Living with
Psoriatic Arthritis

What is psoriatic arthritis?

If you have psoriasis, you may develop a type of arthritis, called psoriatic arthritis.

While there is no cure for psoriatic arthritis, correct treatment can manage symptoms and prevent severe damage to your joints. However, left untreated, psoriatic arthritis can be disabling.

How do you know you have psoriatic arthritis?

Usually symptoms of psoriatic arthritis develop after the skin patches associated with psoriasis are first reported. The symptoms can affect any joint, on just one side or on both sides of your body, and can range from mild to severe.

The symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis with flare-ups at different times.

The common symptoms of psoriatic arthritis are:

• Pain, swelling and stiffness in one or more joints: People with psoriatic arthritis often develop painful, sausage-like swollen fingers and toes. The stiffness is usually worse in the morning and can limit mobility in affected joints.
• Foot- and lower backpain: Psoriatic arthritis can also cause pain where tendons and ligaments attach to your bones (enthesitis), especially at the back of your heel (Achille’s heel tendinitis) or in the sole of your foot (plantar fasciitis). Additionally, some people with psoriatic arthritis develop a condition called spondylitis.
• Pitted nails and a red, sometimes itchy, rash typically appearing on the face, scalp and torso: These are the characteristic dermal/skin manifestations of psoriasis.
• Fatigue
• Inflamed eyes: Your eyes may be red, itchy or painful due to the inflammation caused by your psoriatic arthritis.

When to see your doctor:
If you develop joint pain and other symptoms, seek medical advice, as untreated psoriatic arthritis can severely damage your joints, causing disability.

What causes psoriatic arthritis

Several factors can increase your risk of psoriatic arthritis, including:

• Having psoriasis: Having psoriasis (skin involvement) is the single greatest risk factor for developing psoriatic arthritis.
• Genetics/Having a family history: Your genes may play a role in the development of the condition, as many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis, and researchers have also discovered certain genetic markers that appear to be associated with psoriatic arthritis.
• Age: While anyone can develop psoriatic arthritis, it occurs most often in adults aged between 30-50 years old.
• Certain environmental triggers: These may cause psoriatic arthritis in people who are genetically predisposed and can trigger acute flare-ups where the condition worsens in people already diagnosed with psoriatic arthritis.
  Common triggers include: exposure to cigarette smoke, infections with certain bacteria or viruses (such as associated with strep. throat), skin or joint wounds and other injuries, severe emotional stress, lack of sleep, poor diet, cold weather, drinking too much alcohol and taking certain medications (such as lithium, antimalarial medications and beta-blockers).

Living and managing

Lifestyle tips to manage your psoriatic arthritis and which can benefit you during a flare-up, include:

• Seek medical advice early and stick to your treatment plan: Get medical help as soon as symptoms appear. Once you start treatment, take your medications regularly as prescribed. This is very important, as untreated or improperly treated psoriatic arthritis can cause severe joint damage and disability.
• Stay active: By strengthening the muscles around your joints, low-impact exercise can make your joints more stable. Try light aerobic activities like walking, swimming or water aerobics, which place minimal stress on joints.
  Do not overdo exercise, such that you feel pain in your joints, and stretch and rest as needed before and during exercise. Try not to do hard repetitive movements or to hyperextend joints while exercising.
• Stay generally healthy by getting enough sleep, managing stress properly and having a healthy, well-balanced diet: Not only will these simple measures stop you being exposed to potential triggers, they can also help lower inflammation and pain.
• Maintain a healthy weight: Carrying extra weight puts more pressure on your joints. Even minor weight loss can relieve the stress on your joints.
  Talk to a dietitian about healthy ways to lose weight, including eating a healthy, low-fat diet.
• Quit smoking: Talk to your doctor about ways to quit smoking, as smoking is bad for your health in general and can increase inflammation and worsen many different types of arthritis, including psoriatic arthritis, for which it is a known trigger of flare-ups.
• Limit your alcohol consumption because alcohol can trigger flare-ups as well.

What treatment is available for psoriatic arthritis

It is important that you receive treatment for your psoriatic arthritis, as, otherwise, the condition can severely damage your joints and cause disability.

Treatment of psoriatic arthritis is aimed at relieving pain and reducing inflammation to halt damage to your joints and avoid disability.
Medications used in the treatment of psoriatic arthritis are similar to those used for treatment of rheumatoid arthritis, which you can read about here.

What are the complications associated with psoriatic arthritis

Getting medical attention early and starting, and sticking to, an appropriate treatment plan, is vitally important to avoid the serious complications that psoriatic arthritis can cause.

Examples of some of the complications associated with psoriatic arthritis include:

• Arthritis mutilans: If you have psoriatic arthritis, especially if you do not receive proper treatment, you are at risk of developing arthritis mutilans. Arthritis mutilans occurs in an estimated 5 % of people with psoriatic arthritis and is a severe and extraordinarily painful disorder that causes bones to disintegrate. It most commonly destroys the small bones in the hands, especially in the fingers, leading to permanent deformity and disability.
• Inflammation of the eyes: People with psoriatic arthritis sometimes develop eye problems such as conjunctivitis (pinkeye) or uveitis, which can cause painful, red eyes and blurry vision.
• Heart disease: If you have psoriatic arthritis, you are at higher risk of developing cardiovascular disease, including heart attack and stroke.
• Osteoporosis.
• Depression and anxiety: People living with psoriatic arthritis are much more likely to suffer from depression or anxiety because of the pain and loss of function caused by their condition.