PSORIATIC ARTHRITIS

Psoriasis is an inflammatory disease that causes skin cells to multiply much more quickly than usual, creating bumpy red patches with white scales, particularly on the scalp, elbows, knees, and lower back. It affects about 8 million people in the U.S., both men and women. Roughly one third of them develop psoriatic arthritis (PA) within several years of the skin condition’s onset, often those between the ages of 30 and 50.

Typical symptoms include swollen joints on one or both sides of the body, morning stiffness, reduced range of motion, and fatigue. But psoriatic arthritis can cause everything from swollen fingers and toes to Achilles tendinitis, at the back of your heel, to low back pain–the result of inflammation in the joints between the vertebrae of your spine.

“Psoriatic arthritis is tricky, because it can take different forms,” says Simon Helfgott, MD, a rheumatologist at Brigham and Women’s Hospital in Boston. “One looks like RA. Another looks like OA. Another looks like ankylosing spondylitis, a different form of inflammatory arthritis.” A key distinguishing characteristic: Inflammation usually occurs at the location where tendons attach to bones. “It affects the tissues around the joint instead of the joint itself.”

PA develops due to a complex and not well understood interaction that involves genes, the immune system, and the environment, says Dr. Davis. “Overweight and obesity can play a role, because they promote inflammation,” he says.

Mild psoriatic arthritis can be treated with over the counter drugs.

The good news: The illness is often episodic. It can be extremely painful for six to eight months, then patients can be symptom-free for a year or more. People who respond to the medication can often cut back or even go off it for periods of time. Low-impact exercise can be helpful for managing symptoms, as can strengthening and flexibility exercises. Stress management is vital too, since stress triggers inflammation and has been shown to set off bouts of both psoriasis and psoriatic arthritis. So find ways to build relaxation into your daily routine, whether it’s a morning bout of mediation, an after-dinner stroll, or a warm bath before bed.