A diagnosis of psoriatic arthritis (PsA) can be life changing. You likely have many questions about what it means to live with PsA and how to best treat it.
Here are some questions you may be asking yourself, along with their answers. Hopefully, the following information can help you better understand treatment, lifestyle modifications, and more related to PsA.
PsA is a chronic condition that affects your joints. Currently, there is no cure.
Still, it’s essential to get treatment to avoid deterioration in your joints. Ignoring symptoms and delaying medical treatment could cause serious damage to your body in the long run. There are many treatments available to slow the progression of the condition and avoid severe joint damage.
Some people experience remission, meaning they have no symptoms of PsA.
PsA can affect any joint in your body, including large joints like your knees and shoulders and smaller joints in your fingers and toes. You may even experience symptoms in your spine.
You can experience inflammation in one joint at a time, a few at a time, or many all at once. PsA can also cause inflammation in parts of your body that connect to your bones like tendons and ligaments. This inflammation is called enthesitis.
You may be at greater risk of developing another health condition if you have PsA.
There are several additional conditions that can occur if you have PsA, including:
- anemia
- cardiovascular disease
- depression
- diabetes
- fatigue
- high blood pressure
- high cholesterol
- metabolic syndrome
- metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD)
- obesity
- osteoporosis
Discuss the risks of these conditions with your doctor. You may need to adjust your lifestyle to reduce the risk of developing these other conditions.
Treating PsA often involves different medications and lifestyle modifications. You’ll need to work with your doctor to determine the best treatment plan for you and your symptoms. PsA treatment can involve a combination of treatment methods.
Some of the goals of treating your PsA are to:
- reduce pain, stiffness, and swelling of your joints
- target other symptoms of PsA
- stop or slow the progression of PsA
- maintain mobility in your joints
- avoid or reduce potential complications from PsA
- improve your quality of life
Factors that may affect treatment include the severity of your PsA, the damage it has done to your body, previous treatments, and whether you have any other medical conditions.
A new concept for treating PsA is identified as the “treat to target” approach, where the end goal is remission of PsA.
When you discuss treatment options with your doctor, consider the following questions:
- What does the treatment do?
- How often will I need to take or undergo this treatment?
- Do I need to avoid anything when trying this treatment or taking this medication?
- Are there side effects and risks of the treatment?
- How long does it take to notice the effects of the treatment?
- Does my insurance cover my medication(s)?
Talking with your doctor regularly about your treatment helps make sure your plan is effective for your current situation. You may need to adjust treatments as needed based on your symptoms and lifestyle.
Addressing pain may be a priority for you. The inflammation surrounding your joints can be uncomfortable. This can also affect your mental well-being and overall quality of life.
Your doctor may recommend using nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin as a first-line treatment for pain caused by PsA. More severe pain or pain that does not diminish by using these treatments may require more intense medications. For example, biologics are given intravenously or by injection.
If your pain does not respond to these methods, your doctor may recommend medications that help with neurological pain or your sensitivity to pain.
You may also want to try other methods of pain relief and relaxation techniques. These may include meditation, acupuncture, or yoga.
Treating PsA early can help you avoid more invasive treatments like surgery.
Surgery may help ease discomfort, improve function, and repair damaged joints. In rare cases, your doctor may recommend surgery to repair damage to your tendons or even to replace a joint.
Managing PsA will require regular visits to your doctor. They will likely want you to come in every few months or a few times a year to monitor your PsA. The number of times you see your doctor varies depending on the severity of your condition and the specific medications you’re taking, as medications have different monitoring schedules.
Regular visits to the doctor may include:
- a physical exam
- a discussion about your current treatment
- blood tests to measure inflammation
- X-rays, MRIs, or ultrasounds to observe changes to your joints
Other specialists you may need to see include the following:
- cardiologist
- rheumatologist
- physical therapist
- occupational therapist
- dermatologist
- psychologist
- ophthalmologist
- gastroenterologist
Your medical team can prescribe treatment for all aspects of your PsA, including symptoms related to psoriasis and other conditions that may occur at the same time (comorbidity). They can also provide treatment and resources to support your mental health.
Treating PsA can involve more than medication and surgery. Making lifestyle modifications may help ease symptoms and even delay progression of the condition.
Here are a few changes you can make to manage your PsA:
- maintaining a moderate weight
- staying physically active, such as exercising regularly, per your doctor’s instructions
- following an anti-inflammatory diet
- resting when needed
- managing your stress levels
- stopping smoking if you smoke
- monitoring your symptoms to identify and avoid behaviors that aggravate or trigger symptoms
With PsA, staying organized is important in helping you keep track of your appointments and medications.
You may think you should only rest when you have stiffness and pain in your joints. But staying active, such as regularly exercising, can minimize pain and help you move around. It can also help manage your stress levels, support your mental outlook, and decrease your risk of developing a comorbid health condition.
Your doctor or a physical therapist can recommend proper ways to exercise if you have PsA. Low impact physical activity like walking, bicycling, or swimming may be best for you. You may also find that yoga or lightweight strength training is appropriate for you.
If needed, your doctor can recommend exercise equipment or adjustments to accommodate your PsA symptoms.
Your diet can play a role in your PsA symptoms. Changing what you eat will not treat PsA itself, but it may help reduce the severity of your symptoms.
Maintaining a moderate weight is important in managing your PsA.
A
The study also mentioned that other dietary interventions such as taking vitamin D supplements and following a gluten-free eating plan may have positive effects on PsA symptoms, but results vary depending on individual situations.
You may not need to cut out wheat or other forms of gluten if you do not have celiac disease or gluten sensitivity. You may want to consider trying an elimination diet or keeping a food diary to see if there is a difference in any inflammatory symptoms such as joint pain. Wheat and dairy are often assessed.
If you’re considering a reduced-calorie diet, you can begin by reducing unnecessary carbohydrates and practicing portion control. Regular exercise can also help you lose weight and is a good complement to a weight loss dietary plan.
Always talk with your medical team before changing or adding to your treatment plan.
You should be able to resume work activities after a PsA diagnosis. But you may want to request and make adjustments at work to help manage your symptoms.
You can discuss your modification needs with your manager. For example, you may need to adjust your work schedule to attend doctor’s appointments or use assistive devices to help you work.
Scheduling regular breaks can help minimize joint pain and stiffness.
After your PsA diagnosis, you likely have many questions about your future.
Talk with your doctor and learn as much as you can on your own about treatments, lifestyle changes, and symptom management. Becoming knowledgeable about PsA is the first step to living a healthy and happy life while managing your condition.
Resources: