Psoriatic Arthritis - An Overview
Psoriatic arthritis is a type of arthritis which affects both joints and tendons. It’s a chronic condition, which means that it’s managed rather than cured.
In this blog, we’ll look at how psoriatic arthritis is linked to psoriasis of the skin, what causes the condition, how it can affect the body and more.
How is the condition linked to psoriasis of the skin?
It’s estimated that around 30% of people who live with psoriasis are also affected by psoriatic arthritis. It’s more common for the symptoms to occur after skin psoriasis has developed, but in some cases psoriatic arthritis presents first. Often, psoriatic arthritis develops between five and ten years after psoriasis has been diagnosed.
Psoriatic arthritis can affect people with varying degrees of skin psoriasis, including mild and moderate sufferers. It isn’t considered more likely in those with severe symptoms.
Much like psoriasis, this form of arthritis stems from the immune system attacking healthy tissue. The immune system response can lead to inflammation that in turn triggers joint pain, stiffness and swelling. It’s not yet clear why the condition affects some people and not others.
How does it affect the body?
Psoriatic arthritis can affect different parts of the body:
- The fingers and toes can become swollen, which is sometimes referred to as ‘dactylitis’
- The appearance of the nails can also change; with small pits appearing on the surface or nails becoming raised from their beds
- Stiffness and pain can occur in the lower back, neck, knees, hips and shoulders
- In rarer cases, the hands and feet can also change in shape and become difficult to move
- Some people may suffer from uveitis, an inflammation of the eye, which can lead to eye pain, redness or blurred vision
- Others may develop fibromyalgia - a chronic pain condition which can result in muscle pain
Psoriatic arthritis can also have an impact on emotional well-being; depression and anxiety tend to be diagnosed more in people living with both psoriatic arthritis and psoriasis, than those living with just psoriasis.
How can it be treated?
Once diagnosed, treatment is focused on controlling inflammation in the affected areas, in order to slow progression of the condition and improve overall quality of life. It might be necessary to trial a number of different medicines before finding the most appropriate for your symptoms.
You may be advised to try one of the following treatments:
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NSAIDS - non-steroidal anti-inflammatory drugs, which can provide relief pain and reduce inflammation, and range from over-the-counter drugs like ibuprofen and naproxen sodium to stronger prescribed medications.
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DMARDS - these disease-modifying antirheumatic drugs can slow the conditon’s progression and reduce damage to the joints and tissues. You may be advised to take methotrexate, leflunomide or sulfasalazine.
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Immunosuppressants - these help to counteract the immune response that causes psoriatic arthritis, by weakening the immune system and therefore reducing the impact of the condition. Azathioprine and cyclosporine are immunosuppressants which may be advised for psoriatic arthritis.
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Biologic agents - these drugs target the immune system where it causes inflammation and joint damage. There are a number of medications in this category, which is a newer class of DMARD.
Other treatments include newer medications like apremilast, which decreases enzyme activity to control inflammation, surgical procedures such as joint replacement, and steroid injections which reduce inflammation locally.
All of these treatments have potential side effects. Discussing the risks and benefits of each treatment with your GP or healthcare professional will help you to decide on the best approach.
Lifestyle changes may also help you to manage your symptoms. Taking steps such as protecting joints, maintaining a healthy weight, exercising on a regular basis, and limiting alcohol intake can all play a role in your treatment plan.
What’s the outlook?
It can be challenging to live with psoriatic arthritis. Aside from the symptoms discussed in this blog, there are other diseases associated with the condition, such as diabetes, heart disease and high blood pressure, but screening is available so any complications can be identified. Early diagnosis and treatment are important for maintaining a good quality of life. However, new treatments become available with time, subsequently improving the outlook for people living with the condition. With the medications currently available, it is possible to achieve remission from psoriatic arthritis.
There are lots of resources available online about psoriatic arthritis, but if you would like to seek further information, speak to your GP or a rheumatologist, who will be able to give you advice and guidance on your symptoms.