Psoriatic Arthritis: Managing Symptoms and Your Quality of Life

This article is for people who have psoriatic arthritis (PsA), or their care partners, as well as others who want to learn more about PsA. The goal is for patients to better understand PsA and to encourage patients to discuss treatment and ways to manage their symptoms and quality of life with their doctor.

You will learn about:

• What psoriatic arthritis is and who can have it

• Symptoms of psoriatic arthritis

• Psoriatic arthritis treatment

• Tips to help manage symptoms and maintain your quality of life

• Questions to ask your doctor

PsA is type of arthritis that typically happens in people who have the skin disease psoriasis.

PsA is an autoimmune condition. This means it happens when there’s a problem with your body’s immune system and healthy tissue is attacked by mistake.

PsA causes inflammation that affects your joints, which can become swollen, stiff, and painful. Over time, if PsA isn’t treated, it can damage your joints and tissues.

Up to 30% of people with psoriasis get PsA. Most develop psoriasis first, but joint problems from PsA can begin even before psoriasis skin lesions appear. If you have psoriasis, tell your doctor if you start having joint pain. PsA can severely damage your joints if left untreated.

Both men and women get PsA. It can happen at any age, but it usually happens between age 30 and 50.

Your chance of developing PsA also depends on your family history -- about 40% of people with PsA have a family member with skin or joint disease.

PsA is a chronic (long-term) disease that can get worse over time. You may have times when your symptoms improve -- called remission -- that alternate with times when your symptoms become worse, called disease flares.

Joint pain, stiffness, and swelling are the main symptoms of PsA. They can happen in joints on just one side of your body, or on both sides. Any part of your body can be affected by PsA. Symptoms can range from mild to severe.

Symptoms of PsA include:

• Swollen, painful fingers and toes from dactylitis (or “sausage digits”), which is inflammation of an entire finger or toe; it can happen in fingers and toes on different sides of your body

• Foot pain from enthesitis, which is inflammation where your tendons and ligaments attach to bones; this often happens at the back of your heel (Achilles tendinitis) or in the bottom/sole of your foot (plantar fasciitis)

• Lower back pain from spondylitis, which is inflammation of joints in your spine and between your spine and pelvis (sacroiliitis)

Living with PsA can cause challenges beyond physical pain and stiffness; it can also impact your quality of life.

PsA can affect your ability to function or participate in work and social activities, impact your level of fatigue, and cause emotional distress or stress. In addition, stress can aggravate PsA and trigger flares.

Early PsA treatment has the potential to slow the progress of the disease and may help you maintain your quality of life.

Right now, there is no cure for PsA so treatment focuses on controlling your symptoms and flares -- putting you into remission -- and preventing further joint damage. Without treatment, PsA may be disabling.

Another goal of treatment is to maintain your quality of life -- preserve your physical and social functioning, and your mental and emotional well-being.

There are many treatments for PsA. The plan you create with your doctor will be based on the severity of your PsA, your symptoms, other conditions you may have, and your quality of life.

Medicines used to treat PsA include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve pain

• Steroids to help control inflammation

• Disease-modifying anti-rheumatic drugs (DMARDs) to slow joint and tissue damage

• Immunosuppressants to help control your immune system

• Biologics that block certain cells or proteins that cause inflammation or play a role in PsA

• Enzyme inhibitors to block an enzyme (protein) and reduce inflammation

Your doctor may also recommend surgery to replace a severely damaged joint with a new one made from metal and plastic.

Ways you can help manage your symptoms and preserve your quality of life include:

• Take medicines as directed and report any side effects

• Protect your joints by changing the way you do everyday tasks, like using a jar opener or lifting with both hands

• Maintain a healthy weight to decrease pain and strain on your joints, and to increase energy and mobility

• Stay active to keep your joints flexible and muscles strong; try low-impact exercises, like yoga, swimming, or walking

• Pace yourself by dividing exercise or work activities into short segments

• Develop coping strategies with your doctor or a counselor’s help to reduce stress

Keeping a journal to track your PsA symptoms and remission and flares so you can discuss them with your doctor during visits may be helpful.

Questions to ask your doctor can include:

• What symptoms of PsA should I look for?

• How can PsA affect my quality of life?

• What treatments are available and what are their side effects?

• What can I do to help manage my condition and maintain my quality of life?

• What lifestyle changes and types of exercise should I do?

• What should I do if I start to feel depressed or stressed?

Congratulations!

You have successfully completed the program: Psoriatic Arthritis: Managing Symptoms and Your Quality of Life

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