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Psoriatic Arthritis

Everything you need to know about living well with psoriatic arthritis

  • Introduction
  • Symptoms
  • Treatments
  • Daily Living
  • Support
  • Glossary

Introduction

This guide is designed to give you a better understanding of psoriatic arthritis, whether you have been diagnosed with the condition or know somebody who has, or you’re simply interested in finding out more about what psoriatic arthritis is.

Here, we explore treatments for psoriatic arthritis, what causes psoriatic arthritis and psoriatic arthritis symptoms. We also look at lifestyle factors that may affect the condition, such as psoriatic arthritis diet.

If you are think you have any of the psoriatic arthritis symptoms you read here, consult your GP. This guide is not to be taken as an alternative to seeking professional, medical advice.

Introduction

What is psoriatic arthritis?

Arthritis is very common in the UK and is an umbrella term for lots of different conditions that all cause symptoms of swelling and damage to joints. Psoriatic arthritis is one form of arthritis, which sometimes develops in people who have psoriasis. It is generally a long term health condition, which can worsen with time.

Everyone is affected differently – some people respond well to psoriatic arthritis treatments, which can stop the condition getting worse. Other people experience permanent damage which can affect their mobility and ability to carry out daily tasks. Early diagnosis can really help.

Both psoriasis and psoriatic arthritis affect people of all ages and affect men and women equally.

For more information about psoriatic arthritis, visit the Psoriasis and Psoriatic Arthritis Alliance website (PAPAA), which is dedicated to the condition.

What causes psoriatic arthritis?

Psoriasis and psoriatic arthritis are both caused by inflammation within the body.

In the human body, our skeleton is flexible, not rigid. Bones meet at points called joints, and healthy joints are essential to ensure our bones move smoothly when pulled by our muscles. Cartilage covers the ends of bones and the synovium membrane lubricates the joint area to enable easy, smooth movement. In psoriatic arthritis, the synovium becomes inflamed, which makes it react by releasing too much of the lubricating fluid, causing the joint to become inflamed. This inflammation causes pain, stiffness and can eventually damage the bone or cartilage.

Experts do not yet understand exactly why some people get psoriasis or psoriatic arthritis but they think it is probably a fault within a person’s immune system, which may be caused by genes or environmental factors. You may be wondering what triggers psoriatic arthritis, and there is no clear answer to this. Having an infection, injury to the skin, or using medications seem to be psoriasis and psoriatic arthritis triggers for some people. For others, there seems to be no clear explanation. Both conditions do tend to run in families.

Not everyone with psoriatic arthritis has psoriasis first, or even develops psoriasis of the skin, and people who have psoriasis are not guaranteed to get psoriatic arthritis – but there is a link with the large majority of people.

For more information on what causes psoriatic arthritis, visit the Arthritis research UK website. You may also find it interesting to read more about how our joints work.

Visit the NHS website for more information on psoriasis.

Did you know... “Psoriatic arthritis causes symptoms such as swollen joints, pain, fatigue, discoloured nails and, sometimes, mobility problems.”

Symptoms of Psoriatic Arthritis

Here, we discuss the most common psoriatic arthritis symptoms.

Psoriatic arthritis symptoms may differ from person to person – everyone has a different experience of the condition. Some people may develop all of the symptoms we talk about here, whereas others may only develop one or two. Symptoms vary greatly in severity from person to person as well, with some people finding they can continue daily life with only minor challenges, and others perhaps finding things a little harder. There are differences between symptoms of other forms of arthritis and psoriatic arthritis, which we also cover below.

Introduction

Symptoms of psoriatic arthritis include:

• Stiffness

• Restricted movements

• Swelling and pain in the joints and tendons

• Finger and toe nail problems i.e. may become discoloured or quite thick and hard

• Fatigue

In psoriatic arthritis, certain joints are likely to be affected, with pain and swelling more common in these areas:

• Fingers

• Toes

• Buttocks

• Back

• Neck

• Heels

These areas are likely to be affected due to inflammation in the joints, but also in the tendons e.g. the Achilles heel swelling is caused by tendon inflammation. Tendons are not generally affected with other types of arthritis. This is not an exhaustive list though – some people find other joints are affected, such as the rib cage or jaw.

Often, psoriatic arthritis causes the hands to look particularly swollen or deformed. The finger and toe nails may change, which is not caused by problems with the joints, but is more common in people who have psoriatic arthritis than those who have psoriasis alone. For more information about nail changes, download this leaflet on Nail Psoriasis.

These symptoms may be caused by other environmental factors or health conditions, and are not necessarily psoriatic arthritis, so if you think you may be experiencing any of these symptoms, please visit your GP.

For more information about symptoms of psoriatic arthritis, visit the NHS website.

Diagnosis of psoriatic arthritis

If you think you may have psoriatic arthritis, or have some symptoms you are concerned about, visit your GP in the first instance. If your GP thinks you may have some form of arthritis, they will probably refer you to a rheumatologist, who will conduct tests to diagnose you.

There are many different types of arthritis, so it can take some time to find out the exact condition you have. You may have blood tests, X-rays, and other types of scans and tests to make a firm diagnosis.

Types of psoriatic arthritis

There are a few types of psoriatic arthritis including:

Symmetric – joints on both sides of the body are affected

Asymmetric – affects various joints without any symmetry and may make fingers look swollen

Distal interphalangeal predominant – affects the nails and joints close to the nails

Spondylitis – affects the spine

Arthritis mutilans – the rarest type which causes significant deformity in many people

Did you know... “There are over 100 types of arthritis, and psoriatic arthritis is one of these.”

Treatments for Psoriatic Arthritis

There are psoriatic arthritis treatments available that may help with the condition.

There is not yet a cure for psoriatic arthritis, but there are psoriatic arthritis treatments available to help manage pain, reduce inflammation, and slow down the progression of the disease, to help prevent permanent or further joint damage. Getting an early diagnosis is really important, so that a person can start treatment and get their symptoms under control. With the right course of treatment, many people are able to have a good quality of life and sense of wellbeing, although the condition may still present challenges.

Treatments

Medication used in psoriatic arthritis treatment may include one, or a combination, of the following drugs:

Non-steroidal anti-inflammatory drugs (NSAIDs)

Corticosteroids

Disease-modifying anti-rheumatic drugs (DMARDs)

Biological therapies

These drugs may well have side effects which can be challenging for some people, and some drugs do not work as well for some as they do for others. Your specialist will work with you to ensure your medication regime is working, and may make changes along the way. Many medications will also help control psoriasis on the skin, and topical treatments applied to the skin to help with psoriasis may, in turn, help with the arthritic symptoms.

It is rare for a person to be recommended surgery for psoriatic arthritis, which may only be necessary if a joint has become so badly damaged that it needs replacing.

Some people require treatment for psoriatic arthritis from a physiotherapist, who can help advise exercises for psoriatic arthritis. Eating a healthy diet for psoriatic arthritis is also an important part of trying to manage or treat symptoms, and we cover this in the next section.

Did you know... “Most people who develop psoriatic arthritis have psoriasis, which is a skin condition caused by inflammation within the body.”

Living with Psoriatic Arthritis

Read on to find out more about the positives and challenges of living with psoriatic arthritis.

Receiving a diagnosis of psoriatic arthritis can be concerning, but there are ways to live well with the condition. Many people respond well to psoriatic arthritis treatment and are able to live life to the full. Other people may have difficulties in everyday life, or find living with a long term condition takes its toll on their emotional wellbeing.

In this section, we consider what it is like for people living with psoriatic arthritis. We recommend daily living aids for arthritis that some people use to help them carry out daily tasks that their condition is causing difficulty with. We explore how to live a healthy life and how this can affect your experience of the condition, including eating a healthy psoriatic arthritis diet.

Introduction

Impact on daily living

Living with any long term health condition, or regular bouts of pain, can be challenging but there are ways to help maintain a good quality of life and emotional wellbeing. There are lots of sources of help for psoriatic arthritis, including charities and a host of healthcare professionals who can provide information and advice.

Some people find that talking to others who have arthritis can help, because they are more likely to understand how the condition affects daily life, compared to someone who does not have arthritis. In the next section, we provide a list of online communities where you are able to do this. You may also find it helps to read case stories from people who have psoriatic arthritis.

Products for psoriatic arthritis

Psoriatic arthritis symptoms such as pain, restricted movement and fatigue can make mobility or some daily activities more difficult for some people. If this is the case for you or someone you know, you may wish to find out if you are eligible for an Occupational Therapy (OT) assessment via your local social services team. An OT may be able to recommend different ways you can do tasks, to make them easier. Sometimes they are able to suggest daily living aids to help, which are special types of equipment to use at home and when you are out of the house, to help with mobility or making daily tasks easier. Visit the PAPAA website for more information about occupational therapy and psoriatic arthritis.

Here, we suggest some psoriatic arthritis aids that may help with a variety of daily activities:

Preparing food & drinks

o Cutlery

o Electronic chopper

o Kettle tipper

o Perching stool

Picking things up

o Reacher

Gardening

o Easy grip tools

Carrying things

o Household trolley

o Walking trolley

o Shopping trolley

Mobility

o Grab rail

o Walking stick

o Rollator

o Transit chair

Getting in and out of chairs

o Rise and recline chair

o Furniture raiser

Using the toilet

o Raised toilet seat

o Toilet frame and seat

Getting in and out of the bath

o Bath lift

o Bath step

o Bathroom Rail

Having a shower

o Grab rail

o Shower stool

If you are unsure what products for psoriatic arthritis may help with daily tasks you are finding difficult, please contact the NRS Healthcare Occupational Therapist product advisors by telephone 0345 121 8111 or email [email protected]

Exercise for psoriatic arthritis

Exercise is essential for the body to keep it healthy, strong and supple, and it can help prevent conditions such as arthritis from developing. If you have a psoriatic arthritis diagnosis, you should try to adopt as active a lifestyle as possible, which will help keep your joints and muscles functioning well. A physiotherapist may be able to advise you how to undertake a programme of exercise for psoriatic arthritis.

It is also advisable to undertake exercises for psoriatic arthritis, which are designed to keep joints moving and to work on your range of movement. This leaflet from PAPAA gives example exercises and lots more information on physiotherapy and psoriatic arthritis.

Diet for psoriatic arthritis

Eating a healthy, varied and balanced diet is important for everybody, especially people who may have a health condition such as arthritis. Maintaining a healthy body weight is essential for a person with psoriatic arthritis to ensure extra strain is not put on the joints.

Visit the NHS website for more information about eating a balanced diet.

Some people choose to take supplements for psoriatic arthritis such as omega 3, which is an essential fatty acid that reduces inflammation in the body. There is little evidence to suggest adding psoriatic arthritis supplements to your diet have an effect on your condition but speak to your GP in the first instance.

Psoriatic arthritis and employment

Many people with psoriatic arthritis are able to work but some may need support from their employer. Find out more about your rights at work, finances, benefits and how to cope if you choose to give up work.

Did you know... “There are drug treatments available that help slow down the progression of psoriatic arthritis, relieve symptoms and reduce inflammation.”

Support for Psoriatic Arthritis

Remember – you are not alone!

We hope you have found this guide informative and that it has answered some of your questions about psoriatic arthritis. Remember, you are not alone, and millions of people have arthritis in the UK – with many having a diagnosis of psoriatic arthritis.

You may benefit from sharing your experiences and hearing about how other people are living with psoriatic arthritis and we provide a list of online communities below. We also list many sources of psoriatic arthritis support such as charity websites providing information and services for psoriatic arthritis help.

Introduction

Communities

Arthritis Forum – a forum for people with arthritis to share their stories

Arthritis Care Forum – an online forum for people to share experiences of arthritis

Psoriasis Association Forum – share your experiences of psoriasis and psoriatic arthritis with others in a similar situation

Resources

Arthritis Action – practical help and information about living with arthritis

Arthritis Care – information about living with arthritis, including an online community, helpline, support groups and mentoring

Arthritis Research UK – a charity providing a huge amount of resources and information about living with arthritis online, as well as a helpline, information for health professionals and research projects

NHS – source of official medical information in the UK, including information on all types of arthritis, related conditions, symptoms and treatments

National Rheumatoid Arthritis Society – charity supporting people with rheumatoid arthritis with online resources, publications, peer mentoring, local groups, a helpline and local events

Outside In – lots of information about psoriatic arthritis, including a self-assessment test

PAPAA (Psoriasis and Psoriatic Arthritis Association) – a website dedicated to providing information about psoriasis and psoriatic arthritis, including lots of information about living with the conditions as well as personal case studies

Psoriasis Association – a charity dedicated to supporting people with psoriasis and psoriatic arthritis, including information on the causes, symptoms and how it affects a person’s life

Did you know... “There are lots of daily living aids available to help people who find daily tasks difficult due to their symptoms of psoriatic arthritis.”

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology.

Medical terms are often known for being tricky to pronounce, and if you’re not an expert on the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of psoriatic arthritis as straightforward as possible.


Introduction

Biological treatments

– these are drug treatments that are used to treat the cause of conditions like arthritis e.g. they act on the immune system rather than just trying to stop symptoms

Cartilage

– the tissue found at the ends of bones where joints are positioned, which protects bone and gives it some flexibility

Corticosteroid

– anti-inflammatory steroid medication such as hydrocortisone, which treats allergies and inflammation caused by conditions such as asthma, eczema and arthritis

Disease-modifying anti-rheumatic drugs (DMARDs)

– medications used to treat arthritic conditions by slowing down their progression and reducing inflammation and other symptoms

Immune system

– the process in the body that uses organs and cells to protect the body against invading infections

Joints

– part of the human skeleton, where bones fit together

Non-steroidal anti-inflammatory drugs (NSAIDs)

– a medication such as ibuprofen, which is used to reduce inflammation and pain by blocking proteins in the body

Psoriasis

– an autoimmune disease causing red, crusty skin in various places around the body

Rheumatologist

– a doctor specialising in treating musculoskeletal and related autoimmune conditions such as arthritis

Synovium membrane

– this is a protective membrane made of delicate tissue, found around the joints

Tendons

– cords of tough tissue in the body that connects muscle to bone and enables muscles to make bones move


Last updated on 05/02/2019

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