Affecting millions around the world, psoriatic arthritis is not just a medical condition, but a deeply personal and complex journey. It is a potentially debilitating autoimmune condition that is typically characterized by joint inflammation (arthritis) as well as visible (often emotionally heart-wrenching) changes to the skin (psoriasis). In this blog, we aim to understand the causes and symptoms of psoriatic arthritis, as well as throw light on the various treatment options available.
Understanding psoriatic arthritis
A type of inflammatory condition, psoriatic arthritis occurs in some people with psoriasis, which is a chronic, autoimmune, skin condition that is characterized by scaly, red patches on the skin. It causes the immune system to attack the healthy cells, thereby affecting skin and joints.
There are two types of psoriatic arthritis:
- Polyarticular: A severe form of the condition that impacts four or more joints
- Oligoarticular: A milder form that affects four or fewer joints
NOTE: Psoriatic arthritis can also occur in individuals who do not have the autoimmune condition.
Causes of psoriatic arthritis
Like most autoimmune conditions, the exact cause of psoriatic arthritis is difficult to pinpoint. However, research indicates that the condition can be triggered by a combination of environmental, genetic, and immune system factors. Let’s examine these.
Environmental triggers
This can include infections or trauma, particularly to the skin or joints. Smoking is regarded as a major risk factor of psoriatic arthritis.
Genetic predisposition
If you have a family history of psoriasis or psoriatic arthritis, then you are at a higher risk of developing both conditions. HLA-B27 and other specific genetic markers are typically found in psoriatic arthritis patients. Environmental triggers can also increase the risk of those with a family history of psoriasis or psoriatic arthritis.
Autoimmune response
Individuals with psoriasis are at increased risk of developing psoriatic arthritis. Studies have shown that approximately 30% of psoriasis patients also develop psoriatic arthritis.
You can read more about psoriasis here
You can read about other autoimmune conditions here
Symptoms of psoriatic arthritis
As a heterogeneous condition, the symptoms of psoriatic arthritis can differ from person to person. Apart from the symptoms listed below, patients can also experience systemic symptoms that affect various organ systems, such as respiratory challenges, risk of cardiovascular ailments, etc.
- Joint pain, stiffness, and swelling (typically in fingers, spine, knees, and toes)
- Plaques on skin, just like in psoriasis (especially on knees, elbows, and scalp)
- Nail changes, such as pitting, discolouration, and separation from the nail bed
- Fatigue
- Localised tenderness
- Morning stiffness, more often lasting longer than 30 minutes
- Less range of motion
- Red eyes and pain in the eyes
- Lower back pain
- Foot pain
Diagnosing psoriatic arthritis
Timely diagnosis and assessment of psoriatic arthritis is vital to initiate prompt treatment, as well as prevent further joint damage. The condition can be diagnosed by:
- X-rays
- Magnetic resonance imaging (MR) scans
Both of the above may be used to check for inflammation and assess joint damage
- Blood tests (to rule out other conditions, to check for markers of inflammation)
- Clinical evaluation
- Medical history
- Physical examination
There are many classification criteria used to diagnose psoriatic arthritis.They take into account the presence of psoriasis, extent of joint involvement, nail changes, and any other radiological and clinical findings. Of these, the most commonly used is the Classification Criteria for Psoriatic Arthritis (CASPAR) criteria.
Monitoring disease activity is essential in a chronic condition like psoriatic arthritis. Most doctors use tools like the Psoriatic Arthritis Disease Activity Score (PASDAS) and Disease Activity Score (DAS) to assess the severity and progression of the disease.
Treatment options for psoriatic arthritis
Being a chronic condition, the treatments for psoriatic arthritis aim to control inflammation, prevent joint damage, and reduce symptoms. The choice of treatment is determined by the severity of the disease, individual’s overall health (presence of comorbidities), and specific symptoms. Let’s take a look at the most common treatment options for psoriatic arthritis:
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids may be prescribed for pain relief and inflammation.
Janus kinase (JAK) inhibitors may be used to inhibit certain immune pathways.
Disease-modifying antirheumatic drugs (DMARDs) are prescribed to slow down the progression of joint damage.
Biologic medications can target immune system proteins to help reduce inflammation. Immunosuppressants can curtain the immune system and lower immune response.
Intra-articular corticosteroid injections can provide relief from symptoms.
Non-pharmacological methods
Physical therapy and occupational therapy
Physical therapy and occupational therapy can significantly improve joint function, alleviate pain, and prevent joint deformities. At Plexus, our expert physiotherapists will devise an exercise plan comprising techniques and exercises tailored to suit the patient’s needs.
Assistive devices
Orthopedic supports, mobility aids, and other types of assistive devices determined by the severity of the disease can greatly improve patient’s independence and boost their confidence.
Lifestyle changes
The most commonly prescribed, and effective, management strategy for autoimmune conditions is incorporating certain lifestyle changes. The same applies to psoriatic arthritis as well. Reducing stress, exercising regularly, and maintaining a healthy body weight can go a long way in managing symptoms and improving general well-being.
Surgery
In very serious cases of deformities and severe joint damage, surgical interventions, such as joint replacement surgery can restore function.
Stem cell therapy for psoriatic arthritis
Plexus offers customized regenerative rehabilitation programs for psoriatic arthritis that comprise a combination of the above treatment options as well as the most advanced, risk-free, and minimally invasive treatment – stem cell therapy.
We use autologous (derived from the patient’s body) mesenchymal stem cells (MSCs) to reduce inflammation, modulate the immune system, as well as promote tissue regeneration and repair.
Our team of autoimmune experts, spearheaded by India’s foremost stem cell specialist, Dr Na’eem Sadiq, will leave no stone unturned in providing you with the very best of care. If you choose Plexus as your stem cell partner, a host of benefits await you. Some of these benefits include:
- Minimally-invasive non-surgical procedure
- Faster post-procedural recovery
- Improved everyday functionality
- Less reliance on medications
- Improved quality of life
- Reduced symptoms
- Reduced relapses
If you wish to know more about stem cell therapy for psoriatic arthritis, reach out to Team Plexus today.
FAQs
Is psoriatic arthritis a serious condition?
Yes, if left untreated, psoriatic arthritis can severely impact the joints, bones, and other tissues in the body.
What are the warning signs of psoriatic arthritis?
Joint pain, stiffness, and swelling are the typical warning signs of psoriatic arthritis.
What is the main cause of psoriatic arthritis?
A combination of environmental triggers (infections, injuries, etc.) and family history, as well as the presence of psoriasis can result in psoriatic arthritis.
Can psoriatic arthritis go away?
Unfortunately, no. Psoriatic arthritis is a chronic life-long condition.
How can I reduce psoriatic arthritis?
Reducing stress and pressure on joints, eating well-balanced meals, regular exercise, getting adequate sleep and rest can help reduce the severity of symptoms of psoriatic arthritis.
Does psoriatic arthritis spread?
Yes, if left untreated, the condition can spread to other joints in the body, and over a period of time result in severe joint deformities.
