Treatment and Prevention
Using a number of tests, a doctor is able to diagnose psoriatic arthritis and eliminate other possible conditions. Often, the skin symptoms of psoriasis (present or past) are clear indicators. Pitting of the fingernails is an almost certain sign that joint pain is caused by psoriatic arthritis and not some other form of arthritis.
The first step is to X-ray the joints to see what changes are taking place. Next, a doctor may do a blood test for rheumatoid factor to eliminate the possibility of rheumatoid arthritis. Tests of fluid in the joints can also rule out gout, which may have arthritic symptoms very similar to psoriatic arthritis. This process of elimination is necessary because there's no test that confirms a diagnosis of psoriasis or psoriatic arthritis. That's why diagnosis of psoriatic arthritis is usually based on the characteristic presence of both skin and joint symptoms.
Treatment and Prevention
Currently, there is no cure for psoriatic arthritis, but treatment can relieve pain, reduce swelling, and improve skin symptoms.
The medications used to treat joint inflammation in psoriatic arthritis are similar to those used for rheumatoid arthritis.
Most people are started on a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen, naproxen, or celecoxib,or even acetylsalicylic acid (ASA)* in anti-inflammatory doses. In some cases, these medications are given with another medication to protect the stomach lining from the NSAID. For many people, these medications will control pain and inflammation but they will not stop the joint damage that can occur in psoriatic arthritis.
For many people with psoriatic arthritis, medications called disease-modifying anti-rheumatic drugs (DMARDs) are recommended. These medications affect the immune system, and often stop joint damage. Examples of DMARDs include azathioprine, chloroquine, gold salts, hydroxychloroquine, leflunomide methotrexate, and sulfasalazine The DMARDs known to be most effective in psoriatic arthritis are methotrexate, sulfasalazine and leflunomide. People often notice a change in their symptoms after two to six months. In cases where DMARD therapy doesn't fully control the inflammatory destructive process, some people are recommended biologic therapies. These include agents like etanercept, infliximab, and adalimumab.
Corticosteroids in tablet (e.g., prednisone) or injection form can also be used to control inflammation. Corticosteroid injections are injected directly into the affected joints and can help relieve severe symptoms of both arthritis and tendinitis. There are long-term effects with corticosteroids that require regular monitoring if these are given for prolonged periods of time.
Various types of splints can be used to ease the load on affected joints and keep them aligned. Many people find these extremely helpful. In cases of irreparable joint damage, surgery can substitute damaged joints with artificial joints - these are improving all the time.
Exercise and strength training is usually beneficial for people with arthritis to reduce pain and increase your range of movement. A doctor should be consulted about appropriate exercise programs. People with this condition must also protect their joints. Through stretching, exercise and the use of devices to simplify tasks, daily chores will cause less stress on joints and the body in general.
For skin symptoms, many doctors favor the technique known as PUVA, in which ultraviolet (type A) light is directed on the affected skin after a medication is given that increases the light sensitivity of the skin.
For more information about the treatment of skin symptoms, see the psoriasis condition article.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For more information on brand names, speak with your doctor or pharmacist.