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Psoriatic Arthritis: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

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.

How is the treatment done?

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.

Who is eligible for the treatment? (When is the treatment done?)

People with severe symptoms of psoriatic arthritis like swollen painful joints and lower back pain must consult a doctor before symptoms worsen.

Who is not eligible for the treatment?

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.

Are there any side effects?

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.

What are the post-treatment guidelines?

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.

How long does it take to recover?

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.

Are the results of the treatment permanent?

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.

What are the alternatives to the treatment?

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.

Popular Questions & Answers

I am psoriatic arthritis patient with back pain and si joint pains in addition to other joint pains. I use hcqs 200 mg for psa. Spine surgeon prescribed duloxetine 20 mg one in morning & one in the evening for my back pain. These tablets also reduce other joint pains and also helps in controlling my inflammation. But my problem is because of this duloxetine capsules my sleep has become very much disturbed and I am unable to fall asleep when I wake up in the night. I feel active all the time and suffering with racing thoughts/brain fogg. I am not able to calm my mind by all means. To counter this I added mythy cobalamin 750 mcg and 1/2 of clonotril - .25 mg. But still then I get up between 3 to 4 am and unable to fall asleep. Totally I am getting a sleep of about 4.5 hours to 5 hours a day. Increasing clonotril dose causing me irritation in the stiff muscles surrounding the joints. I tried magnesium supplement which worked nicely but it increased my scalp psoriasis rapidly. I tried all forms of magnesium but same results. Melatonin helped a bit but it causing tiredness during entire day. Could you please suggest any medicine to calm down my thoughts and to get a restful sleep? Thank you.

MS - Orthopaedics
Orthopedic Doctor, Pondicherry
-if duloxetine is causing so many problems better to stop it - start on drugs methotrexate hope you should be recieving for your psoriasis the details of your psoriasis treatment is not available here - if you can upload the treatment details of p...

I am female 39 age having psoriasis arthritis my urine report shows bacteria cocci result 99. Do I have E coli or its normal range. Other bacteria bacilli shows 5 and mucus particles 30. I had urine infection 2 months back for which I have taken antibiotics for 10 days. Please doctor I am worried.

M.B.B.S., Diploma In Dermatology And Venerology And Leprosy (DDVL)
Dermatologist, Delhi
First get your psoriasis work up done from nearby dermatologist. All routine blood investigation should be done and for arthritis xRay should be done along with arthritis markers and medication can be changed depending upon all reports and severit...
1 person found this helpful

Does etova tablets have side effects of stroke or heart attack. Currently taking etova for psoriasis arthritis past 1 year.

MBBS, MD - Internal Medicine, DM - Cardiology, Fellowship in EP
Cardiologist, Delhi
All NSAIDs increase risk of thrombosis. You should try alternative approach like diet for all around improvement. I suggest you discuss your diet on phone with me. Best wishes.
3 people found this helpful

Hi, My mother is effected with psoriasis arthritis. How can it be cured soon. Need doctors help. seriously looking for a support.

BHMS
Homeopath, Noida
Psoriatic arthritis is a long-term inflammatory arthritis that occurs in people affected by the autoimmune disease psoriasis. Pain, swelling, or stiffness in one or more joints is commonly present in psoriatic arthritis. Homeopathy has encouraging...

I am 32 years old man having Psoriatic arthritis having 5.5 lakh platelet count is any problem with me doctor given me nucoxia 90 mg, defza 6 mg, sazo 1 gm please suggest me what to do.

MBBS
General Physician, Mumbai
Psoriasis is an auto immune disease and we can control it but not cure it fully and if it has lead to arthritis than you will have to take medication but also contact a Rheumatologist for further guidance.
3 people found this helpful

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