Psoriasis is a skin disease. However, it can cause severe complications that affect joints. Patients who have psoriasis usually complain of red spots on their skin covered with white or grayish scales. Psoriatic rash can appear on any part of your body. As a rule, psoriasis occurs for the first time to people aged 14 to 45 and it is equally frequent in men and women.
Psoriatic arthritis develops in about 10% of patients with psoriasis. It often occurs after a few or even many years after the first symptoms of psoriasis. However, in some cases psoriasis arthritis may appear before the onset of visible skin symptoms.
What is psoriatic arthritis? The exact cause of this disease is unknown, but doctors believe that the development of psoriatic arthritis is closely connected to immune, genetic and environmental factors. Up to 40% of patients with psoriatic arthritis claim to have either psoriasis or arthritis in their past history of the family.
Psoriatic arthritis can be symmetric, when both joints on the right and left part of your body are equally affected. For instance, both knee or wrist joints are inflamed. Due to this parameter psoriatic arthritis is often misdiagnosed as rheumatoid or juvenile arthritis.
Asymmetric arthritis causes an inflammation of one or several joints anywhere in your body.
Symptoms of Psoriatic Arthritis
Let us have a look at psoriatic symptoms at first. Symptoms of psoriasis include skin changes. You may develop red scaly spots on your skin, scarring looking like pockmarks and discoloration of your nails on your hands and feet. Spots known as psoriatic plaques can be very small. You can find them on your scalp close to the hairline, below your knees, or the spots can cover your upper arm near your elbows. In complicated cases rash caused by psoriasis can be distributed all over your body. It can be found even on your head, hip or fingers. Psoriatic rash is often accompanied by itching and discomfort.
Psoriatic arthritis usually develops over a long time, but it can sometimes occur suddenly. Very often people do not pay attention to early signs of arthritis, because they think it is just fatigue or light pain in joints. They prefer to wait until the unpleasant symptoms disappear on their own.
Further symptoms of psoriatic arthritis include pain and swelling of joints. And these signs are very difficult to ignore. Most often the disease affects the last joints of your fingers and toes, as well as your wrist, elbow and knee joints. In some cases only one joint is inflamed. In other cases inflammation can involve several joints, so that the clinical picture of psoriatic arthritis resembles the clinical course of rheumatoid arthritis. Psoriatic arthritis symptoms in severe cases can include inflammation of a sacroiliac joint and spine. Due to this psoriatic arthritis refers to a group of diseases known as spondylarthroses.
Psoriatic Arthritis Pictures
Diagnostics of Psoriatic Arthritis
It is no need to remind that you should see a doctor if you have any of the above-mentioned symptoms. To make a diagnosis a specialist will ask you to describe your symptoms in more details. He or she will examine your skin and joints. To diagnose your disease a doctor can appoint additional examination because the symptoms of different types of psoriatic arthritis are similar. The necessary procedures may include:
- X-ray examination;
- blood test;
- joint fluid test.
If you have manifestations of psoriasis on your skin, psoriatic arthritis can be diagnosed almost immediately. In other cases your doctor will insist on a thorough examination. Sometimes the diagnosis is confirmed by the appearance of skin rash.
Treatment of Psoriatic Arthritis
Your doctor can get other specialists involved into psoriatic arthritis treatment to create an optimal plan of controlling and treating your disease. In general, healthy lifestyle and overall condition of your body play an important role in your state.
The main goals of treatment include pain relief and removal of joint inflammation, control of cutaneous manifestations of psoriasis and deceleration or preventing your joints from further damage. The therapy is complex and usually involves use of external medication, oral drugs and other treatments.
Psoriasis requires careful skin care. You should use special mild cosmetics and avoid exposure to any skin irritant. You should also pay attention to what you eat, as improper diet can worsen your situation.
Depending on the severity of the disease and degree of painful sensation your doctor will help you to choose a complex program to treat your psoriatic arthritis, which will include well-chosen physical exercises, the optimal schedule of work and rest and appropriate diet. All these measures can make your living with psoriatic arthritis easier.
There are different groups of drugs controlling psoriasis and improving your skin condition. To cure arthritis and to remove pain, inflammation and stiffness of your joints doctors most commonly prescribe NSAIDs, which are non-steroid anti-inflammatory drugs. These drugs act quickly and do not cause addiction. In severe cases of arthritis doctors use corticosteroids and immunomodulatory drugs.
The only problem with these drugs is that they have some side effects. They can badly influence your stomach. That is why in most cases doctors prescribe additional means to protect your stomach, liver and bowels. Also be careful with corticosteroids, as their prolonged intake can lead to erosion and degeneration of your joints.
Patients with psoriatic arthritis often have chronic fatigue and even depression. Your doctor will help you to cope with these psychological problems and will give some recommendations which will help you to improve quality of your life. You can also ask your doctor for natural treatment for psoriatic arthritis that can alleviate its symptoms.
You should understand that psoriatic arthritis is a chronic disease with remission and aggravation stages. No doctor can give you optimistic long term prognosis. Any promises of “instant cure” or “wonderful relief” sound very appealing to patients with this chronic disease. But most of the drugs, nutritional supplements and natural remedies advertised in this way cannot heal arthritis. As a rule, such agents are expensive, but their effectiveness has not been proven or is too doubtful. Before trying new drugs or home remedies against psoriatic arthritis, be sure to consult with your doctor.
How Important is Exercise for Psoriatic Arthritis Treatment?
Regular physical exercise can relieve joints stiffness and reduce pain caused by psoriatic arthritis. Specially designed program of exercises aimed at maintaining your natural range of motion, in combination with general strengthening exercises, will help you to achieve the following goals:
- To ease the symptoms of psoriatic arthritis;
- To preserve normal functional activity of your joints;
- To increase muscle flexibility and elasticity;
- To maintain the optimum weight to reduce excessive loads on your joints;
- To increase general endurance of your cardiovascular system.
A good idea is to attend a swimming pool. Water therapy (hydrotherapy or aqua therapy) is a program of exercises performed in water. Water therapy is a simplified version of physical exercise for your joints affected by psoriatic arthritis, as water decreases the load on your affected joints. Regardless of the selected program, it is important that it corresponds your physical and health condition.
Before you start exercising, discuss with your doctor the various options. It is better that you try out new exercises under the supervision of a physical therapist or a qualified professional with experience of working with psoriatic arthritis patients. It is important to remember that an improper program may aggravate the symptoms of the disease. Discuss the features of your program with your doctor and make changes if you have the following symptoms:
- Constant dizziness;
- Increased fatigability;
- Rapid swelling of your joints;
- Lingering pain that continues more than an hour after exercising.
Are Temperature Procedures Effective for Psoriatic Arthritis Treatment?
Heat and cold treatments involve applying wet hot and cold compresses to the affected joints to provide temporary relief of pain and swelling during psoriatic arthritis. Applying moist hot towel or compress, taking a warm bath or shower can help to relax your muscles and eliminate pain in the joints. However, be very careful with excessively hot bath if your joints are inflamed.
Cold treatments such as using ice packs or frozen vegetables and fruit wrapped in a towel can reduce swelling and alleviate pain, causing numbness in the affected areas.
When is Surgery Necessary?
Most people suffering from psoriatic arthritis do not need to undergo surgery. However, when all the previous methods turned out to be unsuccessful, doctors have no other choice than to appoint a surgical procedure to restore functional activity of your joints by removing the affected parts of the articular soft tissues. In severe cases patient may need arthroplasty or a prosthetic joint, which is a kind of surgery aimed at replacing of the affected joint. This operation can return functionality of the affected area.
If conventional therapy does not help, doctors can suggest surgical fixation of some joints such as wrist, ankle, fingers and toes joints. The operation will reduce pain, increase mobility and improve the physical condition and appearance of the affected joint.