Psoriatic arthritis can affect you inside and out. The main goal of treatment is to control the inflammation that causes your joints to swell and ache. That will ease your pain and help prevent further damage.
Medications can often help manage psoriatic arthritis, but when they don't, surgery might be an option. Your treatment will depend on how severe your condition is. You may need to try more than one thing before you and your doctor find what works.
An accurate and early diagnosis of psoriatic arthritis will help you avoid the damage and deformity it can cause.
Your doctor will make a decision based on:
A physical exam
Your medical history and your family's
No single thing will diagnose psoriatic arthritis, but blood tests, imaging, and other tests can help your doctor. He may want to give you certain tests that check for rheumatoid arthritis, because it can look a lot like psoriatic arthritis.
If your arthritis is mild, your doctor may recommend a non-steroidal anti-inflammatory drug (NSAID). It stops your body from making the chemicals that cause inflammation.
You can get NSAIDs over the counter and by prescription. The most common are aspirin, ibuprofen, and naproxen.
What's good for your joints may be hard on other parts of your body, though. NSAID side effects can include heart attacks, strokes, stomachaches, ulcers, or bleeding -- especially if you take large doses over a long time. To help, your doctor may prescribe a drug called misoprostol that will protect your stomach lining, or something that will lower acid and prevent ulcers, such as omeprazole.
You doctor may suggest a different NSAID, celecoxib (Celebrex), if you have stomach problems.
DMARDs and Biologics
If your disease is more severe or doesn't respond well to NSAIDs, your doctor may prescribe a disease-modifying antirheumatic drug (DMARD). These can slow or stop pain, swelling, and joint and tissue damage. They're stronger than NSAIDs, but they may take longer to work. The most commonly used DMARDs are:
You can often take biologics as a shot under your skin, but for some, you'll need to go to your doctor's office to get the medicine through your vein (IV). You'll probably also take methotrexate.
Biologics work well for many people, but they have downsides. They're expensive, and they can have side effects and risks. You may get dizzy, feel sick like you've got a cold, or have a reaction where you get your shot.
They can also lower your immune system's response. When you're taking one, let your doctor know if you get the flu or another infection. You'll be tested for tuberculosis (TB) before starting your biologic and checked while you're on it. You'll also get tested for hepatitis B and C.
A biologic can raise your chances of getting lymphoma, a blood cancer, although this is rare.