Psoriatic arthritis is a painful type of arthritis that leads to joint pain, swelling, and stiffness.
If you have psoriasis, it’s possible that you may also develop psoriatic arthritis. Around 30 percent of people with psoriasis develop psoriatic arthritis.
If you have this condition, treating it early on can be the key to helping soothe pain and prevent joint damage down the road.
There are several types of drugs that can effectively treat psoriatic arthritis. Certain over-the-counter (OTC) medications, such as ibuprofen, may help reduce your symptoms.
If OTC drugs don’t help your joint pain and swelling, your doctor may need to prescribe stronger medications. These include:
- traditional disease-modifying antirheumatic drugs (DMARDs)
- enzyme inhibitors
Nonsteroidal anti-inflammatory drugs
One of the first treatments that your doctor may recommend is an OTC medication.
A category of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) is commonly used to treat the pain and inflammation that psoriatic arthritis causes.
Some popular OTC NSAIDs are:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve, Anaprox)
NSAIDs are also available in prescription forms that are more potent than OTC versions. Some examples of a prescription NSAIDs that can be used for psoriatic arthritis include:
- celecoxib (Celebrex)
- diclofenac (Arthotec, Voltaren)
- nabumetone (Relafen)
The most common side effect of NSAIDs is digestive problems. These can include things like stomach aches, nausea, and diarrhea.
Your doctor may prescribe a traditional DMARD to help reduce inflammation and slow potential joint damage psoriatic arthritis causes.
These drugs have broad effects on the immune system. They’re also much slower to take effect than NSAIDs and can cause more serious side effects related to the lungs and kidneys.
Some types of traditional DMARDs used to treat psoriatic arthritis include:
- methotrexate (Trexall)
- sulfasalazine (Azulfidine)
- cyclosporine (Neoral, Sandimmune)
- leflunomide (Arava)
These drugs may be used alone or in combination with each other, depending on your doctor’s recommendations.
Immunosuppressants help with immune system suppression for people with psoriatic arthritis.
A frequently used immunosuppressant is azathioprine (Imuran). This drug is used when other traditional drugs don’t work.
Immunosuppressants must be taken with extreme caution under the direction of a doctor because of their risk of side effects.
These drugs can cause:
- liver and kidney dysfunction
They are generally only prescribed for very serious cases of psoriatic arthritis.
Biologics are a newer type of DMARD. They work to target specific parts of your immune system that are causing the inflammation and joint damage associated with psoriatic arthritis.
There are several different classes of biologic. These classifications are made based off of the specific part of the immune system that the biologic targets.
Some biologics that may be used to treat psoriatic arthritis include:
- tumor necrosis factor (TNF) alpha inhibitors, such as:
- adalimumab (Humira)
- certolizumab pegol (Cimzia)
- etanercept (Enbrel)
- golimumab (Simponi, Simponi Aria)
- infliximab (Remicade)
- interleukin (IL) 12 and 23 inhibitors like ustekinumab (Stelara)
- IL-17 inhibitors, including:
- ixekizumab (Taltz)
- secukinumab (Cosentyx)
- IL-23 inhibitors, such like guselkumab (Tremfya)
- T-cell inhibitors like abatacept (Orencia)
It’s important to note that biologics not only help with psoriatic arthritis, but they can also treat psoriasis symptoms as well. It’s also possible that you’ll be prescribed a biologic in combination with a traditional DMARD.
Biologics are given as an injection or infusion. The most common side effect is pain or swelling at the injection site.
It’s also possible that biologics can make you more likely to get infections or may affect your kidneys, liver, or blood count.
Some newer prescription medications have recently been approved for the treatment of psoriatic arthritis. These drugs work to inhibit enzymes that are important for an overactive immune response.
These medications have an advantage in that they can be taken orally, as opposed to being given by injection or infusion. There are currently two that are available:
- Tofacitinib (Xeljanz, Xeljanz XR). This drug works to inhibit the activity of an enzyme called a Janus kinase, helping to reduce inflammation. The most common side effects are headache and upper respiratory infections.
- Apremilast (Otezla). This drug blocks an enzyme called phosphodiesterase 4, which is also involved in inflammation. Common side effects include nausea, diarrhea, and upper respiratory infections.
Oral steroids can help reduce pain and inflammation associated with psoriatic arthritis.
However, they’re typically only prescribed in small doses over a short period of time. This is due to the risk of significant side effects that can happen after you stop taking them.
Your doctor may also recommend surgery or another type of treatment for psoriatic arthritis. Some examples include:
Joint replacement surgery
If your joints become severely damaged by psoriatic arthritis, your doctor may recommend joint replacement surgery.
During joint replacement surgery, a prosthetic made from metal or plastic is used to replace the damaged joint.
If pain and inflammation are localized at a specific joint, your doctor may use a steroid injection to alleviate these symptoms.
Relief can last for weeks to months. However, steroid injections can only be given a limited number of times due to the risk of side effects.
Light therapy involves the use of ultraviolet (UV) light.
This light is applied to the outer layers of skin and can help reduce inflammation associated with both psoriatic arthritis and psoriasis. Some examples of the types of light therapy are:
- UVB. UVB light can help to ease inflammation and can also promote the production of vitamin D. UVB therapy is typically given in a special light box, during which you’re exposed to a specific wavelength of UVB light called narrowband UVB.
- Excimer laser. An excimer laser also produces UVB light. It has an advantage over UVB treatment in a light box because the excimer laser can target specific areas and can also penetrate deeper into the skin.
- PUVA. PUVA involves UVA light exposure in combination with the chemical psoralen. Psoralen is a photosensitizing drug, which means it makes your skin more sensitive to UV light. It’s typically used when psoriatic arthritis hasn’t responded to other treatments.
There are several complementary and alternative therapies that may be used for psoriatic arthritis.
These therapies can be used along with (complementary) or in place of (alternative) standard psoriatic arthritis treatments.
Some examples of complementary and alternative therapies for psoriatic arthritis are:
Acupuncture involves the insertion of thin needles into the skin to stimulate certain areas of the body.
According to the National Psoriasis Foundation, although no studies have been done on acupuncture for psoriasis or psoriatic arthritis, it may be effective for some.
Massage involves manipulating the body’s soft tissues, typically using the fingers, hands, or elbows. It can provide relief for some types of pain, such as that from osteoarthritis.
Although evidence to support its use for psoriatic arthritis
Curcumin is the active ingredient in the spice turmeric.
It’s been found that curcumin has
Vitamin D is important in skin health and has anti-inflammatory effects. Because of this, it may be used as a dietary supplement to help with psoriasis or psoriatic arthritis.
Yoga combines different postures with breathing techniques and meditation. It may be an effective tool for helping to ease stress and promote relaxation.
Additionally, yoga can help people with psoriatic arthritis improve flexibility and range of motion while easing pain.
Tai chi is a form of exercise that involves gentle, flowing movements. Like yoga, it’s a low-impact activity that may help to achieve relaxation and alleviate pain for some people with psoriatic arthritis.
Reiki is a type of therapy where a practitioner places their hands on or above you, aiming to direct your body’s internal energy to promote healing.
According to the
It’s important to note that research into the effectiveness of many types of complementary and alternative therapies is limited.
If you’re interested in making any of these therapies a part of your psoriatic arthritis treatment plan, be sure to speak with your doctor first.
Certain lifestyle changes can also make a difference in the pain and progression of psoriatic arthritis. Some examples of these include the following.
Protecting your joints
Your doctor may suggest heat or cold treatments using an ice pack or heating pad to protect your joints and to provide temporary relief.
Additionally, avoid overdoing tasks like lifting, pushing, or twisting. Be sure to pace yourself, rest often, and take precautions when carrying out your daily tasks.
In addition to any drug treatments that your doctor may recommend, eating a nutrient-dense, balanced diet that’s rich in fresh fruits and vegetables as often as possible can help prevent the joint pain that psoriatic arthritis causes.
Getting regular physical exercise is an important part of a healthy lifestyle and can help prevent things like joint stiffness or muscle weakness.
Additionally, being overweight or having obesity can strain your joints, which might worsen psoriatic arthritis.
Ask your doctor about appropriate types of exercise.
If you smoke, it’s important to consider taking steps to quit. Smoking is
Clinical trials are very important in the development of new treatments for psoriatic arthritis.
In addition to providing valuable information to researchers and healthcare professionals, participating in a clinical trial can help people with psoriatic arthritis gain access to the latest treatments.
For more information on clinical trials near you, try this clinical trial finder provided by the National Psoriasis Foundation.
The National Institutes of Health also has a search tool that you can use to find clinical trials in your area.
Psoriatic arthritis currently has no known cure. However, there are a variety of ways that it can be effectively treated.
The goal of any type of treatment for moderate to severe psoriatic arthritis is to help you better manage symptoms like inflammation and pain while preventing further joint damage.
Things like medications and lifestyle changes can help you achieve this.
If you have psoriatic arthritis, it’s important to talk with your doctor to learn about your potential treatment options. Your doctor can work with you to recommend a treatment plan that helps to best address your needs.