Understanding Psoriatic Arthritis: Popular Questions Answered

Psoriatic arthritis is an autoimmune disease that can appear in people who have psoriasis, which is a chronic skin disease characterized by red patches and silvery scales. According to the National Psoriasis Foundation, over 8 million people in the United States suffer from psoriasis. Between 10 and 30 percent of those affected will also develop arthritis, ranging from mild to severe.

What Is Psoriatic Arthritis?

The condition is mainly characterized by joint pain, inflammation, and stiffness. It can affect a variety of joints and start at any age, though it commonly manifests between the ages of thirty and fifty.

Symptoms tend to occur in waves or flare-ups, which alternate with periods of remission or even symptom improvement. While joint issues occasionally precede changes to the skin, generally the symptoms of psoriasis appear first.

Early Signs and Symptoms

Psoriatic arthritis is a progressive condition and its symptoms generally worsen over time. An early diagnosis is essential to managing the disease.

Some of the most common early signs and symptoms include:

• Painful and swollen joints
• Joints that are warm to the touch and red in color
• Reduced range of motion in the affected joints
• Stiffness, particularly in the morning
• Overall fatigue

Specific manifestations of the condition include:

• Spondylitis – Inflammation and stiffness of spinal joints
• Enthesitis – Inflammation of the area where ligaments/tendons insert into the bone
• Dactylitis – Inflammation of finger and toes (also called “sausage digit”)

Causes

The exact cause of psoriatic arthritis is unknown, but it’s generally thought to be an outcome  of an abnormally functioning immune system, which attacks healthy tissue in the body by releasing inflammatory enzymes in the joints and at the level of the skin.

Both genetic and environmental factors may play a role in this condition, but little is currently known definitively. Further research is being done to identify a specific cause and confirm potential triggers for this form of arthritis.

Risk Factors

Overall, very little is known about the risk factors of this condition at this time. Having an existing diagnosis of psoriasis is considered the number one risk factor. People who have a family history of either psoriasis or psoriatic arthritis also present a 30 to 40 percent higher chance of developing this condition, making heredity another significant risk factor.

While psoriasis itself is not infectious, psoriatic arthritis may result from a viral or bacterial infection that activates the immune system. For example, it may be triggered by an infection such as strep throat.

Treatment Options

Unfortunately, there is currently no cure for psoriatic arthritis. The recommended treatment measures are meant to slow the condition from progressing and offer pain relief. Some of the advised treatment measures for psoriatic arthritis include:

Medication

• Non-steroidal anti-inflammatory drugs – Relief from pain and inflammation; recommended options include ibuprofen, naproxen, etc.
• Enzyme inhibitors – Slow down disease progression
• Steroids – Control inflammation; recommended only for severe cases (high risk of side effects)
• Immunosuppressant drugs – Reduce the aggressive response of the immune system (patient at risk for infection)
• DMARDs (disease-modifying anti-rheumatic drugs) – Slow down the progression and bring relief from symptoms; protect against joint damage; new version of the drug blocks inflammatory enzymes
• Specific treatment for psoriasis, including UV therapy (especially for severe cases).

Physical Therapy

• Address acute symptoms (pain, inflammation)
• Improve range of motion and prevent joint deformity
• Educate the patient on conservative measures

Surgery

• Correction of deformities in case of damaged joints
• Partial or total replacement of a joint in severe cases

If you are experiencing any of the above-mentioned symptoms, please consult with your doctor. Even though psoriatic arthritis cannot be cured, it can be controlled with the right measures and lifestyle changes, under the supervision of a medical professional. Since psoriatic arthritis is a progressive condition, an early diagnosis increases your chance of a more favourable prognosis.