Physical Therapy for Psoriatic Arthritis

Medically Reviewed by Melinda Ratini, MS, DO on July 20, 2022
5 min read

Psoriatic arthritis (PsA) can cause pain, swelling, and stiffness in your joints and muscles. Over time, it can limit your range of motion and make it hard to do your daily tasks. While medications can help, you might still have aches and pains that are bothersome. This can take a toll on your quality of life.

Research shows exercise is key to managing your arthritis-related symptoms in the long run. Adding physical therapy (PT) might help you get your body and joints moving with stretching and strengthening exercises that are safe and effective.

Physical therapy is a medical field in which licensed physical therapists, who are movement experts, work with you one-on-one to help you move more freely and live better.

When you first meet with a physical therapist, they will examine you to see what’s going on with your body. They will ask you questions and go over your medical history and PsA-related physical limits. They then create a personalized care plan that includes different types of techniques, hands-on therapies, and exercises. These are designed to improve your overall physical health.

Physical therapists are usually part of your health care team and will work with your doctor or surgeon to help you meet your goals.

When you have psoriatic arthritis, physical therapy can help:

  • Increase range of motion
  • Improve heart health
  • Teach you strengthening exercises
  • Improve joint motion
  • Boost overall mobility
  • Prevent the loss of function
  • Ease pain
  • Reduce stiffness

When you have PsA, the goal of physical therapy is to help you improve or maintain your strength and fitness levels to support your joints. This will help stop your PsA symptoms from getting worse and allow you to go about doing your daily tasks.

Based on your needs, your physical therapist will come up with a set of exercises, stretches, and therapies that will suit and benefit you most.

This can include:

Exercises. Based on your goals and physical limits, your physical therapist will teach you how to use exercise machines, free weights, elastic bands, or your own body to build strength. These exercises are designed to improve flexibility, strength, coordination, and balance. Your physical therapist may also suggest low-impact aerobic exercises that are gentle on your joints, like swimming or walking.

But avoid swimming during skin flare-ups, as chlorine can make your symptoms worse.

Working on posture. How you sit and stand can make a lot of difference. For example, if you slouch too much, it might make your back pain worse. Your therapist will teach you proper posture and ways to move your body to ease pain and stiffness and improve function.

Cryotherapy. This basically means using cold to manage pain and swelling in affected joints or muscles. It’s also used to lower skin temperature, redness and inflammation, and to manage nerve activity. For cryotherapy, your therapist might use ice packs, coolant sprays, ice massage, whirlpools, or ice baths.

They’ll also teach you how to use these on your own at home when you need them. But if these treatments irritate your skin, let your therapist know.

Thermotherapy. This treatment uses cryotherapy and heat to treat joint pain and reduce swelling and tenderness (using cold) in inflamed joints.

Paraffin wax baths. It’s a machine that can heat and hold wax. During this therapy, you submerge your hands (or feet) in warmed wax. Coating your hands with wax creates a moist, deep heat. This can ease arthritis pain and help relax your sore joints and muscles.

Hydrotherapy. It’s also known as aquatic therapy. In this treatment, your therapist will teach you special exercises that have slow, controlled movements in a warm water pool. The warm water can relax your muscles and lower any stress or impact on your joints. Research shows it may improve your energy levels, sleep, and physical and mental function. It can also help you move more freely as you go about your daily tasks.

Orthoses, splints, or braces. Therapists can recommend custom shoe inserts, splints, or braces and teach you how to use them. These are designed to support your joints and ease stress. They may help prevent or reduce joint deformity in the long run.

Assistive devices. Physical therapists can show you how to properly use assistive devices such as walkers, canes, and wheelchairs. They can also suggest ways to change your environment at work or home to function better. For example, an office chair with better back support or a kitchen mat with a cushion can reduce stress on your back or feet. They can also prevent or slow down joint damage from PsA.

In most cases, you won’t need weekly visits to physical therapy. Depending on your needs, an hourlong visit every few months is usually enough to discuss and create a treatment plan that works for you.

But it takes time and work on your end to see the benefits of physical therapy. That’s because the goal is to teach you how to do things in your treatment plans, like a hot or cold compress or exercise, by yourself at home.

To get the most out of your physical therapy appointments, you should:

Give a detailed medical history. During your first physical therapy appointment, tell your therapist about all your movement problems. Give specific details and a timeline of events. For example, let them know when it started, if it has gotten worse, and what tasks are harder to do. This will help your therapist create a care plan to specifically help with those problem areas.

Set goals. Think about what goal you want to achieve. Are pain and symptoms from PsA holding you back from your favorite sport? Does your wrist hurt when you cook or write? Your therapist can come up with specific exercises to ease pain and stiffness to help you achieve your goals.

Don’t skip appointments. The number of physical therapists you need may vary. If you miss one or two appointments, it can set your progress back. Plan ahead for your visits and commit to attending all of them for the best results.

Do the homework. For physical therapy to work, you need to repeat what you learn during sessions and practice it often at home. This will help you see results over time. If you don’t, it’s hard for your therapist to know if your treatment is working or if they need to adjust the plan to better suit your needs.

Speak up. You may think some of the aches and pains are normal because you have PsA. But it’s best to tell your therapist about all your concerns. They may have doable solutions to reduce or prevent them. And if an exercise or therapy isn’t working for you, speak up. They can adjust your treatment plan or try something else that might work better to help you achieve your goals.