Dr. M.J. Bazos, MD
Patient Handout
ARTHRITIS,
PSORIATIC
About Your
Diagnosis
Psoriatic arthritis causes
inflammation leading to pain, swelling, and warmth of certain joints and a rash.
The joints most frequently affected are the fingers, neck and lower back.
Although the psoriasis rash usually occurs before the joint pain, some
individuals are unaware of this rash. Psoriasis may ffect the nails, scalp,
umbilicus (belly button), and genital areas. Fatigue may also occur in this
disease. Less commonly, psoriatic arthritis may also cause inflammation of the
eyes, nails, and heart. Although certain hereditary and environmental factors
may increase an individual’s risk of developing psoriatic arthritis, the
exact cause of this disease is unknown. Psoriatic arthritis is not an infectious
illness. In other words you cannot “catch” it from another
individual. Psoriatic arthritis usually begins between the ages of 30 and 50
years. It occurs equally between men and women. To diagnose psoriatic arthritis,
a physician obtains a medical history, performs an examination of the joints,
skin, and nails, and orders laboratory tests and possibly x-rays of the joints,
neck, and lower back. Laboratory tests may include an erythrocyte sedimentation
rate (ESR), which measures inflammation in the body, and a complete blood cell
count (CBC).
Living With Your
Diagnosis
The joints most frequently
affected are the fingers, neck, and low back. Psoriatic arthritis of the fingers
can decrease your ability to write, open jars, and lift and carry items. If the
back is affected, it can decrease your ability to bend or stand. If the neck is
affected, it may affect your ability to look around. For some individuals, the
rash of psoriasis causes embarrassment in social situations. There is no cure
for psoriatic arthritis. However, with earlier detection, improved medications,
and comprehensive treatment, individuals with psoriatic arthritis can lead a
full
life.
Treatment
The
best way to manage psoriatic arthritis is through a combination of medications,
therapies, exercise, and education. Medications help to decrease the
inflammation that causes pain and swelling. Nonsteroidal anti-inflammatory drugs
(NSAIDs) are often the first line of therapy. Potential side effects of NSAIDs
include stomach upset, diarrhea, constipation, ulcers, headache, dizziness,
difficulty hearing, and a rash. If these medications do not adequately control
the pain and swelling, a physician may prescribe “disease modifying”
medications that may slow down the disease process. These medications include
hydroxychloroquine, sulfasalazine, and methotrexate. Hydroxychloroquine may
cause nausea, diarrhea, and a rash, and rarely affect the eyes. Sulfasalazine
and methotrexate may affect the blood and liver, and may cause a rash. A
dermatologist (skin doctor) may prescribe medications to manage the psoriasis.
Learning about your arthritis is essential because you may have psoriatic
arthritis for the rest of your life. Exercise is important to maintain joint
movement and muscle strength. Alternating periods of rest and activity helps to
manage fatigue.
The
DOs
• Take your medication as
prescribed.
• Call your doctor if you
are experiencing side effects from
medications.
• Ask you doctor what
over-the counter pain medications and skin products you may take with the
prescription medications.
• Exercise,
because this can help maintain joint range of motion and muscle
strength.
The
DON’Ts
• Wait and see if a
medication side effect will go away. Always call your doctor if you have any
questions.
• Give up. If one
medication does not work for you, discuss this with your physician until you
find a medicine that helps decrease joint pain, stiffness, and the skin
disorder.
• Go on a specific diet
without the consent of your
physician.
• Continue an exercise
program that causes pain. If pain after exercise continues, it usually means the
exercise needs to be modified specifically for
you.
When to Call Your
Doctor
• You experience any of
the side effects listed above from any of the
medications.
• The medication is not
helping the joint pain, stiffness, or swelling, or the skin
disorder.
• You need a referral to a
physical or occupational therapist for exercise or joint
protection.