What is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is an inflammatory arthritis that may cause joint pain and swelling, scaly patches on areas of skin and thickening or pitting of the fingernails and toenails. PsA is an inflammatory disorder that occurs when your body's immune system, which normally fights harmful organisms such as viruses and bacteria, begins to attack healthy cells and tissue. the abnormal immune response causes inflammation in your joints as well as the overproduction of skin cells.

PsA usually starts slowly; some people develop skin symptoms first while others see joint inflammation first. Joint tissue becomes inflamed leading to pain, swelling and stiffness. Over time, the muscles and ligaments around the bone, the cartilage and the bones themselves, can become inflamed and damaged, often leading to joint deformities.

Who gets Psoriatic Arthritis?

Men and women are equally affected with symptoms of PsA, which usually appear during adulthood.

What causes Psoriatic Arthritis?

It's not entirely clear why the immune system turns on the body's own tissues, but it seems likely that both genetic and environmental factors play a role. Many people with PsA have a close relative, such as a parent or sibling, with the disease, and researchers have discovered certain gene mutations that appear to be associated with PsA.

How is Psoriatic Arthritis diagnosed?

PsA may take some time to diagnose. Doctors will ask about medical history and conduct a physical examination, assessing skin and joint symptoms. There wil be a variety of blood tests and X-rays.

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Skin symptoms - Psoriasis

The skin symptoms of PsA usually appear before the joint symptoms - often years earlier. However, it is possible for both skin and joint symptoms to appear at the same time, or for the joint symptoms to appear first. A diagnosis of PsA will be made when both skin and joint symptoms are present and is confirmed by relevant tests.

The most common skin symptoms are scaly, silver-grey skin patches, particularly on the elbows, knees, lower back and scalp, as well as pitted, ridged, split or discoloured fingernails and toenails.

Most people wtih PsA do NOT have severe skin symptoms. If you have severe skin symptoms it does not mean you will have severe joint symptoms.

Joint Symptoms

Any joint can be affected by PsA; sometimes it is just one or two joints, but it can be more. Pain, swelling and stiffness of the joints are the most common problems, often affecting mobility. Swelling of the fingers and toes can give a 'sausage-like' appearance.

In some cases PsA can cause deformity, enlarging the joints so that walking is painful, and making shoes difficult to fit.

Managment of Psoriatic Arthritis

You are the ultimate manager of your healthcare. People who become active self-managers of their disease tend to be better informed and may experience less pain and disability, often having a better long-term outcome.

A range of health practitioners can provide support and advice:

• General Practitioner (GP) - helps coordinate the care and arranges referrals to other associated medical professionals;
• Rheumatologist - specialise in diagnosing and treating bone, joint and muscle disorders;
• Physiotherapist - helps with mobility techniques, stretches and exercises that are appropriate to PsA, including ways to help manage pain and daily activities;
• Occupational Therapist - evaluates and designs programmes to accomplish basic daily tasks;
• Podiatrist or Orthotist - provides professional assessment and management of feet, including supply of such things as shock absorbing soles for shoes.

Tips for living with Psoriatic Arthritis

By managing PsA carefully, most activities should be achievable. For the best part, PsA is not a barrier to employment, raising a family, or keeping physically active. However, PsA affects people differently, so learning about the condition and what can be done is vital for self-management.

Good posture is Vital

It is very important to pay attention to how you stand and sit at all times. It is also important to be aware of posture as you move about. When standing, keep bodyweight balanced and even on both feet with shoulders relaxed (back and down). Keep the back of the neck long, allowing the chin to drop slightly forwards. Do not stand still for too long and when moving, try to maintain this tall, relaxed posture.

Have a good supportive chair when sitting; it should be firm, upright and allow feet to touch the floor with knees and hips at right angles. Avoid neck strain if working at a desk or computer by having the screen at eye-level.

Sleep

A good night's sleep is essential for rest and repair of the body. Use a mattress that gives support, but is not too hard, and a pillow which fits snugly under the neck supporting the head. Sleep in a position that is most comfortable, but if on the side, avoid a lot of bending at the hips and knees.

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