Psoriatic arthritis is one of the more than 100 types of arthritis. Inflammation, swollen joints and patches of scaly skin mark it. It affects both men and women, usually between the ages of 10 and 50.
It is related to psoriasis, where the skin itches and has a scaly rash. About 10% of those with psoriasis develop psoriatic arthritis.
Causes and Risk Factors
Its cause is not known. It may be caused by heredity, immune system disorders, infection or injury.
This condition can also involve:
- Painful, red, swollen joints with reduced motion; usually the small joints of the hands and feet, although it can involve larger joints or the spine
- Prolonged stiffness and tiredness in the morning
- Pitted or discolored nails that may separate from the nail beds
- Conjunctivitis (pink eye) and other eye inflammations
Diagnosis is tricky for several reasons:
- Both skin-related symptoms and joint pains are involved.
- It mimics other conditions, including rheumatoid arthritis, gout or Reiter's syndrome, which involves joint pain associated with inflamed eyes, a skin rash and, in men, a urethral discharge
A doctor will review your medical history and do a physical exam. Additionally, he or she may also X-ray your joints and remove fluid from an affected joint. Blood tests can also help see whether someone has rheumatoid arthritis or psoriatic arthritis. (People with psoriatic arthritis rarely have the rheumatoid factor, an antibody, in their blood.)
Psoriatic arthritis may have less impact than other types of arthritis. Without treatment, it can cause pain, deformity and disability. The earlier it is treated the better.
If you have psoriatic arthritis, your treatment may include:
- Drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. Should these fail to work, you may be prescribed drugs such as Methotrexate, an antimetabolite that blocks an enzyme; sulfasalazine, a disease-modifying antirheumatic drug that slows or stops some types of arthritis; or etanercept and inflixibmab, tumor necrosis factor (TNF) blockers that act as anti-inflammatory agents.
- Physical therapy
- Surgery to stabilize joints
Other things that can help include:
- Heat -- warm water, heating pads, hot packs or heat lamps -- to relax muscles around a painful joint. A physical therapist may apply deeper heat with an ultrasound machine.
- Exercise to strengthen muscles around joints, increase range of motion and improve overall fitness
- Splints to support weak joints and position them properly for restful sleep.
- Relaxation techniques, such as deep breathing, guided visualization and hypnosis, to help ease pain
- Avoiding strain on your finger joints such as purses, bags, briefcases that don't have shoulder straps or twist-open jar lids
- Spreading the weight of anything you carry over several joints, such as using both hands or walking with a cane
- Regular breaks to relax and stretch during physical activities
- Relying on stronger muscles and larger joints. Lean into heavy doors instead of pushing with your hands. Use proper lifting techniques.
- Check your posture during the day. Maintaining the natural curves of your back helps protect joints, muscles and ligaments.
- Pay attention to persistent symptoms