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Psoriatic Arthritis Treatment

Published here for informational purposes as authorized by the American Academy of Dermatology (http://www.aad.org/skin-conditions/dermatology-a-to-z/psoriatic-arthritis/diagnosis-treatment) [email protected]

How is psoriatic arthritis treated?

Today, there are many treatment options for psoriatic arthritis. A treatment plan often includes several of the following:

• Therapy (physical, occupational, massage).
• Patient education. 
• Exercise and rest.
• Devices to protect joints.
• Medicine.
• Surgery.

Therapy (physical, occupational, massage): These therapies can reduce pain. They can make it easier to move and do everyday tasks. If therapy can help, your doctor will write a prescription for the type(s) of therapy you need. Your therapist will work with your doctor and report your progress.

Patient education: Learning about psoriatic arthritis is important. The more you know, the better you can control this disease. Take time to learn the signs and symptoms. Ask your doctor what you should do when the arthritis flares. Learn about arthritis-friendly exercises and exercises that you should not do — at least for a while.

Exercise and rest: Each plays an important role. Arthritis-friendly exercises can help reduce pain, make it easier to move, and sometimes restore lost movement. Rest is important when psoriatic arthritis flares.

Devices to protect joints: Braces, splints, and supports can protect affected joints and prevent further damage. They offer support for painful areas and can stop painful movements. You should not buy one without first talking with your doctor. The device must fit you properly. It must support the area that needs support. Your doctor may recommend that a physical or occupational therapist fit you.

Medicine: Medicine can reduce swelling and ease pain. A few medicines can prevent the arthritis from worsening. The medicines that are often part of a treatment plan for psoriatic arthritis are as follows:

When psoriatic arthritis is mild, patients usually can reduce signs and symptoms with:

• Non-steroidal anti-inflammatory drugs (NSAIDS) (pronounced en-saids): These help reduce swelling and pain. Some NSAIDs that may be part of a treatment plan for psoriatic arthritis do not require a prescription. These include aspirin, ibuprofen, naproxen, and nabumetone.
  
  Prescription NSAIDs include arthritis medicines such as celecoxib.
  
  Some people see their psoriasis worsen when they begin taking an NSAID. If this happens, call your dermatologist.

Tip: If you are taking asprin or another medicine in the NSAID family, take the medicine immediately after you drink a glass of milk or eat a meal. This helps to protect your stomach. You should not drink alcohol when an NSAID is part of your treatment plan.

• Shots of corticosteroids: When arthritis develops in a few joints, injecting this medicine into the swollen joints can quickly reduce swelling and pain.

Some people require stronger medicine to control their psoriatic arthritis. Your doctor may prescribe a disease-modifying, anti-rheumatic drug (DMARD) (pronounced dee-mard). DMARDs also reduce swelling and pain. Some DMARDs can prevent the arthritis from worsening and destroying joints. DMARDs that may be part of a treatment plan for psoriatic arthritis include:

• Methotrexate: This medicine can reduce swelling in the joints and also is approved to treat psoriasis.
• Injectable biologics: This type of medicine can prevent the arthritis from progressing and destroying the joints. Some of the biologics approved to treat psoriatic arthritis also can treat psoriasis.

To provide you with the most effective treatment, your doctor may prescribe 2 DMARDs. Prescribing both methotrexate and a biologic can help patients who have extensive or aggressive psoriatic arthritis. This combination has become a standard of care for aggressive psoriatic arthritis.

All medicine can cause side effects. Before taking a medicine, ask your doctor about possible side effects.

Surgery: If you have badly damaged joints or medicine does not help, surgery may be an option. Surgery can lessen pain. It can help you move more easily. It can improve the appearance of damaged joints. After surgery, you may be able to perform everyday tasks more easily. Surgery requires downtime. It involves some risk.

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