Psoriatic arthritis is a type of inflammatory arthritis that affects some people with psoriasis. In people with psoriasis, the immune system attacks healthy tissues, causing an overproduction of skin cells. Psoriatic arthritis happens when the immune response also causes joint inflammation.
Like psoriasis, psoriatic arthritis is a chronic condition with no cure. It can worsen over time, but you may also have periods of remission where you don’t have any symptoms.
Read on to learn more about the different stages of psoriatic arthritis and how they progress.
In most cases, psoriatic arthritis begins years after the initial presentation of psoriasis symptoms. Psoriasis symptoms include flare-ups of itchy, red, scaly skin.
If you have psoriasis, several things can make you more likely to develop psoriatic arthritis. These risk factors include:
- having psoriasis on your fingernails
- having a family history of psoriatic arthritis
- being between the ages of 30 and 50
- having scalp psoriasis
Like other types of arthritis, psoriatic arthritis often starts with pain and swelling in one or more of your joints. It tends to begin in the smaller joints, such as those in the fingers and toes. But you might also first notice it in larger joints, such as your knees or ankles.
You may also notice swelling in your fingers or toes. This swelling can affect the entire toe or finger, not just the joint.
Psoriatic arthritis progresses differently for every person who has it. Without treatment, it often begins to affect more joints. It may affect the same joints on both sides of the body. But in rare cases, some people experience complete remission even without treatment.
As it progresses, you might have periodic flare-ups of symptoms.
Untreated, psoriatic arthritis can cause permanent damage to your bones. Extended periods of inflammation also cause the affected bones to erode. The joint space may also begin to narrow, making it harder to move.
As it progresses, psoriatic arthritis can start to have more of an impact on your daily life. About 50 percent of people with psoriatic arthritis complain of moderate-to-severe fatigue, and nearly 30 percent complain of severe fatigue.
This combination of fatigue, joint pain, and psoriasis symptoms can become isolating for some people, leading to high levels of depression among those with psoriatic arthritis. They can also make it hard to work or maintain an active social life.
While there’s no way to reverse or cure psoriatic arthritis, there are several things you can do to slow its development. These tend to work best when started earlier rather than later. You may want to consider seeing a rheumatologist as well. This is a type of doctor that focuses on autoimmune conditions.
The first step in slowing down psoriatic arthritis is controlling joint inflammation. There are several types of medication that can help with this, including:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), are a good starting place because they’re available over the counter. They help reduce inflammation and pain.
- Cortisone injections. Cortisone injections target inflammation in a single joint. They work quickly to reduce pain and swelling.
- Disease-modifying antirheumatic drugs (DMARDs). DMARDs, such as methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine), work to slow the progression of psoriatic arthritis. While this can help to prevent permanent joint damage, these drugs have many potential side effects.
- Biologic agents. Biologics are a new generation of arthritis medications that use genetic engineering to target inflammation in the body. They can slow down the progression of psoriatic arthritis and prevent joint damage.
If you have psoriatic arthritis, it’s also important to avoid putting added stress on your joints. This can involve:
- Weight loss. Carrying extra weight puts additional stress on your joints.
- Exercise. Low-impact exercise can help you lose weight (if you need to), improve your heart health, strengthen your muscles, and increase your range of motion. Good low-impact exercises include biking, swimming, and yoga.
- Hot and cold therapy. Applying a heating pad to tense muscles helps them relax, which reduces strain on your joints. You can also apply an ice pack to inflamed joints to help reduce pain and swelling. Just make sure to wrap it in a towel or cloth before applying it to your skin.
In the early stages of psoriatic arthritis, you might just notice occasional joint pain. But over time, you might notice swelling, fatigue, and other symptoms.
There is no cure for psoriatic arthritis, but there are ways to manage it effectively. A combination of medication and lifestyle changes can help you slow down its progression and avoid permanent joint damage.