Psoriatic arthritis (PsA) is a type of arthritis that causes swelling, stiffness, and pain in and around the joints. It usually affects about 30 percent of people who already have psoriasis, a skin condition that causes a red, flaky rash that can become itchy or sore.
Like psoriasis, PsA is a chronic condition that could get worse over time if you don’t receive the proper treatment. To get the best care for PsA, you should see a rheumatologist, a doctor who specializes in joint, muscle, and bone disorders.
Here are seven questions about PsA treatment that you can ask your doctor at your next visit.
Unfortunately, there’s no cure for PsA. Treatment will usually focus on reducing swelling, stiffness, and pain. This can prevent further damage in the joints, and improve your ability to do everyday tasks.
This normally includes a combination of medication, gentle exercise, and physical or occupational therapy.
Medications used to treat PsA include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications relieve pain and reduce swelling. Some are available over-the-counter, such as aspirin and ibuprofen, while stronger drugs are available by prescription.
- Corticosteroids. These can be taken as a tablet or injected into the joints to help reduce pain and swelling.
- Disease-modifying anti-rheumatic drugs (DMARDs). These can ease symptoms and slow down the progression of damage in the joints.
- Biologic drug therapies. Biologics target specific areas of the immune system affected by PsA.
If you have moderate to severe PsA, your doctor is likely to suggest DMARDs or biologics. DMARDs tackle the underlying causes of swelling in joints by suppressing chemicals that cause inflammation.
Biologics are protein-based drugs given by injection or intravenous infusion. Biologics work by blocking particular cells and proteins from triggering your immune system to attack your joints.
These treatments are generally considered safe, but some people may experience side effects such as liver damage and severe infections. See your doctor for regular blood tests and alert them if you develop symptoms of an infection, such as a fever or sore throat.
Your doctor will recommend treatments based on the severity of your PsA, your symptoms, and how you react to the medications.
If you have mild PsA, your rheumatologist will likely prescribe NSAIDs to see if they help ease your pain and reduce inflammation.
If this isn’t enough on its own, your doctor can recommend other drugs such as corticosteroids and DMARDs. Biologics may be prescribed if your PsA hasn’t responded to at least two different types of DMARDs.
If you’re not responding to a specific treatment, your doctor will either adjust the dose or change the drug. Some medications such as DMARDs and biologics can take weeks to work. It’s important to keep taking them, unless you’ve been advised to stop.
If the medication stops working, your rheumatologist may suggest taking you off that drug, swapping to alternative treatments, or trying a different combination of medications.
Even if your symptoms go away, your doctor will usually recommend that you continue to take your medication. In one study, researchers discovered that more than two-thirds of participants experienced a recurrence of PsA within six months after stopping their medication.
Since treatment plans are individualized, if remission occurs, your doctor may recommend you step down your medication to the lowest dose needed.
While the medications may relieve your symptoms, they won’t cure the condition. It’s also possible that damage in your joints that may not have been diagnosed earlier will continue to worsen if you stop taking your medication. The goal of treatment with medication is to block ongoing inflammation and minimize the progression of joint damage.
Surgery may be an option if your joints have been badly damaged. Aside from reducing pain, surgery could improve mobility and the appearance of deformed joints.
Like other surgical procedures, joint replacement surgeries require longer recovery times and have risks.
Aside from medication, there are various self-care strategies you can try to manage your PsA.
- Diet. An anti-inflammatory diet and trials off dairy or gluten may be potentially helpful.
- Exercise. Regular exercise can help prevent stiffness and strengthen your muscles. Your doctor can help you figure out types of exercises to try based on the severity of your symptoms. Since PsA can make you feel unusually tired, take breaks when needed.
- Lose weight. If you’re overweight, excess weight can put added stress on your joints. This can lead to pain and reduce mobility.
- Limit alcohol. Alcohol can react with certain medications or increase the side effects of some drugs. Check with your doctor if it’s safe to drink alcohol.
- Reduce stress. Take up stress-reducing activities such as meditation, yoga, or tai chi. Excess stress can cause flare-ups and worsen your symptoms.
- Quit smoking. Smoking can trigger inflammation and worsen PsA. Talk with your doctor if you need help to quit smoking.
With a regularly monitored treatment plan and self-care approaches, you can manage your PsA symptoms and boost your quality of life. Bring these questions up to your doctor if you have questions about your treatment options or don’t think your treatment is working. They can recommend switching medications or incorporating exercise and other activities for stress relief into your daily routine.