Psoriatic Arthritis – Progression and Management

Psoriatic arthritis (PsA) is a type of arthritis that affects individuals with psoriasis. It advances in stages and can impact people differently. For instance, some experience a gradual worsening of symptoms, while others notice the rapid development of severe discomfort. The condition usually occurs between the ages of 40 and 50 years. Although psoriatic arthritis does not have a cure, patients may experience periods of remission where their symptoms improve significantly.
Early stages of psoriatic arthritis
Psoriatic arthritis usually begins after a person has had psoriasis for a while. Psoriasis is a skin disorder characterized by scaly, itchy, and red skin flare-ups. In the early stages of psoriatic arthritis, one may experience the following:
Pain and swelling
Pain and swelling may develop in smaller joints, such as the fingers and toes. Some people also report swelling in larger joints, such as the knees and ankles. The swelling is called dactylitis when it affects the whole finger or toe. The extent of the pain and swelling may differ from person to person.
Changes in the nails
According to statistics, more than 80% of patients with this condition develop nail changes. These changes are often considered early signs of joint disease. In some cases, this symptom may occur several years before the development of psoriatic arthritis. Some changes patients notice include the development of shallow ridges on the nail surface, small indentions on the nail bed surface, line-shaped clots on the nail, and separation of the nail from the nail bed.
Joint problems
Those suffering from psoriasis may also complain of joint problems, such as reduced range of motion, inflammation of the tendons or ligaments in the affected area, and swelling. In rare cases, patients may also experience spine inflammation, leading to increased discomfort and spinal pain. These symptoms make it hard for one to carry on day-to-day tasks.
The symptoms sometimes extend beyond joints and nails in the early psoriatic arthritis stages. Common examples include fatigue, skin rash, or conjunctivitis. With such varying symptoms, diagnosing the condition early is imperative to manage the symptoms and flare-ups more efficiently.
Progression of psoriatic arthritis
The condition’s progression may vary from one person to another. In some cases, it may affect the same joints on both sides of the body, increasing the patient’s discomfort. Hence, patients are suggested to seek the advice of a healthcare professional at the earliest. As the condition progresses, one may experience periodic flare-ups, which, if left untreated, may lead to permanent bone damage. This happens due to prolonged inflammation of the bones, causing them to erode. Furthermore, the joint space may become narrow, affecting the ability to move. However, in rare cases, patients have experienced complete remission of the condition without treatment.
Later stages of psoriatic arthritis
While the disorder may progress differently in each patient, the worsening of the symptoms usually indicates the progression of the disease and the need for more aggressive treatment. Here are some symptoms one should keep an eye out for as they signify the problem could be worsening:
Constant flares
A one-off flare may not appear serious; it has become more acceptable during periods of remission. However, flare-ups every couple of months could mean the condition has progressed to the later stages. Constant flares might also lead to other complications, like joint damage.
A significant loss in joint mobility
This is another indicator of the condition’s gradual worsening. A patient who could flex their wrist 60 degrees a couple of years ago may now begin to lose 50 percent or more of that range of motion. This might interfere with their inability to carry out day-to-day activities. Decreased joint mobility can also worsen other discomforts like stiffness, pain, and the likelihood of permanent bone changes.
Fused spine
People may suffer damage to the spine in the later psoriatic arthritis stages. Some develop axial spondyloarthritis of psoriasis, a condition where the spinal joints become inflamed, eventually causing their fusion. It leads to decreased flexibility and chronic pain in the spine and affected areas.
Besides the above, patients may experience increased fatigue. Statistics confirm that about 50 percent with psoriatic arthritis report moderate-to-severe fatigue levels, and nearly 30 percent have severe fatigue. Moreover, the combination of symptoms like fatigue, psoriasis symptoms, joint pain, and swelling may lead to isolation in a few people, trigger high levels of depression, and make it hard to maintain an active social life.
Ways to manage or slow down psoriatic arthritis progression
While the condition has no cure and one cannot reverse its severity, there are ways to manage the ailment and slow down its progression. However, these methods may work considerably better when started earlier. Patients can manage the condition and its accompanying symptoms using the following remedies:
Exercise
Additional stress on the joints may lead to an increased level of discomfort. Hence, patients are asked to practice low-impact exercises like biking and swimming to improve overall health, increase their range of motion, and strengthen their muscles. Yoga is also beneficial in improving flexibility.
Hot and cold therapy
Applying a heating pad may help tense muscles relax, reducing joint strain. On the other hand, placing an ice pack on the affected area can reduce swelling and pain. This remedy must be practiced correctly and regularly for the best results.
The best way to deal with psoriatic arthritis is to prevent it in the first place. Those with psoriasis should take the necessary preventive measures as they are more susceptible to this kind of arthritis. Some other risk factors are scalp psoriasis, psoriasis on fingernails, a family history of psoriatic arthritis, and being between 30 and 50 years. Individuals with these risk factors should go for regular screenings to diagnose the problem at the earliest.