Psoriatic arthritis is a long-term condition that causes pain and swelling in the joints. Over time, it can cause be damaging to the joints and cause disability.
It is associated with a skin condition called
psoriasis, but not everyone that has psoriasis will develop psoriatic arthritis.
Psoriatic arthritis is an autoimmune disease which means the body attacks its own healthy tissue.
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The exact cause of psoriatic arthritis is not known. It may be due to a combination of genetics and environmental triggers.
Factors that increase your chance of psoriatic arthritis includes having: Psoriasis for 5-12 yearsPsoriasis with symptoms such as lesions on the scalp and pitted or dented nailsA specific gene characteristic that has been linked to psoriatic arthritisA family member with psoriatic arthritis
Psoriatic arthritis usually develops in people who already have psoriasis. Symptoms that may indicate the development of psoriatic arthritis include: Joint pain and tenderness in one or more joints (can be any joint including knees, feet, hands, wrists, and elbows)Joint swellingJoint stiffness, especially in the morningRed or warm jointsChanges in fingernails and toenails (pitting in the nails, crumbling nails, or nails separating from the nail bed)Swelling of fingersPain and inflammation of tendons where they join musclesBack painFatigue
Your doctor will ask about your symptoms and medical history, especially information about your psoriasis. A physical exam will be done. Your doctor will rule out similar conditions with the physical exam.
To look for signs of an inflammation and cause of joint problem your doctor may order: Blood tests to look for autoimmune diseaseAnalysis of the fluid in the jointsTests to check how the immune system is functioning
Imaging tests may also be done to look for damage to the joint. Images may include: X-raysUltrasoundMRI scan
In addition to treating your
psoriasis, your doctor will also create a treatment plan that focuses on your arthritis symptoms.
Depending on the severity of your symptoms, your doctor may recommend: Nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and inflammationSteroid injections into painful jointsTopical steroids are used for treating the psoriasisOral steroids are occasionally need for acute flare-upsApremilast to reduce inflammation within the cell.Disease-modifying anti-rheumatic drugs (DMARDs) to treat more severe symptoms and slow the progression of the diseaseTumor necrosis factor (TNF) inhibitors to treat more severe symptoms
You may be referred to a physical or occupational therapist. These therapists can help you to improve your range of motion and your ability to do everyday activities.
Proper weight management is associated with improved symptoms. Talk to a dietitian who can help you lose excess weight and keep it off.
Working with a mental health therapist may also be helpful for your overall well-being. You can learn ways to better cope with your chronic condition.
If you have severe pain and disability, your doctor may recommend: Joint replacement surgeryTendon surgery
There are not current guidelines to prevent psoriatic arthritis because the cause is not known.
Psoriatic arthritis. Arthritis Foundation website. Available at:
http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis. Accessed November 9, 2015.
Psoriatic arthritis. National Psoriasis Foundation website. Available at:
https://www.psoriasis.org/psoriatic-arthritis. Accessed November 9, 2015.
Last reviewed November 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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