what is psoriatic arthritis?

Psoriatic arthritis is a form of inflammatory arthritis that primarily affects individuals who have psoriasis, a skin condition characterised by red, scaly patches. While it is estimated that about one in eight people with psoriasis will develop psoriatic arthritis, the onset of joint symptoms can occur either before or simultaneously with the skin condition.

Symptoms of Psoriatic Arthritis

The symptoms of psoriatic arthritis can vary significantly from person to person. Common symptoms include:

• Joint Pain and Stiffness: This can occur in one or more joints, leading to discomfort and reduced mobility.
• Swelling: Joints may become swollen, which can be particularly noticeable in the fingers and toes.
• Spondylitis: Pain and stiffness may also affect the lower back, buttocks, or neck, indicating inflammation of the spine.
• Tendon Pain: Discomfort can arise in tendons, especially at the back of the heel or the sole of the foot.
• Nail Changes: Individuals may notice thickening, colour changes, or separation of the nails from the skin.
• Eye Issues: Pain and redness in the eyes can also occur.

Causes of Psoriatic Arthritis

The exact cause of psoriatic arthritis remains unclear. However, it is believed that a combination of genetic, immune system, and environmental factors may contribute to its development.

• Genetics: A specific gene, HLA-B27, is associated with psoriatic arthritis, particularly in cases involving spinal inflammation. However, many individuals with this gene do not develop the condition.
• Immune Response: In psoriatic arthritis, the immune system mistakenly targets the joints, leading to inflammation and the associated symptoms.
• Environmental Triggers: Factors such as infections and smoking may also play a role in triggering the onset of the disease.

Diagnosis

Diagnosing psoriatic arthritis typically involves a thorough assessment by a healthcare professional. There is no single test for the condition; instead, diagnosis is based on:

• Symptoms: A detailed discussion about your symptoms, including the location and timing of joint pain.
• Physical Examination: A healthcare provider will examine your skin for signs of psoriasis and check your joints for swelling, heat, or tenderness.
• Blood Tests: These may be conducted to check for inflammation and to rule out other types of arthritis.
• Imaging: X-rays or MRIs may be used to assess the condition of the joints.

If psoriatic arthritis is suspected, a referral to a rheumatologist—a specialist in arthritis—may be recommended for further evaluation and management.

Living with Psoriatic Arthritis

While there is currently no cure for psoriatic arthritis, many individuals can manage their symptoms effectively with appropriate treatment. The course of the disease can vary widely; some may experience periods of flare-ups followed by remission.

• Treatment Options: Treatment plans are tailored to the individual and may include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Disease-modifying anti-rheumatic drugs (DMARDs)
  • Biological DMARDs

• Self-Management: Engaging in self-management strategies can also be beneficial. This includes staying physically active, maintaining a healthy diet, and managing stress.

• Emotional Well-being: It is natural to experience a range of emotions upon diagnosis, including fear and frustration. Seeking support from healthcare professionals, family, and support groups can be invaluable.

Conclusion

Psoriatic arthritis is a complex condition that requires a comprehensive approach to management. If you suspect you may have psoriatic arthritis or have been diagnosed with it, it is essential to work closely with your healthcare team to develop a personalised treatment plan. Remember, you are not alone in this journey, and support is available to help you lead a fulfilling life despite the challenges of the condition.