Psoriatic arthritis (PsA) is a long-term condition in which one or more joints become swollen, stiff and sore. People with PsA also have, or may later develop, the skin condition psoriasis. This causes itchy red skin patches with silvery scales, known as plaques.
PsA typically targets the elbows, knees, hands, feet and base of the spine – but other joints, as well as surrounding tendons and ligaments, may also be affected.
The condition usually affects different joints on each side (asymmetrical PsA). However, it may occasionally affect the same joints on both sides of the body (symmetrical PsA).
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Is there a link between psoriasis and arthritis?
Up to 70 per cent of people with PsA develop psoriasis first – but in a few cases, arthritis appears before the skin condition.
But having psoriasis certainly doesn't mean you'll go on to develop PsA. About five to seven per cent of the UK population suffers from psoriasis. Around one-fifth of these people will also develop PsA.
Learn more about psoriasis causes and triggers
Can psoriasis affect your joints?
Psoriasis tends to affect the elbows, knees, scalp, area between the buttocks and on scars, and can become very sore when scratched.
Arthritis and psoriasis usually remain independent of one another in people with PsA, although stress in particular can trigger flare-ups of both conditions.
Aching joints: what's the cause?
Is psoriatic arthritis a serious disease?
The severity of PsA varies considerably from one individual to another. As with osteoarthritis and rheumatoid arthritis, you are likely to have both good days and bad days – but plenty can be done to manage those bad days effectively.
Psoriasis symptoms can vary from a small patch to a severe condition covering most of the body.
Learn more about psoriasis symptoms
Aside from joint pain and the skin condition, other possible PsA symptoms include: swollen and sore joints at the ends of fingers and toes; blemished or thickened nails; sore and swollen heels; jaw pain and associated headaches; sore, red eyes or conjunctivitis; and feeling tired all the time.
You may also feel very stiff first thing in the morning or experience back and neck stiffness throughout the day, caused by inflammation of the spine (spondylitis).
Finally, if you suffer a lot of joint pain or feel uncomfortable or embarrassed about the skin condition, it can lead to low mood and sleep problems.
Learn more about treatment for psoriasis
Is psoriatic arthritis a hereditary disease?
If you have a close relative with either psoriasis or PsA, you may have inherited genes that make you more prone – but certainly not destined – to develop either condition.
Experts believe something else, such as an infection or stressful life event, may act as a trigger for PsA to develop.
How is psoriatic arthritis treated?
Many types of medication are available to treat arthritis symptoms.
Non-steroidal anti-inflammatory drugs (NSAIDs) target joint pain by reducing inflammation. Common NSAIDs include ibuprofen (Nurofen), naproxen (naprosyn), diclofenac (Voltarol) and celecoxib (Celebrex). It's important to discuss the risk of any possible side effects with your GP before taking any of these drugs.
A steroid injection may also help reduce arthritis symptoms such as joint pain and swelling.
Disease-modifying anti-rheumatic drugs (DMARDs) can reduce pain and slow the development of arthritis in its early stages by targeting the causes of inflammation. Given by tablet or injection, they usually take a few weeks to become effective. Common DMARDs include methotrexate (Maxtrex), sulfasalazine (Salazopyrin) and leflunomide (Arava).
Biologics are a relatively new class of drugs that target the damaging chemicals in certain types of inflammatory arthritis. Biologic drugs used to treat PsA include Ustekinumab (Stelara), adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade).
If you take DMARDs or biologics, you'll need regular blood tests to monitor any possible side effects and ensure your blood, liver and kidneys aren't being damaged in any way. You should also have an annual 'flu vaccination.
Various ointments and creams are available to help calm the skin. Your GP may also prescribe retinoid tablets or refer you for light therapy: this is when ultraviolet light is shone on to the skin to reduce psoriasis symptoms. Some DMARDs, such as methotrexate, can also treat skin conditions.
Find out more about medication for arthritis
Who can help with psoriatic arthritis?
PsA can be difficult to diagnose and your doctor may send you for blood tests to rule out other forms of arthritis.
Once diagnosed, you may be referred to a rheumatologist to manage your joint pain, as well as a dermatologist for your skin condition. In some cases, the two consultants may then work together to determine the best treatment plan for you.
You may also see a physiotherapist to help maintain joint mobility and an occupational therapist for advice on using physical aids and making adaptations to your home to allow you to move around more freely.
Alternative therapies, such as acupuncture, may also be of benefit to some people with PsA – but always ask your doctor's advice first. If you do consult a complementary therapist, always ensure they're a member of the relevant professional body.
New ways to ease arthritis
How can I help myself if I have psoriatic arthritis?
Regular exercise can ease pain by keeping the joints mobile. Speak to your GP or a physiotherapist about which exercises may work best for you.
It's also important to maintain a healthy weight as this will reduce the strain on your joints and back. A healthy, balanced diet will boost your strength and energy levels, making it easier to manage your condition. Taking omega-3 fish oil supplements may help reduce arthritis symptoms such as joint pain.
Lastly, listen to your body and be kind to yourself. If you feel very tired, you may need to take a rest in the middle of the day. Stress is often one of the key triggers for arthritis symptoms and psoriasis, so relaxation techniques – such as meditation or breathing exercises – can be of huge benefit.
Learn more about managing arthritis pain
For more information on psoriatic arthritis, go to www.arthritiscare.org.uk and download your free factsheet.
For facts, support and guidance on all aspects of arthritis, call Arthritis Care’s free Helpline on 0808 800 4050. It's open Monday to Friday, 09:30-17:00.
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