Psoriatic Arthritis
What is psoriatic arthritis?
Psoriatic arthritis is an inflammatory disorder that can affect some people with a skin disease called psoriasis. It is a chronic, progressive condition that can cause pain, stiffness and swelling in the joints throughout the body. Common joints affected by psoriatic arthritis include the fingers, wrists, ankles and spine.
Who is affected?
Psoriatic arthritis affects around 1-2 out of 1,000 Canadians. Approximately 30% of people living with psoriasis will develop psoriatic arthritis.
The condition affects men and women equally and can develop at any age.
What causes psoriatic arthritis?
The exact cause of psoriatic arthritis is unknown; however, it is believed to involve a combination of immune system, genetic and environmental factors.
- Immune system: Psoriatic arthritis occurs when an overactive immune system attacks healthy tissues, resulting in inflammation and pain in the joints
- Genetics: The risk of getting psoriasis and psoriatic arthritis increases if a close relative has the condition. However, not everyone with a family history will develop it
- Environmental triggers: Various environmental factors, including infections or physical trauma, may trigger psoriatic arthritis
Several factors can increase your risk of developing psoriatic arthritis, including:
- Having psoriasis, especially on the nails
- Having a parent or sibling with the condition
- Smoking
What are the symptoms of psoriatic arthritis?
Psoriatic arthritis symptoms can range from mild to severe, and may include:
- Joints that are painful, stiff, swollen, red and warm to the touch
- Psoriasis (a skin condition characterized by red, raised scaly patches called plaques. Typically, on areas like the elbows, knees and scalp, and can cause itching)
- Dactylitis which are sausage-like swelling in the fingers and toes
- Plantar Fasciitis or pain in the feet, especially the back of the heels
- Spondylitis or lower back pain
- Nail changes, such as pitting, crumbling or separation from the nail bed
- Fatigue
Many people who develop signs of psoriatic arthritis have already been experiencing symptoms of, or have received a diagnosis of, psoriasis. However, psoriatic arthritis can sometimes occur before the skin plaques from psoriasis is visible.
People living with psoriatic arthritis are also at a higher risk of developing other conditions, including metabolic syndrome, osteoporosis, hypertension and cardiovascular disease. This is due to the inflammation associated with psoriatic arthritis.
How is psoriatic arthritis diagnosed?
Diagnosing psoriatic arthritis can be challenging because its symptoms often overlap with other types of arthritis and conditions. There is no single test to diagnose psoriatic arthritis. Doctors typically use a combination of medical history, physical examinations, blood tests and imaging tests, such as X-rays and MRI, to help diagnose the disease.
There is currently no cure for psoriatic arthritis. However, early diagnosis is important to help manage the condition and prevent joint damage.
Psoriatic arthritis treatment aims to control inflammation, reduce symptoms and prevent joint damage. Your doctor will determine an individualized treatment plan based on the severity of the disease and specific symptoms.
Treatment options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Used to reduce pain and inflammation
- Disease-modifying antirheumatic drugs (DMARDs): Slow disease progression and prevent joint damage
- Biologics (bDMARDs): Target specific parts of the immune system to reduce inflammation
- Corticosteroids: Administered orally or by injection to reduce severe inflammation
Regular exercise and physical therapy are important to help reduce pain and maintain joint flexibility. In severe cases, surgery may be considered.