Psoriatic arthritis

Psoriatic arthritis is a chronic inflammation of the joints, which can develop in people who have psoriasis. The condition causes stiff and painful joints. It sometimes leads to tiredness and fatigue.

Psoriatic arthritis can have a major impact on quality of life – for example, by disrupting sleep, which in turn affects daily life, productivity and concentration. Various treatment methods are available to relieve the symptoms and protect the joints from damage.

The main symptoms of psoriatic arthritis are pain, swelling, joint stiffness and general fatigue.

The swollen joints usually feel warm and are sensitive to touch. In the morning in particular, the joints are often stiff but this stiffness is usually relieved by movement.

Several joints may be inflamed to varying degrees. In many cases, more than five joints are inflamed. The following are often affected:

• hands
• feet
• elbows
• knees
• neck
• spine 

The end joints of the fingers and toes in particular may become deformed in later stages of the disease.

In some cases, the tendons and tendon sheaths become inflamed in addition to the joints.

Psoriatic arthritis develops as a result of an autoimmune response. In other words, the immune system becomes overactive and attacks parts of the body itself. Conditions where the immune system attacks the body’s own tissue are known as autoimmune diseases. When this happens, the immune system produces more chemical messengers, such as cytokines, which trigger an inflammatory response. With psoriatic arthritis, the joints in particular become inflamed.

People who have a parent or sibling with psoriasis or psoriatic arthritis are at an increased risk of developing this condition.

Around 25 percent of people with psoriasis will develop psoriatic arthritis at some point. It can develop at any age but is most common between the ages of 30 and 50.

In almost 80 to 90 percent of people, psoriatic arthritis develops many years after their visible psoriasis first appears. However, it is also possible for joint inflammation to occur before any symptoms of psoriasis are seen on the skin. There is no clear correlation between the severity of psoriasis and the severity of psoriatic arthritis.

Psoriatic arthritis is a chronic condition. In other words, people with this condition have it for life. It is almost impossible to predict how psoriatic arthritis will develop in individual sufferers – while only a small number of joints are affected in some people, others experience additional inflammations over time.

There are various diagnostic methods used to distinguish psoriatic arthritis from other forms of arthritis:

• During the initial consultation, the doctor will ask about the medical history of the patient and their close family to determine whether any family members have psoriatic arthritis.
• A physical examination can detect changes to the hands and feet, for example, that are typical of psoriatic arthritis.
• If certain proteins are detected in the blood, this is a clear indicator that the patient has psoriatic arthritis rather than rheumatoid arthritis.
• Uric acid levels in the blood are also measured to exclude the possibility that the joint pain is being caused by gout.
• X-rays and ultrasound scans can be used to distinguish between psoriatic arthritis, rheumatoid arthritis and osteoarthritis.

Psoriatic arthritis cannot be cured. Treatment seeks to relieve pain and swelling, maintain the functioning of the joints and prevent joint damage in the long term.

Medication plays an important role in this. If the knees, elbows or hand joints are only inflamed to a slight degree, painkillers such as diclofenac, ibuprofen and naproxen are sufficient in some cases.

If these fail to relieve pain or if the doctor suspects that a severe form of the condition is likely to develop, treatment with disease-modifying medication is recommended. These serve to inhibit the inflammation processes in the joints. As a result, symptoms can be relieved and joint damage can be prevented or delayed.

Physiotherapy or occupational therapy can also help people who have problems with their joints, muscles or tendons. In addition, symptoms can be relieved by means of orthopedic aids, such as insoles.

There are several things that people can do to positively influence the progression of their condition and avoid fatigue. These include getting sufficient exercise and avoiding smoking. People who are obese (severely overweight) are advised to lose weight.

Many people with psoriatic arthritis also find it helpful to stay well informed about their condition and the treatment options open to them. The condition is often easier to deal with when expectations are realistic and when it is accepted as part of life.

For more information about lifestyle changes and medical treatment of psoriatic arthritis, visit gesundheitsinformation.de.