Psoriatic arthritis is a disorder that causes pain and inflammation in the joints. It occurs in people with psoriasis, which is a chronic (long-term) skin disease that is characterized by the presence of a dry, scaly, itchy skin rash. This rash is more common on the elbows, knees and scalp. Psoriasis can cause changes in the nails of the fingers and toes as small depressions that resemble dots on the surface of the nails, called fovea.
What is the cause?
The cause of the disease is still unknown. It is believed that genetic factors (hereditary), a malfunction of the body’s immune system that causes inflammation in the joints and the environment, play a role in the development of the disease. Some researchers believe that certain bacteria, such as streptococci, may be related to psoriatic arthritis and cause chronic stimulation of the immune system. This stimulation of the immune system can result in arthritis in those who have a genetic “susceptibility” to psoriatic arthritis. In the inflammatory types of arthritis, such as psoriatic arthritis, the body’s defence system mistakenly attacks the lining of the joints, causing pain and inflammation.
What are the symptoms?
The common symptoms of psoriatic arthritis are:
- Pain and swelling in one or more joints, usually wrists, knees, ankles and/or joints of the extremities (called distal) of the fingers.
- Swelling of the fingers and/or toes that gives them the appearance of a sausage.
- Low back pain or glutes.
- Silver or grey spots scaly with dryness on the scalp, elbows, knees and/or lower end of the spine with scaly skin (peeling).
- Fovea, characterized by tiny depressions in the nails of the fingers and/or toes, and/or detachment of the nails.
The course of psoriatic arthritis varies. Most people are able to lead a normal life. However, some have chronic joint pain and can not use the joints affected by arthritis. The constant presence of heat and swelling in the membrane that covers the joints, called synovium, can cause damage and deformity in the joint.
How is it diagnosed?
To know if you have psoriatic arthritis, your rheumatologist in Delhi will ask about your symptoms and perform a physical examination. The latter can detect abnormalities in the joints such as pain, inflammation, pain during joint movement, or inability to move joints in their entirety. In addition, your arthritis doctor in Delhi will look for evidence of psoriasis on the skin or changes in the nails. Also, they will do some of the following tests:
- X-rays to detect changes in bones and joints,
- Blood tests to rule out other diseases, such as rheumatoid arthritis,
- Joint fluid tests to rule out gout or infectious arthritis.
The goal of psoriatic arthritis treatment in Delhi is to reduce joint pain and inflammation, control skin psoriasis, and delay or prevent joint damage. The most common treatments, including skincare, drugs and exercise, are described below.
The following information does not cover all possible uses, precautions, side effects or drug interactions for the treatment of psoriatic arthritis. You should not replace the advice and guidance of your rheumatologist in Delhi. If you have questions about these or other treatments, consult your arthritis specialist in Delhi.
- Avoid using strong soaps.
- Use soaps that are not deodorants.
- Use a lanolin cream or lotion.
- Put baby oil in the water of your bathtub.
- Use a humidifier if you live in a dry climate zone.
Using special makeup can help hide skin problems and make you feel better.
Inquire with your dermatologist in Delhi about special cosmetics or inquire at the sideboards of any department store. Cosmetics employees can teach you how to apply their products.
TREATMENTS WITH LIGHT
Light treatments, such as those presented below, should only be followed under the recommendation of a dermatologist. Do not apply them if you are taking methotrexate.
- Sit in the sun for short periods of time.
- Try a UVB treatment (ultraviolet light type B).
- Try a PUVA treatment. This is a combination of psoralen prescription medication, which is taken in pill or added to bathwater, and ultraviolet light type A.
- Experiment with excimer laser phototherapy aimed at specific areas of the skin.
The benefits of medications used to treat psoriatic arthritis include helping to relieve joint pain and inflammation, as well as slowing joint damage. However, what works for you may not work for someone with psoriatic arthritis. Take your medicines as directed by your joint pain specialist in Delhi and pharmacist. Be sure to tell your doctor about all prescription and over-the-counter medications and / or dietary supplements or herbalists that you are taking. Taking certain medicines together can cause an adverse reaction.
Your dermatologist or rheumatologist in Delhi may prescribe topical creams or ointments to control psoriasis, such as:
- Creams or ointments of corticosteroids.
- Analogs of vitamin D3, such as calcipotriol, tacalcitol and calcitriol ointments.
- Calcineurin inhibitors such as tacrolimus (Protopic) and pimecrolimus (Elidel).
- Cream based on retinoids.
NON-STEROID ANTI-INFLAMMATORY MEDICINES (NSAIDs) Nonsteroidal
anti-inflammatory drugs or NSAIDs can help reduce pain and inflammation of the joints. You may have to take NSAIDs for a few days, weeks, or maybe much longer, depending on your situation. Over-the-counter or over-the-counter NSAID medications include aspirin, ibuprofen, and naproxen. Some of them are only issued with a prescription. Over-the-counter medications are often available at lower-than-prescribed doses and can control pain, but at these lower doses, they may not control inflammation. Check with your doctor if it is advisable to take over-the-counter medications in addition to those prescribed.
NSAIDs work by inhibiting the production of substances called prostaglandins at the site of inflammation. These drugs carry the risk of creating stomach problems, a fall in kidney function, and heart attacks or strokes. Talk to your doctor to understand the risks. One type of NSAID called COX-2 selective inhibitor, celecoxib ( Celebrex ), was designed to be softer to the stomach but may pose an increased risk of heart attack and stroke. Check with your doctor about the possible risks and to decide which drugs are right for you.
Physical activity is an important part of your arthritis treatment in Delhi. It can limit the pain and inflammation of arthritis that makes the joints rigid. The activity can also improve flexibility, strengthen muscles, improve sleep, strengthen the heart, help lose weight and improve physical appearance. It is essential to exercise as soon as it is diagnosed to maintain complete mobility of the joints.
The aquatic exercise like swimming can be a good choice because it puts less stress on joints that exercise is practised on the ground. Work with your doctor, physiotherapist or rehabilitation specialist to develop an exercise program according to your needs.
Generally, a normal amount of rest and sleep is enough to reduce joint fatigue and inflammation. In some people, however, psoriatic arthritis can cause extreme fatigue. If this happens, you may need to rest more than usual and learn to keep up with your activities so that you can use your energy wisely throughout the day. It is important to rest the individual joints of the forces of tension. If the feet, ankles or knees are compromised, it may be necessary to decrease the activities that involve carrying weight during acute episodes.
Heat and cold
Heat and cold treatments such as getting into a bathtub or hot tub or placing an ice pack on the painful joint can temporarily relieve pain and reduce swelling in the joints. Ask your doctor or physiotherapist about the most appropriate arthritis treatment in Delhi for you. If the joints are hot and swollen, cold should be used. If you feel pain, but without heat or inflammation, then you can apply cold or heat indistinctly.
Splints or splints
splints help you to rest your joints. They can be useful if you have joint inflammation or problems with the alignment or stability of them. Using splints helps reduce pain, swelling and stiffness in them. Your doctor, physiotherapist or occupational therapist can assist you in determining what is the best splint for you and when you should wear it.
Most people with psoriatic arthritis may never require surgery to replace the joints. However, if your joints are seriously damaged by the disease or when other treatments do not diminish the pain, your orthopaedic surgeon in Delhi may recommend surgery, in which the joints damaged by psoriatic arthritis are replaced with artificial joints. The benefits include less pain and improvement in joint function.
Who is at risk?
Psoriatic arthritis occurs in people with psoriasis, a chronic (long-term) skin disease. Not everyone who has psoriasis has psoriatic arthritis. From 10 to 30% of people with psoriasis develop psoriatic arthritis.
The condition affects both men and women. It usually develops between 30 and 55 years of age.