Treatment of psoriatic arthritis

Psoriatic arthritis can manifest for a long time as periodic pain in the joints, morning stiffness, swelling of the fingers, or discomfort in the feet. Often people associate such symptoms with overfatigue or physical exertion and do not immediately consult a doctor. At the same time, a chronic inflammatory process can gradually affect the condition of the joints and lead to limitation of mobility, so it is important to undergo an examination in a timely manner.

At the private clinic «Oxford Medical», patients can undergo a consultation with a rheumatologist, laboratory and instrumental diagnostics, as well as receive recommendations regarding further treatment and control of the disease. Make an appointment at a time convenient for you by phone or through the online appointment form on the website.

Psoriatic arthritis — is a chronic immunoinflammatory disease in which, in people with psoriasis, the inflammatory process can spread to the joints, tendons, and periarticular tissues. Because of this, pain, swelling, stiffness, and gradual limitation of mobility may occur.

In some patients, problems with the joints appear already after the appearance of manifestations of psoriasis on the skin, but sometimes changes occur simultaneously or even earlier. Most often, the fingers and toes, feet, knees, or spine are affected.

Doctors of «Oxford Medical» explain: unlike some other rheumatological diseases, in psoriatic arthritis the joints are not always affected symmetrically. Because of this, the disease is more difficult to suspect at the early stages, especially if pain or swelling occurs only in one joint or on one side of the body.

The exact cause of the development of psoriatic arthritis has not been definitively established. The disease is associated with a disruption in the functioning of the immune system, due to which chronic inflammation is maintained in the joints, tendons, and periarticular tissues. Hereditary predisposition also plays an important role.

Factors that may increase the risk of developing psoriatic arthritis include:

• the presence of psoriasis;

• hereditary predisposition to autoimmune diseases;

• chronic stress;

• infectious diseases;

• injuries;

• excess body weight;

• smoking.

According to the National Psoriasis Foundation, one of the key risk factors for the development of psoriatic arthritis is hereditary predisposition. If close relatives had psoriasis or psoriatic arthritis, the risk of developing the disease may be higher.

Psoriatic arthritis is not always easy to recognize only by complaints, since pain and stiffness may resemble other rheumatological diseases. During the appointment, the doctor assesses whether there is swelling of the fingers, pain in the feet or heels, nail changes, and manifestations of psoriasis on the skin.

To clarify the diagnosis, the following may be prescribed:

• ultrasound of the joints and periarticular tissues to detect inflammation, swelling, and changes in the tendons;

• X-ray of the joints to assess structural changes that may appear during a long course of the disease;

• MRI, if it is necessary to assess the condition of the joints, tendons, ligaments, or spine in more detail;

• laboratory blood tests to assess the activity of inflammation and exclude other causes of joint pain.

Doctors of «Oxford Medical» explain: psoriatic arthritis can be combined not only with joint damage, but also with inflammation of the tendons, ligaments, and tissues around the joint. That is why a combination of laboratory and instrumental diagnostics is often needed to assess the activity of the inflammatory process.

The goal of treatment — is to reduce the activity of inflammation, relieve pain and stiffness, preserve joint mobility, and prevent their further damage. The therapy regimen is selected individually.

The patient may be prescribed:

• anti-inflammatory drugs — help to reduce pain, stiffness, and swelling in the short term;

• drugs for controlling the immunoinflammatory process — are used to restrain the progression of the disease and reduce the risk of joint damage;

• modern immunomodulating drugs — may be prescribed in an active course of the disease if the previous treatment does not give a sufficient effect;

• local treatment of skin manifestations — is used for rashes, itching, skin irritation, or nail changes.

According to the recommendations of EULAR, nonsteroidal anti-inflammatory drugs may be used short-term in a mild course of psoriatic arthritis, and in peripheral joint involvement, early initiation of basic therapy, in particular with methotrexate, is recommended. If disease activity persists, biological or targeted drugs that act on individual mechanisms of the inflammatory process may be considered.

Separately, the doctor may recommend physical rehabilitation: exercises to maintain mobility, stretching, strengthening muscles, and reducing stiffness. The load is selected so as to maintain joint function, but not to provoke increased pain or swelling.

Without control of the inflammatory process, the disease can gradually progress and significantly affect joint mobility. The risk of complications is usually higher with prolonged active inflammation and the absence of regular treatment.

Possible consequences:

• joint deformity and persistent limitation of mobility;

• chronic pain and decreased physical activity;

• damage to tendons and periarticular tissues;

• impaired mobility of the spine;

• decreased ability to work and deterioration in quality of life.

In some patients, prolonged chronic inflammation may also increase the risk of cardiovascular complications. That is why not only pain control is important, but also regular follow-up with a doctor and timely correction of treatment.

It is impossible to completely prevent the development of psoriatic arthritis, however control of risk factors and timely treatment of psoriasis help reduce the risk of progression of the inflammatory process and damage to the joints.

For prevention, it is recommended:

• to maintain normal body weight;

• to regularly engage in moderate physical activity;

• to give up smoking;

• to treat infectious diseases in a timely manner;

• not to ignore pain, stiffness, or swelling in the joints;

• to regularly undergo preventive examinations in case of psoriasis.

Doctors of «Oxford Medical» explain: lifestyle also plays an important role in controlling chronic inflammation. A balanced diet with a sufficient amount of vegetables, fish, products with omega-3 fatty acids, and limitation of ultra-processed food may be useful for patients. That is why a diet for psoriatic arthritis is considered as one of the components of comprehensive control of the disease.

You can preliminarily familiarize yourself with the prices for medical services here. The cost of treatment depends on the course of the disease, the necessary scope of examinations, and the chosen therapy tactics. The doctor will orient you in more detail regarding the recommended examinations, possible treatment options, and prices during the consultation. To make an appointment, contact the contact center or use the online appointment form on the website.

The information is for informational purposes and does not replace a doctor's consultation.

Sources:

• EULAR / Annals of the Rheumatic Diseases

• American College of Rheumatology

• National Psoriasis Foundation