Psoriatic arthritis, or PsA, occurs in approximately 30 percent of people living with psoriasis, according to the Arthritis Foundation. The condition can’t be cured, but it should be actively managed to help reduce joint damage and improve quality of life. Your doctor may recommend a host of medications, alternative therapies, or lifestyle changes to reduce your PsA symptoms.
But PsA doesn’t present the same way in every person who has it, so treatment plans will also vary. It may also take a while for you to find the right treatment plan. It’s important to be aware of the signs that your current PsA treatment is falling short of expectations. Discuss your concerns with your doctor if your symptoms don’t get better. An action plan to treat PsA should consider both your current and future health and well-being.
Consider these four factors when trying to determine if your PsA treatment plan is working for you:
1. Joint pain
PsA treatments are designed to reduce inflammation. When done effectively, most people experience less pain in the joints and enjoy greater mobility. If you’re still experiencing PsA-related joint pain despite your treatment, speak to your doctor.
You may need to simply adjust the dose of your medication or modify your lifestyle. But ongoing joint pain is a potential sign that your PsA is not well-controlled. This can have irreversible effects on your joints. Talk to your doctor about progressing to a more advanced medication or taking on other appropriate lifestyle changes to feel better.
2. Continued fatigue
Overall fatigue is a sign of PsA. If this was one of your original symptoms, you should expect your energy levels to rise with a new medication. When treatment begins, the morning tiredness, stiffness in the body, and general lethargy should improve.
If you are still tired even after beginning a treatment plan, you may want to discuss an alternative treatment plan with your physician. Some medications have side effects, so be sure to ask your doctor to determine whether poorly controlled PsA is the cause of your fatigue, rather than the drugs. Your doctor can tell you if the new drug may be making you tired.
3. Reduced range of motion
Inflammation affects the joints. This prevents unrestricted movement in the extremities and other areas of the body. For some people living with PsA, inflammatory back pain is an ongoing issue. Inflammatory back pain is often characterized by being worse in the morning.
Most people should find it easier to move after a reasonable amount of time on a new treatment plan. If you are not satisfied with your body’s ability to move freely, discuss your mobility issues with your doctor.
4. Your ‘treat to target’ goal
In 2016, the National Psoriasis Foundation published a “treat to target” strategy in Journal of the American Academy of Dermatology. The idea was to help people who have psoriasis and their doctors achieve treatment goals through an established action plan.
The goal is to reduce plaque psoriasis throughout a patient’s body. The target is for less than 1 percent of the body’s surface area to have active psoriasis within three months of starting treatment. If you have psoriasis and PsA, but aren’t meeting “treat to target” goals, it can also be an indication of poorly managed PsA. Some medications that treat psoriasis can also reduce the severity of PsA.
Why is treatment important?
When left untreated, PsA can cause damage to the joints. This damage can’t be reversed. Many people go several years without knowing they have early signs of PsA. During this period, joint health may decline. The results can be persistent pain, along with chronic inflammation that ultimately leads to joint damage. It may also lead to disability due to a lack of mobility.
Successful treatment often results in PsA remission. Most doctors advise to continue taking your medications at this stage. Even if you’re in remission and feel fine, most people experience a new flare-up weeks or months after they stop taking their medication. However, if you’re in remission, doses of medication can generally be decreased. This maintains the benefit of the medication, while potentially reducing risks and side effects. As with any stage of PsA treatment, it’s important to continue the conversation with your doctor.
Through a combination of medication and lifestyle changes, people living with PsA have more options than ever before to treat and manage symptoms. As an active participant in your treatment, you can partner with your doctor to find out what works for you and be on your way to better health.