Symptoms, Causes, and Treatment of Psoriatic Arthritis
What Is Psoriatic Arthritis?
Psoriatic arthritis (PsA) is an autoimmune disease and a form of arthritis that usually occurs in individuals who have psoriasis. Only about 1 out of every 100 people get this disease. Psoriasis is a chronic skin condition characterized by red patches covered with silvery scales.
Approximately 1 in 20 people who have psoriasis develop PsA; the likelihood is increased for those who have lesions on their nails. The cause is currently unknown; however, there may be a genetic component. Stress can also play a role in both conditions. It is possible to develop psoriatic arthritis before developing psoriasis. Early diagnosis is important.
- Joint swelling and pain
- Rough skin patches
- Pitting in the nails
The symptoms can flare up at any time and alternate with periods of remission. They range from mild (only a few joints are affected) to severe (swelling and deformity in the hands and feet).
When the disease is more severe, it will involve more joints, including the spine. When the spine is affected, symptoms include stiffness, pain, and a burning sensation, particularly in the lower spine and sacrum.
An accompanying complication is spondylitis, a condition that causes inflammation of the vertebrae, although some types of spondylitis can also affect other large joints.
Causes and Risk Factors
It is thought that genetic and environmental factors both play a roll in the development of this disease. Many people that develop PsA also have a family member with this disease. There are some possible genetic markers, but researchers do not have all the answers at this time. Although it can occur at any age, it is most prevalent in patients from 30-50 years old.
Other causes include viral or bacterial infections in those with a genetic predisposition and physical trauma. It is also well documented that psoriasis can be triggered by a stress.
The Psoriasis Component
Pictures of psoriatic arthritis reveal a rapid buildup of skin over large areas of skin. These reddened areas with silvery scales tend to be dry, itchy, and sometimes painful. In some cases, this disease causes pitted and deformed nails that become thickened and discolored. The nails may also become separated from the nail bed.
Although there are currently no cures, there are medications to treat the symptoms:
- Anti-inflammatories: To reduce swelling and pain
- Disease-modifying antirheumatic drugs: Methotrexate, sulfasalazine
- Immunosuppressant drugs: Imuran, Azasan, cyclosporines, leflunomide (Avara)
- TNF-alpha inhibitors: For severe pain. Humira, Enbrel, Simponi, Remicade
- Apremilast (Otezla): A new drug approved on March 26, 2014, that will be added to the existing class of biologic drugs used for this condition.
Each of these medications has potentially harmful side effects, including suppression of the immune system, which makes a patient more vulnerable to infection. Otezla can also have side effects, so be sure to ask your doctor questions about the best medications to treat your specific condition.
Psoriatic Arthritis Diet Guidelines
Following a balanced, healthy diet will help reduce inflammation and symptoms of PsA.
Your diet should include:
- Fresh vegetables and fruits
- Cold water fish, rich in omega-3 fatty acids – salmon, tuna, sardines, and mackerel
- Antioxidant-rich foods – apples, beets, blueberries, kale, spinach, and broccoli
Don't skip meals and eat frequent, small meals to maintain steady energy levels. Avoid foods that are processed or high in cholesterol and fats. Limit salt and sugar intake as well as your consumption of red meats (may exacerbate pain).
Maintaining a healthy weight through diet and exercise can alleviate some of the symptoms.
Phil Mickelson's Treatment of Psoriatic Arthritis
Phil Mickelson, one of the highest-ranked golfers in the world, developed psoriatic arthritis in 2010. He has openly talked about his battle with this inflammatory disease; it started very suddenly and almost crippled him.
He went to Mayo Clinic where he was successfully treated with weekly Enbrel injections. He states he is pain-free and has begun a campaign to educate the public on this disease.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.