What is Psoriatic Arthritis (PsA)?
Psoriatic arthritis is an autoimmune disease, where the immune system attacks its own tissues and causes inflammation of the joints. The joints become painful, stiff and often swollen.
Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis — a disease that causes red patches of skin topped with silvery scales. Most people develop psoriasis years before being diagnosed with psoriatic arthritis.
There is no cure for PsA however, with early diagnosis and treatment people with PsA can lead full and active lives.
What causes PsA?
The exact cause of psoriatic arthritis is not known. Genetics, the immune system and environmental factors, such as an infection, may play roles in causing this type of arthritis.
What are the Symptoms of PsA?
Psoriatic arthritis can affect any joint in the body and symptoms can vary from person to person. It can develop slowly with mild symptoms, or come on quickly and be severe. The most common symptoms are:
- pain, swelling and stiffness in one or more joints
- pain and stiffness in the buttocks, lower back or neck (also known as spondylitis, meaning inflammation of the spine)
- pain in tendons, such as at the back of the heel or sole of the foot (tendons are the strong cords that attach muscles onto bones)
- changes in nails, such as thickening, colour change or separation from the skin
- pain and redness in the eyes.
How is PsA Diagnosed?
There is no specific test for psoriatic arthritis.
A GP generally will perform a physical exam, take a medical history, order blood tests and any relevant imaging then refer you to a Rheumatologist who specialises in diagnosing and treating autoimmune dieases, arthritis, and other diseases of the bones, joints, and muscles.
Physical exam: looking at joints and skin, listening to the lungs, feeling the abdomen; examining the eyes.
Medical history: asking about symptoms, what makes them worse or better, when they started and any family history.
Blood tests: Inflammatory markers: C-Reactive Protein (CRP) ; Erythrocyte Sedimentation Rate(ESR); Antibody screening: Cyclic Citrullinated Peptide(CCP)
Imaging tests: X-Rays, ultrasounds, MRI
How is PsA Managed?
Medicines: Modern medicines for PsA can reduce inflammation, decrease pain and stiffness and prevent joint damage.
Team Based Care: Your care is likely to involve many different healthcare professionals, although how this will work will vary from person to person. If you attend a clinic in a public hospital, most of your team-based care will be organised through the clinic.
More people will see a private rheumatologist. In this situation, your GP may coordinate most of your care. They will communicate with your rheumatologist and arrange many of your tests and prescriptions. They may also refer you to allied health workers, such as a physiotherapist or occupational therapist (OT), for support in the home or community.
Counselling: Many people find that counselling can help when dealing with the emotional aspects of PsA. A psychologist or social worker may also be an important person in your
healthcare team.
Exercise, healthy eating and lifestyle: One of the best things you can do for yourself is get some
exercise every day. You can also play an active role by not smoking, reducing stress, and eating a healthy diet.
Surgery: In some cases your doctor may recommend surgery – such as an arthroscopy or joint replacement.
What are Flares?
A flare is a period when PsA symptoms worsen. This can be the result of triggers such as overexertion, stress, infection or poor sleep or the natural progression of the disease. How you experience a flare may vary depending on the type of arthritis you have and the trigger. Some triggers may be obvious. Flares can vary in intensity, duration and frequency, but they’re usually reversible — if treated promptly.
For some people, flares are an inevitable part of the arthritis journey. Although flares can be difficult to predict, there are some things you can do to reduce their number and minimize long-term damage. You can also make a flare plan with your rheumatology team.
If your symptoms are severe or last for more than a few days then contact your rheumatologist, who can prescribe additional medications or alter your regular medications until the flare subsides.
Want to Learn More About PsA?
Psoriatic Arthritis Booklet https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2021/03/Psoriatic-Arthritis-WEB-2019-Mar21-Update.pdfrthritis Australia
Psoriatic Arthritis Fact Sheet https://arthritisaustralia.com.au/wordpress/wp-content/uploads/2024/06/4042-AA-Info-Sheet-Psoriatic-arthritis-AA008-02-24-ISS1.pdf
MyPsA https://mypsoriaticarthritis.org.au/
Psoriatic Road Map https://mypsoriaticarthritis.org.au/document/your-psa-diagnosis-tests-treatments-about-treatment/roadmap-psa
