Psoriatic arthritis is a form of arthritis that typically affects people already suffering from psoriasis. Psoriasis is a skin condition that causes raised, inflamed patches of skin with scaling.
Most people who develop psoriasis usually go on to develop psoriatic arthritis as well. However, it’s not uncommon for symptoms of joint pain to develop prior to diagnosis of psoriatic arthritis. Those afflicted may experience small joint pain without evidence of injury.
It’s hard to determine why some people develop psoriatic arthritis. When the body’s immune system starts to attack healthy cells and tissue, psoriatic arthritis may develop, in addition to other diseases.
Because your immune system is not working properly, it can cause inflammation within the joints of the hands and feet. In turn, painful, swollen, itchy symptoms are the predominant symptomatology.
While it’s not clear as to why someone’s immune system attacks healthy tissue, however, the most likely causes are environmental and genetic. Many people suffering from psoriatic arthritis also have a positive family history of psoriasis or psoriatic arthritis. Certain genetic markers also appear to be associated with the development of psoriatic arthritis.
It’s not uncommon for one or more family members to suffer from psoriatic arthritis. Your age also plays a role in whether you develop the disease. Finally, people suffering from psoriasis is also a contributing factor.
Both psoriasis and psoriatic arthritis are considered chronic diseases. Although symptoms may worsen over time, you may have periods where your symptoms go into remission with alternating with periods of increased symptomatology.
Psoriatic arthritis can affect joints unilaterally or bilaterally The signs and symptoms of psoriatic arthritis are sometimes confused with those of rheumatoid arthritis. Both conditions cause joint pain, swelling and may cause joints to be warm to touch.
However, people suffering from psoriatic arthritis are more likely to have:
- Swollen digits: Psoriatic arthritis may cause painful swelling in your fingers and toes. You may also develop deformities of your hands and feet with swelling prior to having significant joint symptoms.
- Back Pain: Some people may also develop a condition called spondylosis. Spondylosis causes inflammation of the joints between the vertebrae within your spine and causes pain with and without activity.
- Foot pain: Psoriatic arthritis can also affect the ligaments and tendons in your lower extremities, making physical activity painful.
Although uncommon, a very small percentage of people with psoriatic arthritis may go on to develop arthritis mutilans; a very painful and disabling form of the disease. Over time, arthritis mutilans can cause a breakdown of bone in your hands, eventually leading to deformity.
People suffering from psoriatic arthritis may also develop ongoing eye problems such as conjunctivitis or uveitis, both of which are painful conditions that cause itchy, red eyes. People with PA are at higher risk of developing cardiovascular disease.
Diagnosing psoriatic arthritis isn’t always cut and dry. Because the symptoms can mimic those of other forms of arthritis, it’s important to get a proper diagnosis.
Your family physician may refer you to a rheumatologist, a type of doctor who specializes in the diagnosis and treatment of joint diseases. Diagnosis of psoriatic arthritis is made after reviewing your past medical history, physical examination and medical testing.
Past Medical History
Because certain medical conditions are inherited, your doctor will inquire about your and your family’s past medical history. In addition, they will need to know the following:
- Duration of symptoms
- Location of pain
- How the symptoms are impacting daily life
- A list of current medications
- Whether there is a family history of psoriatic arthritis or other types of inflammatory diseases
On physical exam, the doctor will look for signs and symptoms of joint and swelling inflammation. He or she will also look for signs of psoriasis. Since signs of psoriasis aren;t always readily visible, your doctor may look on your scalp, behind your ears, inside your and even in the groove of your buttocks.
Diagnostic imaging can detect destructive changes within your joints. In addition, blood tests can determine increased levels of inflammation. Typically, a C-reactive protein and rheumatoid factor are ordered to diagnose the disease.
Most people with psoriatic arthritis have negative RF factors. In addition, a sedimentation rate can rule out gout and other types of infectious arthritic conditions.
Currently, there is no cure for psoriatic arthritis, however, there are treatments available that focus on controlling inflammation levels to minimize pain and disability.
Currently, there are several different medications used to treat psoriatic arthritis.
- NSAIDS: Nonsteroidal anti-inflammatories reduce both inflammation and pain. Over-the-counter include Motrin, Advil and Tylenol. If needed, your doctor may prescribe stronger NSAIDS that are only available with a prescription. Side effects include stomach upset and possible liver and kidney damage.
- DMARDS: This type of medication slows the progression of psoriatic arthritis and preserve the affected joints permanent damage. The most common DMARDs include methotrexate, leflunomide and sulfasalazine. Side effects may include, bone marrow suppression, liver damage and lung infections.
- IMMUNOSUPPRESSANTS: These medications help to tame the inflammatory process, which causes painful symptoms. Examples include Gengraf, Neoral and Imuran. While on immunosuppressants, you may be susceptible to infection.
In addition to the above-mentioned modalities, there are other medications that may reduce the painful symptoms of psoriatic arthritis. TNF-alpha inhibitors like Enbrel, Humira and Remicade work by reducing inflammation. Possible side effects include nausea, diarrhea and increased risk of serious infections.
Living with psoriatic arthritis isn’t always easy, but it is possible. Learning the right way to manage symptoms and prevent painful flares is what’s important. Above all else, staying active and living a healthy lifestyle goes a long way to ward off painful symptoms. Your doctor can help you determine which form of exercise is best for you.