Living with psoriatic arthritis: understanding the condition

Psoriatic arthritis is a type of joint inflammation occurring in people with a skin condition called psoriasis – an autoimmune disease when some skin cells are produced more rapidly than normal forming red, scaly patches.


It is estimated that 1 in 50 people, around 2% have psoriasis, of which 20% and 40% develop psoriatic arthritis – normally within 10 years of having psoriasis diagnosed. 


Symptoms of psoriatic arthritis are like other inflammatory joint conditions like rheumatoid arthritis. When someone has psoriatic arthritis, the joints which have been affected become tender, swollen, painful and stiff, especially waking in the morning. Tendons which bind muscles to bone are lubricated by a synovial membrane and can become inflamed, too, causing muscle tenderness especially around the elbows, wrists and heels. In some severe cases, joints may lose their range of movement and become misshapen or locked, although this is a less common thanks to the development of powerful new disease-modifying drugs.


Another common problem which has been associated with inflammation is fatigue, which may make you feel exhausted or tired most of the time. Researchers do not know what causes persistent fatigue, but it seems to be linked with increased levels of immune complexes and other inflammatory substances in the body. 


Some people with psoriatic arthritis notice pitting (small dimples) on their nails, or nail thickening and discoloration. Inflammation of a part of the eye (uveitis or iritis) can lead to pain and redness of one or both eyes which needs immediate medical treatment. 


Psoriatic arthritis is a chronic problem where symptoms tend to flare up over periods of time. There are several different types of drugs used to help control symptoms such as non-steroidal-anti-inflammatory drugs, corticosteroid injections into, or around, a single painful joints and disease modifying drugs such as methotrexate, which switch off the immune reactions that are causing inflammation and pain. New treatments, knowns as biological drugs, block the effects of immune substances such as TNF alpha to help reduce damage to joints and reduce symptoms. 


Psoriatic arthritis can be helped by altering several diet and lifestyles approaches such as aiming to lose any excess weight by following a healthy, balanced diet to relieve inflammation throughout the body and reduce strain on weight-bearing joints. Ensuring you eat plenty of fruit and vegetable such as having a Mediterranean style diet is very helpful. As well as this, regular exercise is super important. To help reduce muscle weakness and joint stiffness try to carry out regular, gentle exercise. It could be beneficial to see a physiotherapist who specialises in arthritis who can show you a range of exercises helping to maintain joint mobility, ways of reducing joint pain for example ice packs, massage, applying warmth or using a TENS (transcutaneous electrical nerve stimulation) machine and how to use walking aids to protect your joints. An alternative to having a physiotherapist is seeing an occupational therapist who can suggest ways of making life easier using aids such as wrist splints, blocks to raise your chair, a raised toilet seat with arm rests, rails, long or thick-handled tools, a stick, stocking helpers or modified shoes for example.  


It is important that if you are suffering from psoriatic arthritis to seek help. Having this condition will have a significant effect on your life which can leave you feeling anxious and depressed. We advise that if you are feeling like this to go and see your doctor for advice on what you can do to help yourself.