When most people think about “arthritis,” they think of what doctors call osteoarthritis, the most common type of arthritis. Osteoarthritis is a degenerative joint disease that happens when the cartilage that protects the ends of the bones breaks down, causing pain and joint damage.
However, “arthritis” is actually a general term used to describe “inflammation in joints.” There are many different kinds of arthritis, and though they all cause similar symptoms, they have different causes, and, therefore, different treatments are used to help relieve the pain and prevent further deterioration. How do you know which kind of arthritis you have? Ask a rheumatologist!
What is psoriatic arthritis?
Psoriatic arthritis (PsA) is a type of arthritis, so it is a disease that causes joint inflammation, pain, and damage. It’s called “psoriatic” because about 30% of the people who have psoriasis (a skin condition that causes red, scaly, itchy patches on the skin) end up with psoriatic arthritis. One main difference from other types of arthritis is that psoriatic arthritis often “flares up” rather than having constant pain.
How do I know if I have PsA?
Most people with PsA (60-70%) are first diagnosed with psoriasis, and sometimes, it takes 8-10 years for joint pain to develop. In other patients (15-20%), the first symptoms are similar to osteoarthritis, with pain, redness, and stiffness of the joints. So if you have red, scaly, itchy patches on your skin along with joint swelling, pain, and inflammation, you’ll want to see a rheumatologist as soon as possible. Other common symptoms include the following:
- Swelling of an entire finger or toe (rather than just swelling of the joints)
- Morning stiffness that lasts longer than 30 minutes
- Back pain that wakes you up at night
- Changes, such as pitting, in your nails
I’ve got psoriasis and painful joints. Now what?
Make an appointment with a rheumatologist as soon as you can. All types of arthritis worsen over time, but beginning treatment in the early stages is the best way to help. PsA can substantially affect daily activities and quality of life–one-third of PsA patients report that they miss work because of their disease and that it affects their ability to work full-time. Early intervention is key in keeping you functioning at your best for as long as possible.
What can I expect from an appointment with a rheumatologist?
In addition to listening to your complete medical history, a rheumatologist can evaluate you more specifically for PsA. A physical exam may include the following:
- Looking for psoriasis in places where it’s harder to see, such as your scalp
- Checking finger and toe nails for signs of pitting, etc.
- Feeling joints for redness, tenderness, and swelling
- Asking about tendon and ligament issues, such as plantar fasciitis, tennis elbow, etc.
- Checking your back for mobility, pain, and inflammation
Laboratory or imaging tests that may be ordered to help with diagnosis may include the following:
- ESR and CRP–testing for inflammatory markers in your blood
- RF and CCP–testing for antibodies that may be present in your blood
- X-rays–to look at your affected joints to see if bone is deteriorating
- Ultrasound–to see disease activity and note whether there is damage in tendons and ligaments
- MRI–especially to see if your back is affected
I’ve been diagnosed with PsA. What’s next?
There are numerous treatments that can help mitigate the symptoms and prevent the condition worsening over time. These may include medications and physical therapy to counteract the loss of mobility that PsA may cause. You’ll want to be patient–these therapies may take time to improve your symptoms. The goals of PsA therapy include the following:
- Relieve pain
- Protect joint mobility
- Reduce inflammation
- Improve skin and nail conditions
- Keep you from developing other possibly related conditions
Conclusion
There is currently no known cure for PsA, but early intervention is critical to avoid further deterioration, relieve pain and inflammation, protect joint mobility, and minimize the impact PsA will have on your everyday life.
Written by Shlomo Witty