About Psoriatic Arthritis

Psoriatic arthritis affects the joints and skin of patients. There are many treatments available to manage this disorder.

What is Psoriatic Arthritis?

Patients with psoriasis, a skin condition with silvery scales and red patches, may develop a form of arthritis called psoriatic arthritis. These patients will have skin lesions and joint problems. With the arthritis, symptoms include swelling, stiffness, and joint pain, affecting the spine, fingertips, or any part of the body. Symptoms can flare up or go into remission, and they may be severe or mild. Left untreated, “psoriatic arthritis may be disabling”, but there is no cure.¹ Inflammatory arthritis affects between “10%-30% of the…Americans who have…psoriasis”. There are 5 kinds of psoriatic arthritis: symmetric, asymmetric, distal interphalangeal predominant (DIP), spondylitis, and the very rare arthritis mutilans (which is severe and deforming). In symmetric psoriatic arthritis, joints are affected on both sides of the body, whereas with the asymmetric version, only a few joints in the body (e.g., knee, hip) may be affected. For patients with DIP, symptoms affect the “small joints in the fingers and toes”. Spondylitis could attack connective tissue and ligaments, as well as the spinal column. Symptoms might impact the spinal vertebrae, sacroiliac region, neck, lower back, and even the arms, legs, feet, or hips. Other symptoms of patients with psoriatic arthritis include morning fatigue, stiffness, less range of motion, throbbing and swelling of the joints, scaly spots, joint inflammation, nail pitting, nail detachment, and eye inflammation.² The causes of psoriatic arthritis are unknown, but heredity and immune system infections (such as strep) are thought to have an impact.³

Treatments

NSAIDs (Advil, Aleve, etc.) are some of the medications used to initially manage the pain of psoriatic arthritis. DMARDs (disease modifying anti-rheumatic drugs) may also be prescribed. Humira, Remicade, and Enbrel are newer medications, in the category of “anti-tumor necrosis factor agents”, that can be prescribed to manage the skin psoriasis and arthritis.⁴ Golfer Phil Mickelson has psoriatic arthritis and is a spokesperson for Enbrel.⁵ If the joints are too swollen, some doctors could recommend corticosteroid injections or surgery.⁶ It is also important that patients stay physically active. Cold and heat treatments may also relieve symptoms. DMARDs and other medications can impact the immune system, so patients taking those will need monitoring.⁷Vitamin D may improve symptoms of psoriatic arthritis.⁸ There are also alternative treatment options for patient with this disorder, including diet and nutrition changes (to maintain a healthy weight), mind/body therapies for stress reduction (aromatherapy, meditation, mindfulness, spa therapy), hands-on therapies (acupressure, acupuncture, massage, Reiki), exercise, yoga, and tai chi. Some of the herbal remedies include aloe vera, apple cider vinegar, capsaicin, Epsom salts, oats, tea tree oil, turmeric, and mahonia.⁹