Psoriatic arthritis, commonly abbreviated as PsA, is a type of arthritis with inflamed joints. It usually shows up in people with psoriasis, a skin condition causing red, itchy patches¹. This joint inflammation can happen all over the body. It targets large and small joints and can cause pain, stiffness, and swelling¹. Other symptoms include swollen fingers and toes, foot pain, and changes in your nails¹.

This condition often starts between the ages of 30 and 55¹. It can be mild or lead to serious joint damage without proper treatment¹. Males and females face an equal chance of developing it. Having psoriasis puts you at the highest risk¹. Left without treatment, it can harm your joints and increase health risks like diabetes and heart disease¹.

Psoriatic arthritis is complicated and can be tough to identify². It affects nearly 60 million people, including children, in the U.S². Research shows the risk of heart disease is almost twice as high for those with this condition². Flares in psoriatic arthritis can affect the skin and joints or cause back pain². Often, it comes with obesity or diabetes as well². Every donation helps fund research to help patients².

Key Takeaways

Psoriatic arthritis is a chronic inflammatory autoimmune condition that affects the joints and often co-occurs with psoriasis.
Symptoms of psoriatic arthritis include joint pain, stiffness, and swelling, which can affect various body parts.
Psoriatic arthritis typically develops between ages 30 and 55 and can lead to severe joint damage if left untreated.
Psoriasis and family history are significant risk factors for developing psoriatic arthritis.
PsA is associated with an increased risk of other health conditions, such as cardiovascular disease, obesity, and diabetes.

What is Psoriatic Arthritis?

Psoriatic arthritis is a long-term inflammatory problem. It affects the joints and spots where tendons and ligaments join bones. The immune system gets too active, causing pain and swelling. This happens with psoriasis, which shows red, scaly patches on the skin.

It affects some people with psoriasis¹. About 3 out of 20 to 3 out of 10 psoriasis patients get it³. Most get psoriasis first, but not always. Sometimes, joint issues start before the skin shows signs¹.

Definition and Overview

This type of arthritis is caused by the immune system attacking healthy cells. It inflames the joints and causes the skin to produce too many cells¹. It is a long-term issue that causes joint pain and swelling and can affect any part of the body¹.

It often starts in those aged 30 to 55¹. Sadly, there’s no cure, but we can manage the symptoms. Without treatment, it harms the joints badly³.

Relationship Between Psoriatic Arthritis and Psoriasis

Many people with psoriasis are eventually getting psoriatic arthritis¹. The most common type, plaque psoriasis, resembles red, scaly patches¹. A family history of psoriasis raises the risk, too¹.

Besides joint issues, it can make you very tired or cause anemia³. It also links to diseases like diabetes and obesity³. Though it has no cure, treatments help manage the symptoms³.

Causes and Risk Factors of Psoriatic Arthritis

The exact causes of psoriatic arthritis are not fully known. It’s likely a mix of genetics and the environment. Knowing these risk factors can help people lower their chances of getting this disease.

Genetic Factors

Genetics are a big part of psoriatic arthritis. If someone in your family has psoriasis or PsA, you might be more likely to get it too¹. About 40% of people with psoriatic arthritis have these conditions in their family history, showing it can run in families⁴.

Researchers found many genetic variations linked to psoriasis and PsA. This shows a clear genetic side to the disease⁴.

Environmental Triggers

Outside factors can also cause psoriatic arthritis. If you’ve had certain injuries, it might begin this issue¹. Such injuries cause skin inflammation, which leads to psoriatic arthritis symptoms⁴. Infections like strep throat may also play a role in starting the disease for some people⁴.

Other things that can raise the risk of psoriatic arthritis are:

Having psoriasis: If you have psoriasis, you also have a higher risk of getting PsA¹⁴.
Age: It mostly appears in adults between 30 and 55 years old¹.
Obesity: Being overweight can make PsA symptoms worse, even though it’s not a direct cause⁴.
Certain medications – Some drugs can make PsA symptoms more severe in those who already have it⁴.

By learning about genetic and environmental factors, people can work with doctors to develop customized prevention steps. These include living healthily, dealing with stress well, and being alert for early signs of disease.

Symptoms of Psoriatic Arthritis

Psoriatic arthritis is a long-term condition that causes inflammation. It shows up differently from person to person. This disease links to psoriasis, a skin issue marked by red patches with silvery scales¹. Most folks start noticing psoriasis before they know they have psoriatic arthritis. But, joint problems could show up simultaneously or even earlier¹.

Body parts affected by PsA

Joint Pain and Swelling

Joint pain, stiffness, and swelling are usual signs of this arthritis. It can impact different body areas and vary in intensity from mild to harsh feelings¹. A fingertip or toe can swell up like a sausage, which is called dactylitis⁵. Psoriatic arthritis might lead to foot discomfort, like Achilles tendinitis and plantar fasciitis. It can also cause lower back pain, known as spondylitis¹.

Skin and Nail Changes

Those with psoriatic arthritis might see scaly, red patches of skin, mainly plaque psoriasis, that form dry plaques with silvery scales¹⁵. Nail issues, like pitting or crumbling, are also common¹⁵.

Fatigue and Other Symptoms

Feeling tired is a big part of living with psoriatic arthritis⁵. Other symptoms include soreness in entheses, eye problems (uveitis), and gut inflammation¹⁵. Remember, the symptoms might come and go. This happens in both psoriatic arthritis and psoriasis¹.

Symptom	Description
Joint pain and swelling	Affects various body parts, ranging from mild to severe
Dactylitis	Sausage-like swelling of an entire finger or toe
Skin changes	Scaly, inflamed patches, particularly plaque psoriasis
Nail changes	Pitting or crumbling of the nails
Fatigue	A common symptom among those with psoriatic arthritis

Don’t ignore joint pain possibly caused by psoriatic arthritis. If it goes untreated, it can badly harm your joints. Getting medical advice early is key to managing symptoms and avoiding long-term problems. Unfortunately, there is no cure for psoriatic arthritis¹.

Types of Psoriatic Arthritis

Psoriatic arthritis is not a simple illness. It can show up in many forms, leading to various classifications. Some of the main types include symmetric and asymmetric models⁶. About half of us who have it see symptoms on both sides of our bodies, like in our knees or hands⁷. However, 1 in 3 may only feel pain and swelling on one side or in just a few joints⁷.

If the pain is mainly in your fingers or toes, it’s called distal interphalangeal predominant type⁶. This type often changes how your nails look and feel⁸. Roughly 80% of people with this disease also have trouble with their nails⁸.

Sometimes, psoriatic arthritis affects the spine, leading to spondylitis⁶. This happens to less than 1 in 20 of us who have the disease⁷.

The most severe form, affecting less than 5% of those with the disease, is arthritis mutilans⁶⁷. It can badly harm the joints in our hands and feet, making our fingers and toes shorter⁷.

Types of PsA	Characteristics	Prevalence
Symmetric Polyarthritis	It affects matching pairs of joints on both sides of the body	Approximately 50% of people with psoriatic arthritis⁷
Asymmetric Oligoarticular	Affects fewer than five joints, typically on one side of the body	About 1 in 3 people with psoriatic arthritis⁷
Distal Interphalangeal Predominant	It mostly affects the end joints of fingers and toes, often with nail changes	Nail changes occur in up to 80% of people with psoriatic arthritis⁸
Spondylitis	Affects the spine and sacroiliac joints	May affect fewer than 1 in 20 people with psoriatic arthritis⁷
Arthritis mutilans	Severe, deforming arthritis that can cause bone loss and shortening of fingers and toes	Fewer than 5% of individuals with psoriatic arthritis⁶⁷

Knowing the various forms of psoriatic arthritis is key to the right diagnosis and care. This sickness usually occurs between 30 and 50 years old but can start at any time⁶. Getting early help can stop joint damage and improve life for those with this challenge.

Diagnosis and Testing

Diagnosing psoriatic arthritis is complex. No single test can confirm it for sure⁹. Doctors use a mix of exams, imaging tests, blood tests, and more to help them identify psoriatic arthritis accurately and rule out other conditions¹⁰.

Physical Examination

During a check-up for psoriatic arthritis, the doctor will examine your joints, skin, and nails closely. They’ll check for swelling, tenderness, and changes associated with this condition. They’ll also assess how well your joints move and how mobile you are.

Imaging Tests

X-rays are key for spotting joint changes associated with psoriatic arthritis. More advanced scans, such as CTs, ultrasounds, and MRIs, show even more detail. They help get a clear diagnosis and determine the extent of joint damage10.

Blood Tests and Other Diagnostics

Blood tests are vital for ruling out other health issues. Notably, many with psoriatic arthritis have normal inflammatory markers. This includes tests for ESR and CRP¹⁰. Tests for RF and anti-CCP, usually high in rheumatoid arthritis, might be negative in psoriatic arthritis. The HLA-B27 test can find various autoimmune diseases, including psoriatic arthritis. Joint fluid checks and skin biopsies can also help confirm the diagnosis^9,¹⁰.

After diagnosis, patients need regular checks like skin and joint exams. This includes more blood and imaging tests. These help track the disease’s progress and adjust treatment¹⁰. Working closely with doctors and using various diagnostic methods ensures a correct diagnosis. This step is key in planning the best treatment to reduce symptoms and enhance life quality.

Treatment Options for Psoriatic Arthritis

There’s no one-size-fits-all approach to treating psoriatic arthritis. Each plan is unique and based on the person’s needs. It considers the severity of the symptoms and the number of joints involved. The goals are simple: lessen pain and swelling, stop joint harm, and improve life.

NSAIDs and Pain Management

For those with mild symptoms, NSAIDs like aspirin can help. They tackle the swelling and pain¹¹. But consuming them for a long time might upset your stomach or harm your heart.

Disease-modifying antirheumatic Drugs (DMARDs)

When NSAIDs aren’t enough, DMARDs might be added. These include drugs like methotrexate, which dial down the immune system⁹. Methotrexate and newer DMARDs and biologics can work together to ease symptoms well¹¹. Yet, they can make you more likely to get sick.

Biologic Medications

For worse cases, biologics might be the way to go. They go after specific parts of your immune system to dial down swelling¹¹. If one kind of biologic doesn’t work, others can be tried. These drugs might cause dizziness or flu-like symptoms and could raise the risk for rare blood cancer¹².

Lifestyle Changes and Home Remedies for Psoriatic Arthritis

Medication aside, how you live and care for yourself at home is very important. A big part is keeping a healthy weight. Study results show that just losing a bit of weight can make your psoriatic arthritis treatments work better¹². Exercise helps, too. It can make you feel better and move more, easing your symptoms^9,¹¹.

Quitting smoking can help your skin and joints feel better. Dealing with stress by unwinding or talking to someone is also key. A diet filled with good fats, fish, and veggies is recommended. You might also try acupuncture for pain¹¹¹². Using heat or cold on your joints can also reduce soreness and swelling¹¹.

Living with Psoriatic Arthritis

Psoriatic arthritis is tough, but you can handle it well with smart strategies and support. To control the disease, it’s important to see your rheumatologist regularly. Along with doctor visits, changing your lifestyle and managing stress can improve your life13.

Coping Strategies

Dealing with how psoriatic arthritis makes you feel is as crucial as the physical pain. Being in a support group connects you with others facing the same challenges. Here, you can share stories, tips, and support, which fight loneliness and boost happiness. To manage stress, try deep breathing, meditation, or yoga. These activities can calm you and are key for your mental health and well-being¹³.

Exercise and Physical Therapy

Moving your body is vital for joint health if you have psoriatic arthritis. Try gentle activities like walking, swimming, or yoga¹⁴. These keep your joints strong, make you more flexible, and reduce stiffening. Doing simple tasks and hand exercises can also reduce pain and stress from psoriatic arthritis¹³.

Working with a physical therapist to make a workout plan that fits your needs is a good idea. Start any new exercise slowly, and watch how your body reacts. It’s normal to feel a bit sore at first. But, if you notice any pain or more discomfort the day after, it might be time to take it easier¹⁴. And remember, you need to change up your routine as you get fitter to keep making progress¹⁴.

Besides workouts, medicines are important for psoriatic arthritis. Drugs like NSAIDs can reduce pain and swelling¹⁴. Biologic drugs act on our immune system and lessen the pain, working faster to improve mood than to reduce pain¹⁴. Sometimes, you might have to try a few different treatments before finding the one that works best for you¹³.

Living with psoriatic arthritis is hard, especially on your emotions. Being depressed might make the pain feel worse¹⁴. That’s why taking care of your mind and body is essential. Mixing exercise, stress relief, and talking with your doctors helps make living with this disease easier. This approach can help you feel better, even on tough days¹³.

Complications and Related to Psoriatic Arthritis Conditions

psoriatic arthritis development Psoriatic arthritis can cause serious complications, which can make life very difficult. For example, it can lead to arthritis mutilans. This rare form of PsA might permanently deform the fingers and toes, especially in 2-21% of those affected¹⁵.

Another serious issue is spondylitis, affecting 35-75% of people with PsA. It’s when the spine’s joints become inflamed, possibly leading to bones fusing together¹⁶¹⁵. This makes movement hard and painful.

Those with psoriatic arthritis also have a higher chance of heart disease and other health problems. They are more at risk for type 2 diabetes by more than 40% compared to others. The risk goes up even more compared to people with psoriasis¹⁵. Plus, a review in 2018 suggested that PsA might raise the odds of getting heart disease alone¹⁵.

People with PsA could face heart issues, especially if they’re obese or have diabetes¹⁶.

Other health issues linked to PsA include:

Inflammatory Bowel Disease (IBD): PsA and IBD often go together, sharing genetic traits. PsA increases the risk of IBD, like Crohn’s disease and ulcerative colitis¹⁶¹⁵.
Depression and anxiety: Around 20% of people with PsA have these issues. PsA’s inflammation can also affect the brain, leading to mood changes¹⁶.
Eye problems: Uveitis, inflammation in the eye’s middle layer, is common in PsA. It impacts about 7% of those with PsA¹⁶¹⁵. Quick treatment is key to avoiding vision loss.
Kidney and liver issues: PsA raises the odds of kidney and liver diseases. They can cause stomach pain or fatigue¹⁵.
Gout: PsA could up uric acid in your blood, increasing the chances of gout¹⁵.
Nonmelanoma skin cancer: Psoriasis and PsA link to a higher risk of this kind of skin cancer¹⁵.

It’s crucial to know the potential risks of PsA treatments. For instance, biologic DMARDs can increase the risk of ILD, which scars the lungs¹⁵.

Complication/Related Condition	Prevalence or Risk
Arthritis mutilans	Affects 2–21% of people with PsA
Spondylitis	This occurs in 35–75% of individuals with PsA
Type 2 diabetes	PsA increases risk by over 40% compared to the general population and more than 50% compared to individuals with psoriasis.
Uveitis	It affects around 7% of people with PsA
Depression and anxiety	Comorbidities of PsA, affecting around 20% of individuals with the disease

Dealing with PsA complications needs a full plan. This plan should involve watching for other diseases, living healthily, and teaming up with doctors. Also, focusing on certain markers in PsA treatment could help a lot and maybe lower the risk of getting PsA¹⁵.

Holistic Treatment for Psoriatic Arthritis

Psoriatic arthritis (PsA) can be extremely painful and difficult to manage. However, there are measures you may take to manage the pain that doesn’t require taking extra medication, using prescription creams, or seeing your doctor again.

These more natural methods cannot cure you. However, if you consult with your physician and devise a plan together, these homemade cures may help relieve your sore joints.

Some individuals discover that using complementary and alternative therapies can be beneficial. However, before using any herbs or supplements, consult your physician.

In addition to natural and alternative therapies, current medical therapy options can help reduce the growth of PsA, avoid flare-ups, and ease symptoms.

While some strategies reduce the likelihood of a flare-up, others try alleviating symptoms. However, not all of these treatments have supporting scientific evidence.

The following natural remedies may help with PsA:

1. Turmeric

Turmeric’s constituent, curcumin, seems to have anti-inflammatory qualities. The authors of a 2018 review concluded that curcumin might be a viable option for a natural PsA treatment. Turmeric can be consumed in food or taken as supplements.

2. Chili powder

The ingredient that gives chili peppers their heat is called capsaicin. Some studies show capsaicin-containing lotions may numb pain receptors, relieving discomfort in aching joints. These lotions can be applied to the afflicted joints.

3. Using Epsom salts

Taking a warm bath with Epsom salts may lessen joint discomfort and inflammation. Epsom salts contain magnesium, which supports healthy bones and may relieve irritated skin.

Additionally, warm water helps to ease discomfort and release joints. The ideal temperature range is 33–37.8°C (92–100°F).

Epsom salts, however, may not be appropriate for diabetics since they can accelerate the release of insulin.

4. Fish Oil

Fish oil contains omega-3 fatty acids. These fats may lower inflammation, which may lessen uncomfortable swelling. Omega-3 supplements, fatty seafood like tuna, and other cold-water fish are examples of potential sources.

5. Ginger

Ginger is a spice and root that seems to have anti-inflammatory qualities. According to the Arthritis Foundation, ginger may benefit rheumatoid arthritis.

6. Work Out

Exercise can improve a person’s general health and quality of life. It can also improve muscles, ease stiffness, help control weight, and lessen the chance of cardiovascular disease.

Experts suggest low-impact exercises like yoga, tai chi, and swimming for those with PsA.

7. Steer clear of or give up smoking

Current policies highly advise against smoking since it might cause PsA and flare-ups of symptoms. One option is to seek their doctor for advice on a good smoking cessation program or product.

8. Therapeutic massage

A massage therapist knowledgeable in PsA can help release tense muscles and joints and ease joint discomfort. Getting a massage can significantly reduce the pain associated with arthritis.

9. Acupressure

A therapist can relieve tension, boost the immune system, and lessen discomfort by applying pressure to various body parts.

10. Essential Oils

Essential oils are extracted from flowers, trees, herbs, and other plants and can be used in bath and massage products or for aromatherapy. Breathing in particular scents, such as lavender and rosemary, might help your body release “feel-good” hormones. Although essential oils are typically harmless, utilize diluted versions if they come into contact with your skin.

9. Acupuncture

A licensed acupuncturist can place needles at different pressure sites to treat chronic pain. There is evidence to support this in the treatment of PsA.

Acupuncture can be costly and cause skin complaints in certain psoriasis sufferers.

Acupuncture for Psoriatic Arthritis

Acupuncture for PsA

PsA patients undoubtedly use acupuncture, but is it effective? It is difficult to know. Studies on the use of acupuncture for PsA are “conspicuously absent,” as the authors of a 2020 review put it.

The study on acupuncture for joint pain may offer some hints. But what about the findings of those studies? They are, indeed, mixed.

A 2018 analysis of forty-three trials on acupuncture for rheumatoid arthritis revealed that the treatment enhanced quality of life and range of motion. Despite acknowledging that the research wasn’t well constructed, the authors concluded it was worth a try.

Real acupuncture did not alleviate hip pain any more effectively than phony acupuncture, according to 2018 research on the subject of acupuncture for osteoarthritis.

Therefore, the conclusion about acupuncture for PsA is that treatment shows promise, but much more research is required.

Homeopathy for PsA

The various methods by which homeopathic medications can treat psoriatic arthritis depend primarily on the condition’s severity, persistence, and family history. These essential characteristics aid in assessing the likelihood that psoriatic arthritis can be cured. Patients who do not use conventional treatments respond very well to homeopathic medicines. Once the illness is detected, choosing homeopathy as soon as possible is best because it offers immediate treatment.

The homeopathic remedies Thuja occidentalis, Rhus toxicodendron, Radium bromatum, Kali carbonicum, and Ledum palustre are used to treat psoriatic arthritis. These drugs help lower inflammation and stiffness and relieve pain.

Homeopathic medications also halt the progression of the disease, improving the patient’s quality of life and restoring their ability to carry out everyday tasks. By using homeopathic remedies, one might lessen their reliance on opioids to manage their pain.

Homeopathy for psoriatic arthritis

Before using homeopathic remedies for PsA, consider the following:

Researchers have clearly demonstrated that homeopathic medication is always safe for treating psoriatic arthritis.
Patients with psoriatic arthritis now have a better quality of life, thanks in part to homeopathic medications.
Homeopathic medications are desirable and positively affect various body tissues and organs. However, the homeopathic physician must perform a comprehensive evaluation for positive outcomes.

The following are a few of the most widely recommended homeopathic remedies for psoriasis: Science has not demonstrated that any of these are effective in treating psoriasis or its symptoms.

1. Sepia

Some homeopaths use Sepia to treat dry skin and extensive psoriasis. Sepia Succus is a useful homeopathic remedy for PsA if joint pain is associated with the presence of large oval discoloration on the skin.

2. Arsenicum Album

Scientific evidence indicates that Arsenicum helps people whose scaly, dry skin worsens when scratched and gets better when they apply heat.

3. Graphite

Graphites are used in homeopathy to treat leathery, cracked, and chronic skin diseases.

4. Sulfur

Evidence suggests that Sulfur lessens irritation and skin problems. While the efficacy of sulfur as a stand-alone homeopathic remedy is unknown, it can be combined with other well-researched psoriasis remedies like salicylic acid or coal tar.

5. Petroleum

Petroleum appears to aid those whose bodily issues worsen during stress. Petroleum can be extremely toxic to consume, even in small amounts. However, homeopathic petroleum and petroleum jelly—like Vaseline—can help hydrate your skin and lessen irritation, flaking, and itching.

6. Carbonica calcarea

Shell-based Calcarea carbonica is used in homeopathy to treat a wide range of ailments, especially those prone to cold environments and fatigue.
Although psoriasis sufferers have low blood calcium levels, scientific data support the use of Calcarea carbonica in treating this condition.

7. Staphysagria

Based on an animal study, Staphysagria may have anti-inflammatory properties, but the plant’s benefits for psoriasis sufferers are merely anecdotal. It is usually used to treat scalp psoriasis in homeopathy.

8. Solubilis Mercurius

Mercury is in the form of Mercurius solubilis, which is hazardous when applied topically or consumed. Excessive exposure can potentially result in mortality, respiratory problems, and renal failure. Scientific research shows that Mercurius solubilis is a safe and effective treatment for psoriasis.

9. Rhus Toxicodendron

Rhus toxicodendron, also known as poison Ivy. There is conflicting information regarding its ability to treat arthritis, including psoriatic arthritis. On the other hand, evidence supports the “like cures like” idea, suggesting that it can alleviate other psoriasis symptoms.

10. The Mezereum

A blooming plant called mezereum is used in homeopathy to treat thick, crusty plaques. It is toxic to humans, whether applied topically or consumed. According to scientific research, Mezereum is a safe or efficient treatment for psoriasis.

Conclusion

Handling PsA well requires working closely with healthcare teams, especially rheumatologists. The key is to get diagnosed and treated early for the best long-term results. A delay in diagnosis for over six months can make things worse for the patient¹⁷. Studies also show that smoking and late diagnosis mean worse functional results for patients¹⁷.

Dealing with psoriatic arthritis means using various medical treatments and making changes in how we live. Research, like PSUMMIT ¹ and SIRROUND-D, supports the use of biologic drugs¹⁷. They are seen as effective and safe for treating active psoriatic arthritis. Losing weight can also help obese patients with psoriasis, and those on biological therapy have better outcomes¹⁸.

Working with doctors and being proactive about managing PsA is crucial. It helps control symptoms, prevent joint damage, and maintain a good quality of life. Living a full and active life with this condition is possible with the right support and strategies.

FAQ

What is PsA?

Psoriatic arthritis is a long-term condition in which joints get inflamed. It happens with or without psoriasis. Psoriasis is a skin condition with red, scaly, and itchy patches.

What are the symptoms of psoriatic arthritis?

Symptoms may vary. You might have skin patches, joint pain, fatigue, or swollen fingers or toes. Nails can change. Inflammation of the eyes or bowel issues might also show up.

What causes psoriatic arthritis?

The exact cause is unknown. But, being obese and having severe psoriasis might raise the risk. Stress, joint or bone injuries, and infections can start it. Family history plays a role, and certain genes seem to matter.

How is psoriatic arthritis diagnosed?

Diagnosis includes a physical exam and looking at nails and skin. Imaging tests and blood work help. A skin biopsy might confirm psoriasis.

What are the treatment options for psoriatic arthritis?

Treatment targets pain, swelling, and stiffness and aims to prevent joint damage. Options include NSAIDs, DMARDs, and biologics. Exercise and weight control are advised.

Can homeopathy cure psoriatic arthritis?

Homeopathy might ease symptoms for some, but it’s not scientifically proven to cure psoriatic arthritis. Working with a rheumatologist for a treatment plan is essential.

Is acupuncture effective for managing psoriatic arthritis?

Studies suggest that acupuncture may reduce pain and improve function. But, its full benefits for psoriatic arthritis need more research. Talk to your doctor about trying acupuncture.