Types of Psoriatic Arthritis
There are five main types of psoriatic arthritis:
Asymmetric arthritis: This affects joints on only one side of the body. It most commonly affects the fingers and toes. One or a few joints may be swollen at a time.
Symmetric arthritis: This type affects the same joints on both sides of the body at once, such as both knees or wrists.
Distal interphalangeal predominant (DIP) arthritis: This causes pain, swelling and stiffness in the fingers and toes closest to the nails. It often affects multiple joints at the same time.
Arthritis mutilans: An aggressive rare form of the disease that seriously damages finger and toe joints. Over time this can lead to permanent deformities.
Spondylitis: Inflammation of the spine that can cause stiffness, pain and deformation. It often affects the sacroiliac joints of the pelvis.
Medication Options for Psoriatic Arthritis Treatment
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are commonly the first line of Psoriatic Arthritis Treatment. They help relieve pain and reduce swelling and stiffness in the joints. Common NSAIDs include ibuprofen, naproxen and celecoxib. Potential side effects are gastrointestinal problems like ulcers.
Disease-Modifying Anti Rheumatic Drugs (DMARDs)
DMARDs work to slow progression of joint damage over the long term. Methotrexate is often the first DMARD prescribed due to its effectiveness and low cost. Other options include leflunomide, sulfasalazine and hydroxychloroquine. Side effects can be nausea, fatigue and liver or lung problems.
Biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs)
For cases where DMARDs provide inadequate relief, biologics may be prescribed. They specifically target certain proteins that play a role in inflammation. Common biologics prescribed are etanercept, adalimumab, infliximab, secukinumab and ixekizumab. Potential risks are increased vulnerability to infections.
Corticosteroids
Short courses of corticosteroids like prednisone may be used at times of flare ups. Side effects are potential weight gain, mood changes, high blood pressure and risk of infections. Long term daily use is not recommended.
Complementary and Alternative Treatments
Some people with psoriatic arthritis find relief through complementary and alternative therapies alongside medical treatments. However, it's important to discuss these options with your doctor to ensure safety.
Physical Therapy
Exercise and physical therapy are vital components of effective psoriatic arthritis management. Range of motion, strengthening and low-impact cardio exercises can help reduce pain and stiffness while maintaining mobility in the joints. Heat or cold therapy also provides comfort.
Topical Treatments
Over-the-counter topical creams with menthol or capsaicin from chili peppers temporarily relieve localized joint pain. Prescription topical NSAIDs and corticosteroids applied to affected joints may help as well.
Lifestyle Changes
Making dietary modifications, managing stress levels through yoga or meditation, getting adequate rest, and maintaining a healthy weight all support psoriatic arthritis treatment. Consuming an anti-inflammatory diet rich in omega-3 fatty acids, vitamin D and antioxidant-rich plant foods can further optimize wellness.
Alternative and Complementary Methods
Acupuncture, massage therapy, supplements like turmeric, ginger or fish oil often enhance quality of life for people living with psoriatic arthritis. As with any treatment, it's essential to check with your doctor before incorporating significant alternative therapies into your treatment plan.
Treatment Goals and Management Strategies
The treatment aim is to control symptoms, halt joint damage progression and maximize functional ability and quality of life long term. An individualized treatment strategy considers the type and severity of arthritis presentation as well as personal choice and goals. Treatments may take time to start working, so ongoing communication between the patient and rheumatologist ensures the best regimen. By tailoring treatment options based on response to therapy, psoriatic arthritis can usually be effectively managed for many years.
Surgery
In extreme cases where joint damage is severe or medication regimens are not working fully, surgery may be required. Common procedures are synovectomies to remove inflamed synovial tissue, joint fusions to immobilize severely damaged joints, or even joint replacement in the hip, knee or finger joints.
The Importance of Self-Care and Support
Taking an active role in one's treatment and engaging in healthy behaviors is vital for successful psoriatic arthritis management. Attending support groups and connecting with others improves coping skills and boosts emotional wellbeing too. With today's varied treatment options, maintaining open communication with one's care team enables customized care
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