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Psoriatic Arthritis.

Psoriatic arthritis is a type of spondyloarthritis (SpA), predominately a chronic inflammatory disease of peripheral involvement. It involves the small and large joints in the body particularly the fingers, toes, neck, spine or pelvis, and can also occur in patients with skin psoriasis.

The arthritis develops following onset of the skin disease in most people, though the skin disease is not present in all people with psoriatic arthritis. Often, there is variation in the location and pattern of joint involvement and can be one side not the other, both sides, or could be widespread throughout the spine. 

It is characterised by:

  • Pain, stiffness and swelling in the affected joints 
  • Warmth in the affected joints
  • Pain and swelling at the back of the heels, under the feet, or the elbows
  • Red and silver-white flaky and scaly patches of skin (skin psoriasis)
  • Red and sore eyes
  • Nail discolouration or separation of the nails from the nail bed

Clinical features and symptoms vary between individuals and not all individuals experience all the features and symptoms. Furthermore, the condition can be unpredictable and can flare-up or worsen and other times almost disappear.  

Causes of Psoriatic Arthritis

The definitive cause of Psoriatic Arthritis remains unknown, although a triggering infection, mechanical stress and disruption of the external barrier causes immune and inflammatory mechanisms to respond, which are thought to be involved. It is an autoimmune disease, so the immune system is overactive and effects the body’s healthy tissues and creates increased inflammation.

Psoriatic Arthritis is a disease process that begins at the entheses and involves an immune system mechanism and pathway that when activated leads to chronic inflammatory disease including Psoriatic Arthritis. This is followed by characteristic bone loss (erosion) and new bone formation – a clinical manifestation of the disease.

Diagnosing Psoriatic Arthritis

Diagnosis is made by a Rheumatologist. Diagnosis of Psoriatic Arthritis is a major challenge as it is generally made by careful consideration of several criteria. Reasoning and combining clinical criteria of inflammatory back pain, enthesitis or arthritis with clinical features and history, thorough physical examination, testing and observation, laboratory (blood) testing, and radiological findings provides a diagnosis. 

Early identification is critical along with referral to a rheumatologist if Psoriatic Arthritis is suspect.

Treatment of Psoriatic Arthritis

Although there is no cure, and the course of progression of the disease variable, Psoriatic Arthritis can be managed in many ways. Treating the disease early can be effective in relieving symptoms and possibly preventing progression and further long- term problems. 

Every individual is different, and everyone’s symptoms, severity and progression of the disease is different. Your doctors will work with you to develop and refer you for a treatment plan specific to you. Improving movement patterns, Education, Exercise, Diet, Sleep and relevant lifestyle modification combined with medication is the gold standard.

The aims of treatment are to:

  • Reduce pain, stiffness and fatigue
  • Limit spine and joint damage as much as possible
  • Control other skin or body problems
  • Improve mobility of spine and joints, flexibility and strength 
  • Improve cardiovascular health
  • Improve inflammatory markers
  • Improve function and quality of life

The treatment of Psoriatic Arthritis can broadly be divided into two types of management categories:

  • Pharmacological or medication
  • Physiotherapy 

Pharmacological or medication management to treat the disease as well as treat the co-existent conditions (such as psoriasis, uveitis) is critical and prescribed, managed, and reviewed by the treating Rheumatologist.

Allied Health play an important role in Psoriatic Arthritis and Physiotherapists and Exercise Physiologists play an integral role in ongoing therapy. A tailored treatment plan involving specific exercises, education and advice can assist with treatment aims.  

At Move For Better Health, we pride ourselves on our collaborative approach to treatment to ensure you can be the best you. We have a multidisciplinary approach to management regularly liaising with other health professionals involved in your care.

At our Malvern and Magill locations, we have Physiotherapy, Exercise Physiology, Clinical Psychology (with specialisation in sleep dysfunction), Podiatry and Dietetics. Being able to provide you with the recommendations of gold standard care for Psoriatic Arthritis, please get in touch to discuss your treatment options with one of our friendly staff. You can:

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