Psoriatic arthritis is a type of arthritis that can develop in some people who experience the skin condition psoriasis. There are five main types of psoriatic arthritis- Symmetric arthritis, Asymmetric arthritis, Digital Interphalangeal Predominant (DIP) arthritis, Arthritis mutilans and Spondylitis. In this article we will examine treatments available.
Generally speaking, psoriatic arthritis treatment will be the same as treatment for any other form of arthritis. Your doctor will advise on treatment based on the type or types of the condition you have and the range and severity of symptoms. An early diagnosis will help to slow the progression of the disease and help to prevent further damage to the joints. Ideally treatment for psoriatic arthritis should go hand in hand with treatment of psoriasis.
Exercising can be beneficial as it will help to reduce stiffness and pain, and will strengthen the muscles around the joints. Your physiotherapist should be able to show you certain exercises designed to improve joint mobility and function. Low impact aerobic exercise, such as swimming and walking, can improve overall health and fitness, reduce excess weight and improve muscle strength and flexibility.
Physiotherapy can provide relief for some individuals, as can relaxation techniques of using electrotherapy, for example a TENS machine.
Use of ice packs to the affected joints can help to relieve swelling and joint pain.
There are also a number of prescription medications which can reduce symptoms.
Non- steroidal anti-inflammatory drugs (NSAIDS)
NSAIDS can be prescribed early on to relieve inflammation and swelling. As they are largely aspirin based, they can cause irritation to the stomach so should be avoided if you are prone to stomach ulcers.
Steroids are strong anti-inflammatory drugs which may be prescribed if the symptoms are severe, or if the patient experiences a flare-up. If used in high doses, the condition of the skin should be monitored as steroids can affect psoriasis. Steroids are often used in lower doses to reduce the risk of these side effects whilst stabilizing the arthritis.
Steroids can also be administered in injection form directly to the joint. They can be particularly effective when only one joint is affected, but there is a risk of adverse side effects of injections are given too often.
Disease-modifying antirheumatic drugs (DMARDs) contain agents that target the specific occurrences within the body which cause both psoriasis and psoriatic arthritis. They can help to slow the progression of arthritis and help stop further joint tissue damage from occurring.
Cyclosporine is an immunosuppressive drug used to treat psoriasis that can also slow the progression of psoriatic arthritis. Prolonged use can cause kidney damage so regular blood tests should be undertaken.
Methotrexate can help prevent joint deterioration and relieve the symptoms of the condition. However, there are a number of potential side effects, including liver damage, so should be carefully monitored.
Sulfasalazine is an anti-inflammatory drug which has been proven effective in the treatment of the condition.
Antimalarial medication is usually used to treat rheumatoid arthritis, but has also been used to successfully treat psoriatic arthritis. As side effect scan include headaches and blurred vision, regular eye tests should be undertaken. Some antimalarial medication can also exacerbate symptoms of psoriasis.
If you think you may have psoriatic arthritis, you should see your doctor in the first instance for a diagnosis and to discuss possible treatment options.