It’s always emotional and scary when a loved one is diagnosed with psoriatic arthritis. Instead of lamenting, anyone in such a situation should think of what to do next. Psoriasis is a double edged ailment that makes the skin break out in rashes and patches of red that are always itchy and sometimes flaky. The rashes and patches of red due to psoriatic are found in different areas of the skin and scalp.
Arthritis is another ailment that affects the joints. It’s painful and could be debilitating in extreme cases. Medically, Psoriatic Arthritis is called PsA, and it’s just what most people believe it is: the two of those flare-ups joining forces materializing together. When someone has psoriasis, he or she could have joint tenderness, as well as scaly rashes on the skin of their body.
Both Psoriatic arthritis and psoriasis are autoimmune infections. People get these infections when their immune system that ought to have protected them against illness and infection aggressively attacks the normal healthy cells. Similar to psoriasis, psoriatic arthritis is a long-term illness that could get worse if not given considerable attention.
If it’s extreme, patients’ joints could become affected, leading to risk of damage or deformity. And in such situation, surgery is highly recommended. There’s no age limitation when it comes to being infected by PsA. Anybody is prone to this infection, irrespective of their age, but experts opine that the symptoms often begin between ages 30 and 50. Generally, psoriasis patients will start experiencing arthritis after 10 years of psoriasis flare ups.
Can a patient develop PsA without having Psoriasis first? Of course, there are cases where patients have PsA without traces of psoriasis, but it’s rare. Medical studies and researchers suggest that 20% of people tend develop psoriatic arthritis.¹
There are five types of PsA²:
1. Symmetric PsA
This is a type of PsA that affects the same joints on both sides of the body (usually the left and right knees). Sometimes, symmetric PsA symptoms are similar to rheumatoid arthritis(RA), but it’s milder and causes less deformity to the joint compared to RA. That doesn’t mean that symmetric PsA can be disabling. About 50% of patients with this joint and skin infection are symmetric PsA.
2. Asymmetric PsA
Patients with asymmetric PsA have damaged or deformed joints on one side of their body. Some of the symptoms of asymmetric PsA are; feeling sore in the joints, redness of the joints, etc. However, it’s a bit mild, and only accounts for about 35 percent of PsA cases.
3. Distal interphalangeal predominant PsA
The Distal Interphalangeal predominant is a rare strain of PsA. Patients with this strain experience serious pains around their distal joints – that’s joints of the fingers and toes. About 10% of PsA patients have Distal Interphalangeal Predominant strain.
4. Spondylitis PsA
Spondylitis PsA affects the spine. In most cases, the patients entire spine (from neck to the lower back) may be affected. And it could make movement difficult. In extreme cases, spondylitis PsA affects patients’ hands, feet, legs, arms, and hips.
5. Psoriatic arthritis mutilans
Psoriatic arthritis mutilans is arguably the most dangerous type of PsA. It’s extreme and could deform patients’ joints. About 5 percent of PsA patients have psoriatic arthritis mutilans. Most times, it affects hands and the neck, and when not given maximum care, it could cause serious pain in the neck and lower back.
TREATMENT
Ideally, patients must consult with a physician first before starting any form of PsA treatments. This will help to ensure that they are taking the right treatment for the situation. For instance, treating Distal interphalangeal predominant PsA with a treatment meant for Psoriatic arthritis mutilans will be counter productive.
That being said, every PsA patient should see a rheumatologist before they start any form of treatment. They are the right people to recommend the correct treatment option to undergo, and there are three ways patients can flare up³.
Once a patient is diagnosed with the illness, certain medications will be coming directly from the patient’s doctor. These medications help to cushion the effect of skin inflammation on the skin and help ease the itchiness and redness. Again, the medications will manage pain and inflammation patients experienced around the joints without damaging them.
There are studies that show that regular exercise can help stave off afflictions on the joints⁴. The psoriasis is something that may not be stopped but can be managed through exercise. Low impact exercises that can possibly improve arthritis and alleviate some of the pains are walking, yoga, etc.
The most extreme treatment out there would be a surgery for the joints. Surgery is only recommended when the arthritis has become extreme and medication is no longer enough to ease the pain. After ward a physical therapy will help the patient through the recovery process.
Any which way, patients must get a doctor’s proper diagnosis to be able to figure out which is the right treatment for their case.
Tips For Managing Psoriatic Arthritis
According to the National Center for Health Statistics, over 50 million adults are living with arthritis.⁵Even though arthritis is a difficult and debilitating illness, it’s possible to manage and handle it. Arthritis is not a dead sentence. There are different ways of managing this ailment, some of them include; self-management, self-care, exercise, diet changes, etc.
Self-management
Self-management is an important technique for managing any kind of pain including arthritis’ pains. The term “self-management” includes the day-to-day activities patients can do to manage their ailment.
However, learning new self-management skills or enrolling in self-management classes, regular exercise, talking to a medical expert, weight management, and joint protection are the 5 self-management strategies the CDC’s arthritis program advise for regulating arthritis and subsequent. Once patients practice any of the aforementioned strategies, they will experience relief.⁶
Exercise/Physical Therapy
Arthritis and the subsequent pain can often be debilitating, but there are other methods to diminish this affliction. An oft-overlooked treatment is a tailored exercise regime and physical therapy regimen; there can be a variety of exercise and therapy strategies that can be utilized, most effectively by talking with a primary care physician and creating a system tailor-made for patients’ lifestyle and illness. Doctors have identified a handful of primary reasons to introduce exercise into patients plans for combating arthritis symptoms including, but not limited to, keeping the joints from becoming too stiff, keeping muscles around the joints strong, and to keep bone and cartilage tissue strong and healthy.There are three main types of exercises that can be focused on; range-of-motion/flexibility, strengthening, and fitness. Physical and Occupational therapists, along with patient’s doctor, will recommend what types of exercise and regimen will work better for the patients.⁷
Diet
According to experts, diet plays an important role in managing arthritis. Of course, there’s no particular diet that treats arthritis, but certain foods such as fish, nuts, seeds, fruits, vegetables, beans, olive, oil, grains, etc, that are found in the Mediterranean diet are good for the joints and could help reduce inflammation.
Furthermore, some foods could trigger arthritis pain, and it’s recommended for patients to stop eating such foods. For instance, different studies have figured nightshade vegetables to arthritis pain because they contain solanine. While study results have been mixed, there have been patients who report a reduction in symptoms when avoiding these vegetables. However, for clarification, it’s advisable for patients to contact their primary physicians and talk about what dietary options, if any, could work better for them and their situation.⁸
Managing Fatigue
Fatigue is a common and persistent foe and an expected symptom when managing Arthritis. An important part for patients when managing this aspect of their diagnosis is to open a clear and communicative dialogue with their doctors. Fatigue can be caused by different factors and can require a plethora of different remedies, which is why an open dialogue with a doctor is very important for patients; they will help tailor a plan that fits the patient needs and lifestyle, whether that focus on medication lifestyle changes or a combination of both.
Though a 2017 study published in “Current Rheumatology Reports” cites that many arthritis medications don’t target fatigue specifically, unchecked inflammation caused by arthritis can be a leading cause in patients fatigue and talking with their doctor about the right medication to treat these symptoms can go a long way when managing fatigue symptoms.Various Lifestyle changes can be a big help in managing arthritis fatigue as well; studies conducted by Patti Katz, PhD, of the University of California San Francisco, identifies proper hydration, an exercise regime, and maintaining good sleep habits as important steps to maintaining fatigue.⁹
Finding A Support Network
As I earlier said, psoriatic arthritis isn’t a death sentence, but it comes with wear and tear on the body which could be tiring both physically and emotionally. With a support network, patients won’t be as prone to confusion, frustration, depression, or sadness. Instead, they will have the assurance that there are better days ahead. So try to talk with a doctor, engage in social and community activities, and if you have the means, seeking a professional counselor would be great.¹⁰
Conclusion
In conclusion, there are various ways to handle and manage a psoriatic arthritis diagnosis. Generally, patients should have a honest conversation with their primary care physician. This will enable the physician to come up with a plan that works for the patients’ lifestyle and diagnosis. Of course, living with arthritis is a challenging time in one’s life, but these tips could help in a little way.
REFERENCES:
[1] “Psoriatic Arthritis.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
[2] “Psoriatic Arthritis.” NHS. 19 December 2019. https://www.nhs.uk/conditions/psoriatic-arthritis/
[3] “Everything You Need to Know About Psoriatic Arthritis.” Healthline. https://www.healthline.com/health/psoriatic-arthritis
[4] “Psoriatic Arthritis.” Arthritis Foundation. https://www.arthritis.org/diseases/psoriatic-arthritis
[5] OrthoInfo. “Managing Arthritis Pain With Exercise – OrthoInfo – AAOS.” OrthoInfo. Accessed April 20, 2020. https://orthoinfo.aaos.org/en/treatment/managing-arthritis-pain-with-exercise/.
[6] Centers for Disease Control and Prevention. “5 Proven Ways to Manage Arthritis.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, February 5, 2019. https://www.cdc.gov/arthritis/basics/management.htm.
[7] U.W. Medicine.“Exercise and Arthritis.” Patient Resources. Accessed April 20, 2020. https://orthop.washington.edu/patient-care/articles/arthritis/exercise-and-arthritis.html.
[8] Nichols, Hannah. “Arthritis: Causes, Types, and Treatments.” Medical News Today. MediLexicon International, November 14, 2017. https://www.medicalnewstoday.com/articles/7621#natural_remedies.
[9] Arthritis Foundation. “How to Beat Arthritis Fatigue: Arthritis Foundation.” How to Beat Arthritis Fatigue | Arthritis Foundation. Accessed April 20, 2020. https://www.arthritis.org/health-wellness/healthy-living/managing-pain/fatigue-sleep/how-to-beat-arthritis-fatigue.
[10] “Managing Emotions and Arthritis: Arthritis Foundation.” Managing Emotions and Arthritis | Arthritis Foundation. Accessed April 20, 2020. https://www.arthritis.org/health-wellness/healthy-living/emotional-well-being/emotional-self-care/managing-emotions-and-arthritis.
