At Long Island Spine Rehabilitation Medicine, our doctors treat patients with all kinds of disorders, including psoriatic arthritis. Because so far modern medicine has not found a cure for arthritis, we focus on relieving arthritic pain and restoring as much mobility and function as possible to our patients.
What is psoriatic arthritis?
For the majority of patients, psoriatic arthritis begins as psoriasis alone — a disease that causes red patches of skin topped with silvery scales. For some patients, however, joint problems are the first symptom and skin patches appear later.
Either way, psoriatic arthritis is characterized by pain, stiffness, and swelling of the joints, especially in the fingertips and spine, as well as a serious skin condition. Like other forms of arthritis, psoriatic arthritis can be mild or severe. Patients experience periodic flare-ups and periods of remission.
Until fairly recently, psoriatic arthritis rarely came to the attention of the public, but now that there are new medications to treat this condition, TV ads are focusing attention on a problem that has made approximately 1.5 to 2 million Americans miserable for decades.
The fact that psoriatic arthritis affects both skin and movement makes it difficult to treat. Not only do patients have to deal with pain and immobility. They also have to endure living with patches of skin that are not only very uncomfortable, but unsightly as well.
Why Treatment Is Critical
Although this disease is not curable at present, it is important to control symptoms going forward in order to prevent joint damage. Left untreated, it can lead to greater and greater disability.
Psoriatic arthritis may affect joints on only one side or both sides of the body. Joint symptoms of the disease are similar to those of rheumatoid arthritis. In both cases, joints become swollen, painful, and warm to the touch. Psoriatic arthritis, however, is more likely to result in:
- Foot pain, especially Achilles tendonitis and plantar fasciitis
- Swelling of the fingers and toes
- Lower back pain (spondylitis or sacroiliitis)
- Nail damage (e.g. pits, crumbling, separation at the nail beds)
- Eye inflammation (uveitis) that can cause eye pain, redness, blurry vision, and if untreated, vision loss.
Because symptoms are likely to worsen over time, it is important to start treating the condition as soon as it is diagnosed.
Psoriatic arthritis is an autoimmune disease which means that the body’s immune system attacks healthy cells and tissue. This overwhelming immune response causes inflammation in the joints and the overproduction of skin cells.
Research has shown that both genetic and environmental factors play a role in this condition. Many patients with the disorder have a family member (parent or sibling) with either psoriasis or psoriatic arthritis, and scientists have found genetic markers associated with the disease.
There also seems to be a correlation between environmental factors — such as physical trauma or a viral or bacterial infection — and psoriatic arthritis. It is believed that some patients have inherited a tendency toward the problem that is then triggered by an outside force. It has been noted that the onset of the condition most often occurs between the ages of 30 and 55.
Potential Complications from Psoriatic Arthritis
Less than 5 percent of patients who have psoriatic arthritis develop arthritis mutilans — a virulent, disabling form of the disease. Over time, arthritis mutilans destroy the small bones in the hands, especially the fingers, leading to permanent deformity and disability. Some people with psoriatic arthritis are also at higher risk of developing diabetes, cardiovascular disease, metabolic syndrome, or hypertension.
How Psoriatic Arthritis Is Diagnosed
The physiatrists of Long Island Spine Rehabilitation Medicine are well-known for their diagnostic skills. In order to diagnose psoriatic arthritis, and particularly to differentiate it from other types of arthritis, if you present with arthritic symptoms, we will do one or more of the following:
- Perform a physical examination, paying close attention to signs of swollen or tender joints, fingernail abnormalities, tender areas on your feet and heels
- Administer a blood test for Rheumatoid factor (RF), an antibody often present in the blood of people with rheumatoid arthritis but not in psoriatic arthritis patients
- Extract joint fluid from an affected joint (frequently the knee) to look for uric acid which would point to gout, rather than psoriatic arthritis, as the cause of your difficulty
- Administer imaging tests like X-rays or an MRI scan to look for joint and other tissue damage (e.g. of tendons and ligaments, especially of the feet and back)
As previously mentioned, in the absence of a cure, it is crucial to take steps to control symptoms and lessen potential damage to joints, skin, and other affected body parts.
Our doctors are well-schooled in various treatments of this disorder and find that it is usually best to use a combination of therapies to keep the condition at bay, including:
- NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain and inflammation.
- Biologic agents, also known as DMARDs, that target the immune system — e.g. Enbrel, Stelara, Cosentyx, Tremfya, and Orencia. These drugs, although they do make patients more susceptible to infections and increase the risk of heart-related events and cancer, can be very effective.
- Newer oral medications, such as Otezla, that affect the immune system through a different route than biological agents. Though these products do not seem to increase susceptibility to infections, they can cause vomiting, diarrhea, and may increase the risk of depression.
Therapies Long Island Spine Rehabilitation Medicine Offers
In addition to prescribing medications to help you manage your psoriatic arthritis, we provide a number of other therapeutic options, including:
- Customized physical and occupational therapy to meet your particular needs
- Acupuncture to lessen inflammation, pain, and swelling
- Steroid/analgesic injections to provide relief from pain and inflammation
Contact Our Experienced Psoriatic Arthritis Doctors Today
While we recognize the emotional, as well as physical, components of being diagnosed with psoriatic arthritis, we are here to help you adjust and successfully manage your symptoms. Why not make an appointment to consult with us today so we can begin helping you take charge of your condition tomorrow? Remember, our focus is relieving your pain and increasing your capacity to enjoy life.