Treatment options for psoriatic arthritis

If you have been diagnosed with psoriatic arthritis, a variety of treatment options exist. Your doctor or specialist will work with you to find a treatment plan that works best for you. The goal of treatment is to reduce the pain and swelling in your joints, and to help you maintain the greatest range of motion. In addition, treatment may prevent any further damage from occurring.

Treatment for psoriatic arthritis can involve medications, exercise, skin care, hot/cold applications, relaxation techniques, or surgery.

Medications – NSAIDs: Your doctor may suggest that you take NSAIDs (nonsteroidal anti-inflammatory drugs) to help control your pain and reduce the swelling and stiffness in your joints. Some types of NSAIDs (such as ASA and ibuprofen) are available over the counter (without a prescription), while most require a prescription from your doctor. Your doctor will work with you to see which of these medications give you the most relief while causing minimal side effects (such as stomach problems).

Medications – DMARDs: DMARDs (disease-modifying anti-rheumatic drugs) may be recommended for cases of advanced psoriatic arthritis, and they work to alleviate the inflammation in your joints. They may take several months before they reach their full effect, and may be used in combination with NSAIDs. These types of medications include methotrexate, sulfasalazine, hydroxychloroquine, and azathioprine. Side effects that may arise include mouth sores, diarrhea, and nausea.

Medications – Steroids: Steroid injections to the joint (and areas around it) may be beneficial in managing symptoms as they help reduce inflammation quickly.

Medications – Biologics: Biologics such as abatacept (Orencia®), adalimumab (Humira®), and infliximab (Remicade®) are another treatment used for psoriatic arthritis. These medications help reduce pain by targeting specific parts of the immune system that trigger inflammation. However, they can increase the risk of infections.

Exercise: Exercise is important to help keep your joints moving and prevent further damage. If you don’t use a joint, it will stiffen and the surrounding muscles will weaken, both of which can cause further problems. Do your best to keep your joints in use, and talk to your doctor about starting an exercise schedule. They can recommend specific exercises designed to help improve and manage your condition.

Light therapy: For people with psoriatic arthritis, light therapy may be a simple yet safe treatment that can improve their symptoms. Narrowband UVB phototherapy is the gold standard light therapy used to treat psoriatic arthritis, usually together with other medications.

Hot/cold applications: Most of us know that applying hot packs can help when we have sore muscles, or cold packs for an injury that might swell. These same principles can be used to help manage psoriatic arthritis pain and swelling. Applying heat (such as a hot pack, or having a hot shower) can help relax tight muscles around painful joints and improve circulation to the desired area. Applying a cold pack (such as a bag of frozen peas) helps constrict the blood vessels in the area and helps reduce swelling and pain. Talk to your doctor before trying these treatments to make sure they are safe for you.

Relaxation techniques: Easing tension not only helps reduce the pain of sore, aching muscles around tender joints, but it can also improve your outlook on your condition. Different people prefer different methods of relaxation. Explore what works well for you. This may involve a walk in the park, an hour of solitude, or prayer or meditation.

Surgery: Surgery is an option for some people whose psoriatic arthritis has reached a point where their joints have become severely damaged. Surgical options might include:

  • Joint replacement: the surgeon will replace the damaged joint with a better-functioning, artificial one.
  • Synovectomy: the surgeon will remove the synovial tissue, or lining, of particular joints such as the shoulder, elbow, or knee.
  • Joint fusion: the surgeon will fuse 2 bones together to make a joint stronger and reduce pain.

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