Psoriatic arthritis is a chronic form of inflammatory arthritis that can cause inflammation of the spine (spondyloarthropathies). Psoriasis is a skin condition that patches of red and scaly skin. Psoriatic arthritis is a systemic rheumatic disease that can also cause inflammation of tendons, cartilage, eyes, lung lining, and, even the aorta.
Symptoms of psoriatic arthritis include joint pain, stiffness and swelling. These swellings may flare and subside on its own. Morning stiffness is a common phenomenon occurring in people with psoriatic arthritis. Even mild skin psoriasis can cause a significant degree of arthritis in people depending on the age.
Unfortunately, there is no permanent cure to this condition but treatment and medication are essential to reduce the pain and swellings. If left untreated, the situation is likely to get worse. Drugs like Nonsteroidal anti-inflammatory drugs (NSAIDs), Disease-modifying antirheumatic drugs (DMARDs) and biologics may be used to suppress inflammation and prevent joint damage and reduce symptoms. NSAIDs include aspirin and ibuprofen which are over-the-counter medications. DMARDs may relieve more severe symptoms. It attempts to slow or stop joint and tissue damage and the progression of psoriatic arthritis to other parts of the body. Biologics are usually prescribed for psoriatic arthritic patients who did not respond to other treatments. New oral treatments which are taken as tablets by mouth, improve symptoms of psoriatic arthritis by inhibiting specific molecules associated with inflammation.
Doctors first need to closely diagnose the condition and then begin treatment. Tests of different types help to rule out other possible causes of joint pain and may reach a proper underlying root cause. Doctors will examine the joints for signs of swelling or tenderness, finger tips and fingernails, soles of the feet and around the heels to find tender areas. Imaging tests like X-Ray and MRIs can help to better understand the proper direction of treatment. It helps to check the condition of the tendons and ligaments. Laboratory tests like rheumatoid factor and joint fluid test are also conducted.
Medication includes drugs like NSAIDS, biologics, DMARDs, TNF-alpha inhibitors and oral medicines. NSAIDs that is Nonsteroidal anti-inflammatory drugs help to relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Disease-modifying antirheumatic drugs (DMARDs) include drugs like methotrexate (Trexall), leflunomide (Arava), and sulfasalazine (Azulfidine). They help to retard the progression of psoriatic arthritis and save the joints and other tissues from permanent damage. Immunosuppressants act as medicines provided to tame the immune system. Examples of this drug are azathioprine (Imuran, Azasan) and cyclosporine (Gengraf, Neoral, Sandimmune). Biologics are complex drugs which are applied when patient does not respond to the other treatments. They help to stop inflammation at the cellular level and are usually given by injection or infusion. Two types of biologics are effective in the treatment of psoriatic arthritis. The first type are called anti-tumor necrosis factor-alpha (TNF-alpha) drugs. They help to block a specific protein produced by immune cells that signals other cells to start the inflammatory process. These include etanercept, adalimumab,golimumab,infliximab and certolizumab. A second type of biologic, called ustekinumab, blocks interleukin-12 and interleukin-23, two pro-inflammatory proteins.
Surgical procedures can also be applied to treat psoriatic arthritis. Joint replacement surgery can be opted if the joints have been severely damaged. By surgical operations the damaged joint can be replaced with artificial prostheses made of metal and plastic. Also, Steroids may be injected into the affected joint to fasten the cure and reduce inflammation and pain.
People with severe symptoms of psoriatic arthritis like swollen painful joints and lower back pain must consult a doctor before symptoms worsen.
People with minor pains which fade away in a few days do not require any treatment. Also, redness caused due to allergies or other issues do not need to undergo a treatment for psoriatic arthritis. Hence, it is always examined whether the symptoms are due to arthritis or not.
Side effects of using the medicinal drugs may include stomach irritation, heart problems, and liver and kidney damage. While biologics are very effective, they suppress the immune system and increase the risk of infections. Bone marrow suppression and severe lung infections have also been noted in patients as adverse effects of this treatment. Side effects also include nausea, diarrhea, hair loss etc.
This treatment has no permanent cure, thus extra attention and care must be taken for those who have already suffered from it. After treatment, one must be cautious not to hurt or pressurize their joints. They should use their entire body to push or open something without jus using the fingers. It is important to maintain a healthy weight. It helps to place less strain on the joints, leading to reduced pain and increased energy and mobility. Eating a lot of fruits, vegetables and whole grains help to reduce the chances of psoriatic arthritis. Regular exercising can help keep the joints flexible and muscles strong. Patients should be reviewed timely to be on the safe side.
Treatment of psoriatic arthritis can help to reduce joint and muscle pain, redness and inflammation in the patients. This disease is most common in people older than 60 years old. However, it can also be found in younger ages. But, there is no permanent cure to this. It is a chronic disease that can last for years or be lifelong.
Unfortunately the treatment is not permanent. Psoriatic arthritis pain and inflammations can be reduced but not cured forever. It recurs if proper precautions are not taken and if additional pressure is exerted on the jointed areas.
Patients with chronic conditions of psoriasis and psoriatic arthritis resort to complementary and alternative therapies. These therapies include herbs and supplements, diet, mind/body therapies like aromatherapy, yoga and meditation. Physical therapies, exercise and the ancient arts of acupuncture and tai chi are also practised to reduce joint pains. Homeopathic treatment may also help to cure the pain and inflammations. Symptoms of psoriatic arthritis fade away with a long term usage of homeopathic medicines.