Psoriatic Arthritis

What is psoriatic arthritis?

Psoriatic arthritis is pain, stiffness, and swelling of the joints. It is a type of arthritis that happens to people who have psoriasis. Psoriasis is a skin disease that causes patches of red, thick, scaly, skin.

Any joint in the body can be affected, but psoriatic arthritis is most common in the legs, back, fingers, and toes. It is a chronic (long-term) problem that can get better or worse over time. However, treatment can relieve symptoms and prevent or delay joint damage.

What is the cause?

The exact cause of psoriatic arthritis is not known. Psoriasis, the skin disease, is thought to be an autoimmune disease, which is a disease that causes your body to mistakenly attack your own tissue. Most people with psoriatic arthritis have psoriasis of the skin, although sometimes the joint problems will start before the skin problems.

Psoriatic arthritis is more common in people who:

  • Have one or more family members with psoriasis or psoriatic arthritis
  • Have been infected with strep throat or HIV, the virus that causes AIDS

What are the symptoms?

Most people who have psoriatic arthritis have symptoms of psoriasis for 10 to 20 years before they have joint symptoms. Some people get psoriasis and psoriatic arthritis at the same time. Symptoms of psoriasis may include:

  • Thick, red, rough, patches of skin, which may or may not itch. The patches may look like small, scaly drops or may occur in larger patches.
  • Fingernails or toenails with pits or dents in them. The nails may get thick and misshapen. Nail symptoms are more common in people who get psoriasis at the same time as psoriatic arthritis.

Symptoms of psoriatic arthritis may include:

  • Swollen fingers and toes
  • Redness, swelling, stiffness, and warmth around painful joints
  • Changes in the shape of joints
  • Tiredness

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. You may have tests such as:

  • X-rays of your joints
  • MRI, which uses a strong magnetic field and radio waves to show detailed pictures of soft tissue damage around the joints
  • Blood tests
  • Joint aspiration, which uses a needle to take fluid from a swollen joint for testing
  • A skin biopsy, which uses a needle to take a small sample of skin for testing

You may have tests or scans to check for other possible causes of your symptoms, such as osteoarthritis.

How is it treated?

There is no cure for psoriatic arthritis, but treatment can help:

  • Relieve pain and stiffness
  • Reduce swelling
  • Keep the shape of the joints more normal so they move well and you can do your usual activities
  • Stop or slow down damage to the joints

There are many ways to treat psoriatic arthritis.

Medicines

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, can help relieve pain and swelling. NSAIDs may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.
  • Steroid medicine may be prescribed to decrease pain and swelling. It can be given as a pill, cream or ointment, or shot. Using a steroid for a long time can have serious side effects. Take steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider’s approval. You may have to lower your dosage slowly before stopping it.
  • Disease-modifying antirheumatic drugs (DMARDs) slow down or stop damage to the joints. They can be given as pills or as shots to help lessen pain and inflammation in the joints. Your healthcare provider will check you regularly to see how these medicines are working. DMARDs may cause infection or other serious side effects.

Exercise

Three types of exercise are best for people with arthritis:

  • Range-of-motion exercises are gentle stretching exercises that help you move each joint as far as possible. Examples include low-speed bike riding, tai chi, and yoga. Range-of-motion exercises help you keep or improve your flexibility and relieve stiffness.
  • Strengthening exercise, such as weight training, makes muscles and tendons stronger. Strong muscles and tendons support joints better. You will be able to move more easily and with less pain.
  • Aerobic or endurance exercise at a moderate pace, such as walking or bicycle riding, improves your overall health and helps control your weight.

Talk with your healthcare provider before you start an exercise program. Too much exercise too soon or even at the wrong time of day may make arthritis worse. Your provider may refer you to a physical therapist to design a program that is right for you.

Surgery

Your provider may advise arthroscopy, which is a type of surgery done with a small scope inserted through a small hole in the skin into your joint. Your provider can look directly at your joint and repair it without having to cut open the joint.

If you have a joint that is severely damaged, surgery may be done to replace your joint with an artificial joint.

Other treatments

  • Your healthcare provider may recommend physical or occupational therapy to treat pain and help you have better use of your joints.
  • Your provider may suggest using heat or cold therapy, depending on your symptoms.
  • Sometimes it may help to use a splint or brace to rest a joint and protect it from injury.
  • Transcutaneous electrical nerve stimulation (TENS) may relieve some types of arthritis pain. TENS directs mild electric pulses through the skin to nerves in the painful area.
  • Acupuncture and massage are other possible treatments.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider.

Here are some things you can do that may help relieve pain and other symptoms of arthritis:

  • Take a warm bath or apply heat directly to the painful joints with a heating pad or hot towel. Do not fall asleep on the heating pad.
  • Rest your joints when they are warm, swollen, or painful.
  • Learn how to move in ways that are easier on your joints. Be open to using devices to help you. These devices include canes and walkers; bath seats and grab bars for the bathtub; and larger grips on tools, utensils, pens, and pencils. Velcro fasteners on clothes and shoes are very useful, too.
  • Join a support group.
  • Take classes on how to manage your arthritis.
  • Eat a healthy diet. Ask your provider about the benefits of talking to a dietician to learn what you need in a healthy diet.
  • Try to keep a healthy weight. If you are overweight, lose weight. Losing some weight can lower the stress on your joints.
  • If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
  • Try to get at least 7 to 9 hours of sleep each night.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • What activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-05-07
Last reviewed: 2014-04-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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