Psoriatic arthritis: Early signs of autoimmune disease you shouldn’t ignore

As the name suggests psoriatic arthritis develops in people suffering from psoriasis, the skin disease which is painful and itchy and causes scaly patches on different parts of the body. Many symptoms of psoriatic arthritis are similar to that of rheumatoid arthritis and they may appear either before or after the onset of psoriasis. (Also read: World Psoriasis Day: Not just skin, psoriasis can affect your heart, liver and other organs too)

Dr Shekhar Srivastav HOD, Orthopedics Department, Sant Parmanand & Parmanand Special Surgery Hospital, Delhi says, “Psoriatic arthritis is an autoimmune disease. It occurs when your body’s immune system mistakenly attacks healthy tissue. It most often takes a toll on your skin and joints, causing swelling, stiffness, and pain. Over time, if not treated, the inflammation can damage joints and tissues. It affects men and women equally.”

Dr Srivastav also talks about early warning signs of psoriatic arthritis, risk factors, treatment and lifestyle changes for patients.

Warning signs and symptoms

Sausage fingers: People with psoriatic arthritis often have painful swelling in the fingers and toes.

Changes in nails: You may find nail pitting or holes developing in your nails. Deformity, discolouration, thickening and separation of the nail bed are other nail changes.

Scaly patches on elbows and knees: Psoriatic arthritis could be the cause of itchy, painful, red patches or build-up of dead skin cells on the body. This appears generally on the knees, elbows and scalp.

Pain and redness in eyes: You may develop inflammation in the eye, especially in the middle layer of the eye, a condition known as uveitis. Psoriatic arthritis leads to extra vision symptoms, comprising eye pain, redness and blurry vision. Delays in treating eye inflammation can result in vision loss.

Joint pain and stiffness: Psoriatic arthritis causes mild to severe pain and stiffness in the joints. This condition can get worse if the disease is not controlled.

Stomach problems: This autoimmune disease can be the cause of inflammation in the digestive tract. Many people suffering from psoriatic arthritis also develop inflammatory bowel disease.

Tenderness: People with psoriatic arthritis have tenderness in areas where tendons or ligaments attach to bones. Pain and swelling in the toes, ankles, heels and soles are also most commonly seen.

Difficulty moving: People with psoriatic arthritis may have a reduced range of motion. With time, it can become more difficult for them to move, and the disease may cause disability.

Fatigue: Fatigue is common for people with psoriasis and psoriatic arthritis.

Lower back pain: People suffering from psoriatic arthritis can develop pain in the lower back. Pain may also travel down into your hips and buttocks.

Psoriatic arthritis produces some symptoms similar to rheumatoid arthritis. But Rheumatoid Arthritis usually affects joints on both sides of your body. People with psoriatic arthritis are more susceptible to other skin and nail changes.

Causes of psoriatic arthritis

Genes: If your parents suffer from psoriasis, it increases your chance of getting psoriasis threefold and makes you more prone to psoriatic arthritis.

Infection: An infection that provokes your immune system could be blamed. Psoriasis, for example, is often provoked by strep throat.

Psoriatic arthritis risk factors

Age: You can develop psoriatic arthritis at any age, but it most commonly affects people between 30 and 50.

Family history: As many as 40% of people with psoriatic arthritis have a family history of skin or joint disease.

Treatment

– For medical treatment of psoriatic arthritis, non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed. There are over-the-counter medications like ibuprofen and naproxen. Disease-modifying anti-rheumatic drugs (DMARDs) are advised to slow or stop the pain, swelling, and joint and tissue damage.

– If NSAIDs don’t respond, your doctor will try DMARDs. They may take longer to work. If you can’t take a DMARD, you might be advised to get a type of drug called an immunosuppressant.

– Therapy with UVA light can help ease skin symptoms in people with severe psoriasis. But it may also raise your chances of skin cancer. If immune suppression doesn’t work, a biologic may be prescribed by your doctor.

– Rather than weaken your entire immune system, Newer DMARD medications prevent a protein that causes inflammation. Enzyme inhibitors work by blocking a certain enzyme, a kind of protein, called PDE-4. It helps slow other reactions that cause inflammation. Steroids can help check inflammation, but doctors don’t use them often for psoriatic arthritis because they can make your skin rash worse.

– Doctors prescribe steroids only when you really require them. Long-time use of steroids could bring you serious side effects such as brittle bones, weight gain, hypertension, and diabetes.

– Surgery: In most cases of Psoriatic arthritis, surgery is not required. But if joints are severely damaged by the disease, you may be advised for joint replacement surgery.

Lifestyle changes and home remedies:

· Try to maintain a healthy weight. Having extra pounds puts more stress on your joints. It may also affect how well your medications respond.

· Stop smoking

· Limit alcohol

· Do regular exercise to protect your joints and keep your weight in check. Stronger muscles can also support your joints. Low-impact exercises like swimming or walking should be preferred. Meet your doctor about an exercise plan.

· Try physical or occupational therapy as recommended by your doctor. This can include exercises, body adjustments, hot and cold therapy, and tips for changing the way you do certain things. With the help of a physical or occupational therapist, you can pick assistive devices like braces or splints to support your joints.