As a dermatologist, I deal with conditions of the skin, psoriasis being one of them. Now, arthritis is typically a disease that affects the joints of the body, but a specific type of arthritis is also associated with psoriasis. It is called psoriatic arthritis.
Over 600,000 Americans have psoriatic arthritis, a condition of the immune system, which causes the typical raised red patches and silvery skin scales of common psoriasis along with the typical symptoms of pain, stiffness, swelling in the joints of arthritis. Talk about double trouble.
I’d like to share with you the same information I give my patients with this type of arthritis and some recommendations on how to cope with it.
What Causes Psoriatic Arthritis and Who’s At Risk?
Psoriatic arthritis typically affects people in the 30 to 55 age groups. It is a somewhat complex condition that, as mentioned above, arises out of the human immune system. Simply put, certain people develop too much of a certain type of protein TNF (tumor necrosis factor) which causes skin cells to reproduce and shed too quickly.
This shedding process causes the skin cells to build up and form raised red patches of dead skin cells, the typical silvery scales of psoriasis. This same protein, when over-produced, creates inflammation in the joints, causing them to be stiff and painful to move. If left untreated, psoriatic arthritis can cause permanent joint damage. It can also mean an increased risk of developing diabetes.
Symptoms of Psoriatic Arthritis
As I counsel my patients who come in with concerning skin and joint conditions, there are several tell-tale symptoms associated with psoriatic arthritis of which you may get only a few of. They include:
- Swelling and pain of the joints of the shoulders, spine, hands, elbows, knees, ankles.
- Red, raised scaly patches of skin with dry silvery scales with flaking.
- Nail pitting in the hand and toenails seen in 90% of psoriatic arthritis patients.
- Back and neck pain and stiffness.
- Skin psoriasis usually is present several years in 70% of patients before joint symptoms occur.
Treatments for Psoriatic Arthritis
When I see patients with psoriasis who I am concerned may also have psoriatic arthritis, I may also refer them to see another specialist as well, a rheumatologist . This type of doctor treats conditions arising out of the immune system which psoriatic arthritis is. A rheumatologist can also help confirm if psoriatic arthritis is present by doing a specific physical exam and perhaps some additional blood tests.
After determining that psoriatic arthritis is present, usually a combination of the following treatments are helpful:
- Pharmaceutical: Certain BRMs, or “biologic response modifier” type drugs like Enbrel are often prescribed for psoriatic arthritis. Since these types of drugs affect your immune system, they are not without side effects and can influence your ability to fight infections. Other drugs include anti-inflammatories, both prescription and over-the-counter (ibuprofen, naproxen), and work to reduce the inflammation. These too have side effects like stomach and intestinal bleeding. Other drugs, like steroids (prednisone, etc) are sometimes used but these carry a greater risk of the patient developing diabetes as well. Anti-fungal medications like Nystatin and Nizoral, and also certain antibiotics, may also benefit psoriasis sufferers where fungal, staph, E. coli infections can aggravate it. Be sure to discuss specific side effects with your doctor and/or pharmacist.
- Diet: A healthy diet helps decrease inflammation which is at the core of psoriatic arthritis. Include Omega-3 fats, 1-2,000 mg a day and limit the amount of sugar in your diet, not just added sugar, but natural sugars (fruits), to decrease inflammation and risk of developing diabetes. Add antioxidants, vitamins C, E, D, resveratrol, selenium.
- Exercise: Regular exercise helps keep psoriatic arthritis joints moving, preventing swelling and decreasing inflammation. Specifically, vibration exercise on a “power plate” vibration machine at low intensity can be of great benefit to arthritis. It stimulates blood flow and circulation in the joints and oxygen to cartilage, allows the synovial fluid around joints to drain adequately and prevent swelling. Strengthens muscles supporting joints in a short period of time. However, avoid vibration in inflammatory flare-ups, as it can increase temperature in the joints.
- Heat, Massage, Baths: Far infrared saunas, warm hydrotherapy, massage and Epsom salt baths help decrease inflammation in joints and keep them moving.
- Acupuncture: Acupuncture has been around for centuries as an effective way to reduce pain, swelling, and improve mobility. Research has shown it to reduce pain in 44% of people using it on a regular basis.
Psoriatic arthritis can be a distressing condition but getting proper diagnosis and treatment for the condition will go a long way in helping you stay comfortable and active. If you have any of the symptoms listed above, please see your doctor. If you already have psoriatic arthritis, trying some of the non-drug suggestions of vibration exercise, far infrared heat and massage may give you added levels of relief and comfort that may allow you to decrease medications.
Jay Brachfeld, M.D.
Natural Health News
Photo Credit: health.com