Psoriatic Arthritis Treatment Plan

If you’ve been diagnosed with psoriatic arthritis (PsA), your doctor has probably talked to you about your treatment plan. There are several ways to ease symptoms like stiff, aching joints and scaly, itchy skin patches. Some may even help protect your joints, too.

Using several treatments together often works better than one alone. While every person with PsA is different, treatment plans typically include medication, regular checkups, and lifestyle steps like exercise and a healthy diet.

Medication

Most people with psoriatic arthritis use medication at some point, especially during flares when symptoms like stiffness and pain are worse. Depending on your symptoms and health history, your doctor might prescribe:

Topical treatments: These include ointments, creams, gels, shampoos, and other medications you put directly on psoriasis that affects your skin or scalp. They help with itching, scaling, and pain from psoriasis plaques (which are red, pink, or silvery scaly spots on your skin). Topical treatments can be over-the-counter (OTC) or prescription.

Nonsteroidal anti-inflammatory drugs (NSAIDs): These prescription or OTC medications are usually in pill form. They can ease pain, stiffness, and inflammation in your joints. They’re often the first type of medication doctors recommend for treating PsA-related joint pain.

Disease-modifying antirheumatic drugs (DMARDs): These prescription medicines are used to treat more severe symptoms. They’re usually pills or injections (shots). They can slow, and sometimes prevent, joint and tissue damage caused by PsA.

Biologics: These drugs target specific parts of your immune system to help ease or stop PsA symptoms and limit damage to your joints. They’re given by injection (a shot) or infusion (a slow drip of medicine into your vein).

Light therapy. Exposing your skin to ultraviolet (UV) light can help get rid of psoriasis skin plaques. But because UV light can damage skin and possibly lead to skin cancer, it’s important to only get light therapy with a doctor’s supervision.

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Complementary and Alternative Therapies

Many people with PsA use yoga, acupuncture, meditation, or herbal therapy along with medications. These therapies may help you relax and de-stress, which may help with pain.

While complementary and alternative therapies can often be a safe part of a treatment plan, it’s a good idea to talk to your doctor before trying them. For example, some herbal supplements can affect how some medicines work.

You also may want to talk with a naturopathic doctor (a licensed doctor who uses natural therapies and lifestyle changes as treatment options) who works with people with PsA.

Lifestyle Changes

Small changes to your everyday routine can help ease and possibly prevent PsA symptoms.

Stay a healthy weight. If you’re overweight, losing a few pounds can take pressure off your joints, which can help with swelling and pain. Even a small amount of weight loss can help you feel better.

Move more often. Regular physical activity can help you lose weight and keep it off, and help with stress, too. But that’s not all: Exercise protects your joints by building joint-protecting muscle, and it reduces chemicals in your bloodstream that cause inflammation. Try slowly building up to 30 minutes of exercise a day. Walking, swimming, yoga, and even stretching are good options.

Eat as healthy as possible. A nutritious diet that’s low in added sugar and other processed foods can ease inflammation and help you keep your weight in check. Fruits, vegetables, lean protein, fatty fish (like salmon, which is rich in inflammation-easing omega-3 fatty acids), nuts, olive oil, and whole grains are all good choices. If you need a little help, ask your doctor to recommend a dietitian who works with people with PsA. 

Lower your stress level. Stress can trigger psoriasis flares and pain. Adding exercise or deep breathing techniques to your daily routine can help. If you’re going through a tough time, talk therapy with a mental health professional might be a good idea. Ask your doctor for a recommendation.

Regular Checkups

You may not think of doctor’s visits as part of your treatment plan, but they are. It’s important for your doctor to know if the medications and other steps you’re taking are working. If your symptoms don’t get better, your doctor may recommend a different medication or strategy.

They may encourage you to work with other health care professionals, too, like a physical therapist, who can create an exercise plan that’s safe for your joints.

Check in with your doctor 4 to 6 weeks after you decide on a treatment plan or any time you have a flare or want to try a new treatment strategy.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on November 05, 2019

Sources

SOURCES:

The Psoriasis and Psoriatic Arthritis Association (UK): “Psoriatic Arthritis: When to Treat.”  

National Psoriasis Foundation: “Treating Psoriatic Arthritis,” “To Treat or Not to Treat? Managing PsA,” “Complementary and Alternative Therapies,” “Herbs/Natural Remedies,” “13 Ways to Stress Less and Live More,” “Weight loss greatly improves psoriasis, study finds.” 

The Arthritis Foundation: “Psoriatic Arthritis Treatment.” 

Barrea, Luigi. Journal of Translational Medicine, published online January 2015.

Nathan Wei, MD, director of the Arthritis Treatment Center, Frederick, MD.

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