Psoriatic arthritis

About

Psoriatic arthritis is a type of inflammatory arthritis caused by an autoimmune disorder that affects the skin and joints. It is a chronic disease that can cause pain, stiffness, swelling, and limited range of motion in the joints. It typically involves both the skin and joints, which can lead to inflammation, tenderness, and fatigue. The exact cause of Psoriatic arthritis is unknown, but it is believed to be associated with genetics and environmental factors. Treatment typically includes medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs). Physical therapy and lifestyle changes may also be recommended to help manage the symptoms of Psoriatic arthritis.

Symptoms

The common symptoms of Psoriatic arthritis include pain, stiffness and swelling in the joints, particularly in the feet, ankles and knees. Other common symptoms include fatigue, nail changes, redness and irritation of the skin around the joint, loss of range of motion and difficulty walking or climbing stairs. Additionally, some people with Psoriatic arthritis may experience inflammation of the back and sacroiliac joints, which can cause pain in the lower back, buttocks and posterior thighs. Psoriatic arthritis may also cause red, scaly patches of skin called psoriasis to appear.

Causes

The exact cause of psoriatic arthritis is not known. However, it is believed to be the result of an immune system dysfunction, where the immune system mistakenly attacks healthy cells and tissue. This is thought to be linked to a combination of genetic and environmental factors, including family history and certain infections. Additionally, people with psoriasis may be more likely to develop psoriatic arthritis due to their genetic predisposition.

Risk factors

The risk factors for Psoriatic arthritis include having a family history of psoriasis or psoriatic arthritis, being a certain age (especially young adults and elderly adults), having other inflammatory diseases like Crohn’s disease, being overweight or obese, smoking, having prolonged stress, and having certain bacterial infections.

Diagnosis

Psoriatic arthritis is typically diagnosed based on a physical examination, laboratory tests, X-rays, and other imaging tests. Your doctor may also ask about a family history of psoriasis or psoriatic arthritis and your medical history. During the physical exam, your doctor may look for signs of swelling and pain in the joints, check for skin changes that accompany psoriasis, and test your reflexes and range of motion. Laboratory tests may be used to check for signs of inflammation and potential problems with the immune system. X-rays and ultrasounds can be used to look for signs of joint damage or narrowing of the joint space that is often seen in psoriatic arthritis. Other imaging tests such as CT scans and MRIs can also be used to get a better look at the joints and surrounding tissues. In some cases, a biopsy of the skin or joints may be used to confirm the diagnosis.

Sub-types

There are five major subtypes of Psoriatic arthritis:

Asymmetric Psoriatic Arthritis: The most common type, this form of psoriatic arthritis affects one or only a few joints on one side of the body, such as the index finger and the thumb.
Symmetric Psoriatic Arthritis: This form affects similar joints on both sides of the body, such as wrists or ankles, at the same time.
Distal Interphalangeal Predominant Psoriatic Arthritis: This form affects the last joints of the fingers and toes, causing painful, bony swellings at the ends of the digits.
Spondylitis Psoriatic Arthritis: This form of psoriatic arthritis affects the spine, causing pain and stiffness.
Arthritis mutilans: This is the rarest and most severe form of psoriatic arthritis, which causes destruction of the joints, particularly the fingers and toes, leading to deformity and disability.

Treatments

The treatment options for Psoriatic arthritis depend on a variety of factors, including the severity of the condition, the type of joint involvement and the individual’s overall health. Generally, treatment options include lifestyle management, medications, physical therapy, occupational therapy and surgery.

Lifestyle management: A healthy lifestyle — including regular physical activity, a balanced diet, stress management and healthy sleep habits — can help reduce symptoms and improve overall quality of life for those living with psoriatic arthritis.

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), biologic therapies, corticosteroids, analgesics and supplements can all be used to reduce pain and inflammation, and slow down joint damage.

Physical therapy: Physical therapy can help improve joint range of motion, strength and flexibility, as well as help relieve pain and stiffness.

Occupational therapy: Occupational therapy may be recommended to help individuals adapt to their disease and help them continue to do everyday activities.

Surgery: Surgery may be recommended in severe cases of psoriatic arthritis to help repair joint damage or to reduce pain and stiffness.

Prevention

To reduce the risk of developing psoriatic arthritis, there are a few steps you can take.

Manage your psoriasis: Controlling your psoriasis well can help reduce the risk of psoriatic arthritis. Talk to your doctor to find an effective treatment plan that works best for you.
Exercise regularly: Regular exercise can help to relieve joint pain and stiffness as well as improve joint flexibility.
Eat a nutritious diet: Eating a balanced and nutrient-rich diet can help reduce inflammation and improve overall health.
Get enough sleep: Getting adequate sleep can help to reduce inflammation and help you better manage your disease.
Reduce stress: Stress can worsen your symptoms, so it’s important to practice stress reduction strategies such as yoga, meditation, and breathing exercises.
Talk to your doctor: Talk to your doctor about what you can do to reduce your risk of developing psoriatic arthritis and other joint diseases.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Psoriatic arthritis. Men tend to be more likely to have more severe psoriasis and psoriatic arthritis symptoms including more swollen and tender joints. Women may experience more prolonged morning stiffness and are at a higher risk of developing peripheral joint involvement than men. Women are also more likely to have higher pain levels and fatigue associated with their psoriatic arthritis.

In terms of management, women may benefit more from biologic therapies such as TNF inhibitors to help reduce joint pain and stiffness. Additionally, women are more likely to respond better to disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, than men. Finally, joint replacement surgery may be a more viable option for women than men due to their smaller joint sizes.

Nutrition

Nutrition plays an important role in the management of Psoriatic arthritis. Eating a healthy diet that is rich in anti-inflammatory foods may help reduce inflammation and slow the progression of Psoriatic arthritis. Foods such as fatty fish, fruits, vegetables, nuts and seeds, whole grains, and healthy fats have been found to have anti-inflammatory properties and help manage the symptoms associated with Psoriatic arthritis. Additionally, consuming a diet that is low in processed foods, sugar, and saturated fats can help reduce inflammation and improve overall health. Ensuring that you are getting enough vitamins and minerals in your diet is also important for managing inflammation. Vitamins A, C, D, E, and K are essential for reducing inflammation and improving joint function. Supplementing with omega-3 fatty acids such as fish oil can also help reduce inflammation associated with Psoriatic arthritis. Finally, staying adequately hydrated is key in managing inflammation and treating Psoriatic arthritis.

Physical Activity

Physical activity is beneficial for people with psoriatic arthritis (PsA) because it can help reduce joint pain, stiffness, and inflammation. Research has shown that physical activity can also improve quality of life and overall health for people with PsA. Regular physical activity can improve overall physical health, strengthen bones and muscles, increase strength and endurance, reduce fatigue, and improve sleep. Individuals with psoriatic arthritis can increase their physical activity by participating in light aerobic activities such as walking, swimming, and using low-impact machines or elliptical trainers. Resistance training is also beneficial for PsA and can be done using light weights or resistance bands. However, it is important to begin slowly and gradually build up intensity and duration of exercise. Being consistent with physical activity can help reduce symptoms and improve overall health.