Psoriatic arthritis is an inflammatory joint disease associated with the skin ailment, psoriasis. Like all arthritis, it most commonly affects the joints in the hands and feet, but can also cause inflammation, swelling and pain in larger joints, including the knees, elbows, hips and the spine. In cases of psoriatic arthritis, the tendons (the fibrous tissue attaching the muscle to the bone) can also be affected.
Psoriasis causes red, scaly patches on the skin called plaques, which can become itchy and sore. The plaques can cover a small area (usually on the head, knee, elbows and buttocks) or a larger area. It also affects the nails.
The chances of getting psoriasis or psoriatic arthritis are the same for men and women, although women are at more risk after pregnancy or the menopause.
Psoriatic arthritis can occur at any age. It usually only develops if the sufferer already has psoriasis. However, having psoriasis does not automatically mean it will develop into psoriatic arthritis. In around 70% of cases psoriasis precedes psoriatic arthritis, in 15% the skin and joint conditions occur at the same time and in the remaining 15% psoriatic arthritis is present before the skin condition psoriasis appears, according to the Psoriasis Association.
People with psoriasis can also develop other forms of arthritis, such as rheumatoid or osteoarthritis. The severity of psoriatic arthritis isn’t necessarily related to how bad the psoriasis is. This means bad psoriasis can come hand-in-hand with little or no arthritis, or well-controlled psoriasis with more severe arthritis.
There are five types of psoriatic arthritis, according to Bupa, and some overlaps:
- Symmetric arthritis affects the same joints on each side of the body – symptoms in several joints are likely.
- Asymmetric arthritis affects different joints on each side of the body, for example a few finger joints and a knee joint.
- Distal interphalangeal predominant (DIP) arthritis happens in the joints closest to the finger- and toenails.
- Arthritis mutilans leads to serious deformity in the fingers and toes, and can also affect the spine.
- Spondylitis – the arthritis develops in the spine and the sufferer will experience pain and stiffness in the back and neck.
What are the symptoms of psoriatic arthritis?
Symptoms of psoriatic arthritis can come and go and vary from mild to severe. Common ones include:
- General tiredness.
- Tenderness, pain, redness and swelling over tendons
- One or more entire fingers or toes swelling up – this is called dactylitis, caused by the joints and tendons becoming inflamed
- Stiffness, pain, throbbing and swelling in one or more joints
- A reduced range of movement
Nail changes – pitted or thickened nails
- Flaking white patches of skin with red, inflamed skin underneath
- Conjunctivitis or sore, red eyes
How is it treated?
There are many different medicines and treatments available for psoriatic arthritis and they depend of the type and severity of the condition. Seeking professional medical advice is essential to managing the condition properly. Living with the illness can be frustrating and a change in lifestyle, as well as close cooperation with a doctor, is essential.
Keeping up a moderate amount of exercise is important as otherwise the muscles around the joints will weaken and become stiff. Exercise will also help reduce pain and stiffness and make it easier to move around.
There are three types of exercise that can help, according to Bupa, including:
- Strengthening the muscles around your joint
- Range of motion exercises to maintain joint motion and improve flexibility
- Aerobic exercise, such as walking, swimming, cycling or hydrotherapy (supervised exercises in a pool)
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