Some people who have psoriasis — a skin condition with red, itchy, scaly patches — develop a form of arthritis called psoriatic arthritis. This condition is characterized by red skin patches topped with silvery scales. According to the Mayo Clinic, most people who develop psoriatic arthritis are diagnosed with psoriasis first.
Not everyone with psoriatic arthritis has the same experience. However, just about everyone has flare-ups. Flare-ups are when symptoms are worse than usual. During flare-ups, some days you feel better than others. According to the American College of Rheumatology, some people only have occasional flare-ups. Other people have chronic pain flare-ups, which can damage joints if left untreated.
The main symptoms of psoriatic arthritis include:
- swelling of toes and fingers
- foot pain, especially in the sole of the foot and the back of the heel
- lower back pain
- joint pain
Joints can become swollen, warm to the touch, and painful. The impact of these symptoms ranges from mild to severe. They can affect joints on both sides of your body or just one side.
Every person has their own unique experience with psoriatic arthritis flare-ups. Something may cause a flare-up in one person but not in another. That’s why it’s important to track and log the triggers that set off your symptoms. Show the log to your doctor. Finding a link or pattern between certain activities and your psoriasis flare-ups can help control your outbreaks.
Common psoriatic arthritis triggers include the following.
Skin trauma or injury: This might include cuts, bumps, bruises, scratches, scrapes, or infections. Prevent injuries by being careful when cooking, gardening, nail trimming, and shaving. Wear gloves and long sleeves when doing an activity that could potentially cause injury.
Dry skin: Dry skin can cause a flare-up. Aim to keep skin hydrated with moisturizing lotions and creams.
Sunburn: While sunshine is good for psoriasis, getting sunburned is not. Always carry a hat and sunscreen.
Stress: Relaxation and stress reduction tactics such as yoga and meditation can alleviate stress and anxiety. Consider joining a psoriasis support group.
Alcohol: In addition to potentially causing flare-ups, alcohol can interfere with the effectiveness of certain medications.
Climate: Cold, dry weather that sucks the moisture out of your skin can worsen symptoms. Drying heat units also strip moisture from your skin. Additionally, the season’s lack of sunlight can trigger flare-ups (sunshine may improve psoriasis). Minimize your time spent in the cold and use a humidifier at home to add moisture to the air.
Certain medications: Drugs that can worsen psoriasis include antimalarial drugs, certain beta blockers that treat high blood pressure and some heart conditions, and lithium, which is prescribed for some psychiatric disorders. These medications get in the way of your body’s autoimmune response and can cause a flare-up. If you take these medications, find out if they can be substituted. Always let your healthcare providers know that you have psoriasis before starting any new medications.
Excess weight: Extra pounds can stress joints. Additionally, psoriasis plaques can develop in skin folds. People with psoriasis are at a higher risk of cardiovascular disease, which can be triggered by an unhealthy weight. Talk with your doctor about a diet and exercise plan.
Smoking: Quitting might help clear your skin (and it’s good for your overall health anyway).
Gluten: Research has found that this protein, which is found in some grains including rye, wheat, and barley, can aggravate psoriasis symptoms.
Common infections: Thrush, strep throat, and upper respiratory infections are all potential triggers for a flare-up. See a doctor for treatment if you think you have one of these health conditions.
Psoriatic arthritis flare-ups are unpredictable. You can feel fine one day yet experience a flare-up the next. Some people have short flare-ups while others have seemingly never-ending ones. The length of a psoriatic arthritis flare-up varies from person to person.
Treatment depends on how much pain you are in. You may only need treatment during flare-ups and when you have symptoms. If this is the case, you may be able to stop treatment when your flare-ups subside and your symptoms are less active. Medical treatment for psoriatic arthritis includes the following.
Immunosuppressants can help rein in your overactive immune system.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can lower inflammation and reduce pain.
Tumor necrosis factor-alpha (TNF-alpha) inhibitors decrease the molecule tumor necrosis factor, which initiates inflammation in the body and leads to morning stiffness, swollen or tender joints, and pain.
Disease-modifying antirheumatic drugs (DMARDs) can slow the progression of psoriatic arthritis.
Steroids may be injected into an affected joint to quickly reduce inflammation.
Joint replacement surgery repairs or replaces severely damaged joints with artificial ones made of plastic and metal.
Making lifestyle changes can prevent and control flares as well as alleviate the muscle weakness and joint stiffness associated with psoriatic arthritis. Lifestyle remedies include the following:
- Use assistive devices during flare-ups. Immobilize certain body parts with the use of splints, braces, orthotics, crutches, or walkers so they can rest.
- Exercise can keep joints flexible, strengthen your muscles, and boost your overall health. Walking, biking, swimming, and yoga are just a few exercises that won’t stress your joints.
- Protect your joints by modifying how you perform daily tasks. For example, use a jar opener to remove a lid.
- Apply hot and cold packs. The heat and cold can help lessen the pain sensation.
- Keep your weight at a healthy level. Your joints will have less strain on them as a result.
Psoriatic arthritis can’t be cured, and the flare-ups can be painful enough to interfere with your day-to-day life. However, you can lessen their impact by proactively controlling your symptoms and the inflammation.