid arthritis, and gout. A skin biopsy may be done to confirm psoriasis. Treatment will depend on the level of pain, stiffness, and swelling. With mild symptoms that occur as flare ups, non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen are prescribed first. Anti-rheumatic drugs are prescribed when symptoms don't respond to the anti-inflammatories. These drugs include:
- sulfasalazine (Azulfidine)
- cyclosporine (Neoral, Sandimmune )
- methotrexate (Rheumatrex, Trexall,, Rasuvo Otrexup )
- Azathioprine (Imuran) for severe cases
Hydroxychloroquine, an anti-malarial drug is helpful but is usually avoided because it can cause the skin psoriasis to flare. Biologic types of drugs are available for treatment by injection or infusion. Certain TNF Inhibitors can help both skin and arthritic psoriasis. They include adalimumab (Humira), golimumab (Simponi), certolizumab (Cimzia) etanercept (Enbrel), and infliximab (Remicade). Corticosteroid injections can relieve swollen joints. Arthritis creams are available that can relieve joint pain when applied topically. They tend to work best on the knees and joints in the hand. Pain-relieving ingredients in these creams include salicylates, counterirritants, and capsaicin. Doctors advise patients to exercise to keep the joints flexible. Walking, swimming, yoga, and stretches can help.
No information on this website should be used to start the use of dietary supplements and vitamins, natural and herbal products, homeopathic medicine and other mentioned products prior to a consultation with a physician or certified healthcare provider.