Psoriatic Arthritis

Overview

Psoriatic arthritis can affect any joint, but it is most common in the fingers and toes. In mild cases, only one or a few joints are affected. In severe cases, psoriatic arthritis can significantly impair daily functioning and quality of life.

Only about 15 percent of people with psoriasis develop psoriatic arthritis and in most cases, the skin symptoms appear before the joint problems. The condition typically arises in people ages 30 to 50, but can also begin in younger and older people. It affects men and women at roughly equal rates.

Scientists do not fully understand why psoriatic arthritis develops. They believe that genetic, environmental and immunological factors all play a role.

Symptoms

Common symptoms of psoriatic arthritis include:

• Fatigue
• Joint pain
• Pain or inflammation of the eye
• Pitting or other changes in the nails
• Scaly red and white patches on the skin
• Stiffness
• Swelling of joints
• Tenderness where tendons and ligaments connect to bones (e.g. at the back of the heel)

Diagnosis

Psoriatic arthritis is a complex disease where symptoms can mimic other problems, such as rheumatoid arthritis, reactive arthritis (arthritis that develops in response to an infection) and gout. There is no definitive test for psoriatic arthritis, so IU Health physicians use a combination of medical history, physical examination, laboratory testing and imaging procedures to diagnose the condition. Early diagnosis and treatment may help to prevent permanent damage to your joints.

Treatment

Although there is no cure for the psoriatic arthritis, current treatments can control pain and preserve your mobility. When necessary, you may be referred to specialists in dermatology, orthopedics and other fields for additional care.

Treatment options include:

Medicine Therapy

Depending on the severity of your symptoms, you may be prescribed medicine to help reduce pain and swelling.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

These medications, which come in over-the-counter and prescription versions, can help to alleviate symptoms such as pain and swelling. NSAIDs typically serve as an initial treatment.

Corticosteroids

Administered in low doses in oral or injectable form, these medications can relieve swelling and pain in joints.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

DMARDs can ease symptoms and improve quality of life while also possibly delaying the course of psoriatic arthritis.

Biologic Response Modifiers

These genetically engineered medicines, which are also DMARDs, disrupt the immune system responses that lead to joint inflammation. They are used in severe cases of psoriatic arthritis.

Symptom Management

Symptoms of psoriatic arthritis can be painful and disrupt your daily activities. You can address skin issues, painful joints and other symptoms with the following:

Phototherapy

Ultraviolet light treatment under a physician’s supervision can help to alleviate the skin symptoms of psoriatic arthritis.

Physical Therapy

An individualized exercise plan designed by IU Health physical therapists can help you to build flexibility and strength and avoid joint problems.

Psoriatic Arthritis Education

IU Health professionals can help you use diet and exercise to reduce inflammation and manage the symptoms of psoriatic arthritis.

Surgery

If you have severe joint damage, surgery may help to restore function and relieve pain.

Research

In partnership with the IU School of Medicine, IU Health carries out research to find new treatments for rheumatic conditions such as psoriatic arthritis and to train the next generation of physicians. This partnership also ensures that you benefit from the latest innovations in diagnosis and treatment of rheumatic disorders.