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PSORIATIC ARTHRITIS

PSORIATIC ARTHRITIS
PSORIATIC ARTHRITIS

WHAT IS PSORIATIC ARTHRITIS?


Psoriatic arthritis a type of arthritis that is seen in some patients with psoriasis. People with psoriatic arthritis may have symptoms of both psoriasis and arthritis.

{Psoriasis is a skin condition that causes red scaly rashes on places like elbow, knees, scalp, back etc}

Around 15-30% of people with psoriasis develops psoriatic arthritis. Most people with psoriatic arthritis have skin symptoms before joint symptoms. However, sometimes the joint pain and stiffness strikes first. In some cases, people get psoriatic arthritis without any skin changes. It ia an autoimmune condition meaning it happens when your immune system goes haywire and starts attacking healthy cells of body.This condition causes widespread inflammation  that affects many systems in body from immune system to digestive system.


TYPES OF PSORIATIC ARTHRITIS


  • Symmetric psoriatic arthritis: This type affects the same joints on both sides of your body, so both your left and right knees.


  • Asymmetric psoriatic arthritis: This affects a joint or joints on one side of your body. Your joints may feel sore and turn red. Asymmetric psoriatic arthritis is generally mild.


  • Distal interphalangeal predominant psoriatic arthritis: This type involves the joints closest to your nails. These are known as the distal joints.


  • Spondylitis psoriatic arthritis: This type of psoriatic arthritis involves your spine. Your entire spine from your neck to your lower back may be affected. This can make movement very painful so hands, feet, legs, arms, and hips may also get affected.


  • Psoriatic arthritis mutilans: This is a severe, deforming type of Psoriatic arthritis. Psoriatic arthritis mutilans usually affects your hands and feet. It can also cause pain in your neck and lower back.


TRIGGERS


Certain things may trigger psoriasis, including:

  • Injury to the skin, like a scrape or sunburn
  • Infection(mostly some preceding throat infection)
  • Lack of sleep
  • Dry skin
  • Mental and emotional stress
  • Over weight: Excess weight puts more pressure on joints that are already sore. 
  • Heavy drinking and smoking, which is prevalent in people with psoriasis.
  • Cold dry weather

Avoiding these triggers may help prevent PsA or a flare from starting.


RISK FACTORS


  • Psoriasis: About 15% to 30% of people with psoriasis get psoriatic arthritis.


  • Sex: It affects men and women equally.
  • Age: You can get the condition at any age, but it usually affects people between the ages of 30 and 50.


  • Family history: A family history of skin or joint disease makr you more vulnerable.

COMPLICATIONS


  • A small percentage of people with psoriatic arthritis develop Arthritis mutilans (a severe, painful and disabling form of the disease). 
  • Over time, arthritis mutilans destroys the small bones in your hands, (especially fingers), leading to permanent deformity and disability.
  • People who have psoriatic arthritis sometimes also develop eye problems such as pinkeye (conjunctivitis) or uveitis, which can cause pain and blurred vision. 

SYMPTOMS AND CAUSES


SYMPTOMS


  • Pain, swelling or stiffness in one or more joints
  • Joints that are hot to the touch with redness.
  • Frequent joint tenderness or stiffness
  • Sausage like swelling in one or more of the fingers or toes
  • Pain in and around the feet and ankles
  • Changes to the nails such as pitting, nail thickening or separation of nail from the nail bed.
  • Pain in the lower back (just above the tailbone).
  • scaly skin patches, which may get worse when joint pain flares up
  • flaky scalp.

Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but you may have periods when your symptoms improve or go into remission/relapses alternating with times when symptoms become worse. Mild psoriatic arthritis is sometimes referred to as oligoarticular, meaning it affects four or fewer joints in the body. Severe psoriatic arthritis is often referred to as polyarticular, meaning it affects four or more joints.


CAUSES


Psoriatic arthritis occurs when your body's immune system begins to attack healthy cells and tissue. The abnormal immune response causes inflammation in your joints as well as overproduction of skin cells.It's not entirely clear why the immune system turns on healthy tissue, but it seems likely that both genetic and environmental factors play a role.


DIAGNOSIS AND TREATMENT


DIAGNOSIS


There is no definitive test for psoriatic arthritis. The diagnosis is made mostly by symptoms evaluation and by a process of elimination. 

To diagnose PsA, doctor has to rule out other causes of arthritis, such as RA and gout, with the help of some imaging and blood tests.

Imaging tests :

  • X-rays: These check for inflammation and damage to bones and joints. This damage is different in PsA than it is in other types of arthritis.
  • MRIs: These images can help your doctor check for joint, tendon, or ligament damage.
  • CT scans and ultrasounds: These can help determine how advanced PsA is and how badly the joints are affected.

Blood tests for these substances help assess any inflammation present in your body:

  • C-reactive protein:This is a substance your liver produces when there’s inflammation in your body.
  • Erythrocyte sedimentation rate(ESR): This only reveals how much inflammation is in your body not the cause of it. 
  • Rheumatoid factor (RF):  Helps to rule out rheumatoid arthritis.
  • Joint fluid: Checked for presense of any uric acid crystals, to rule out gout.
  • Red blood cells. A low red blood cell count is common in people with proriatic arthritis.

TREATMENT


Conventional treatment includes use of NSAIDS, biologics, immunosuppressants and light therapy.Joints that have been severely damaged by psoriatic arthritis are sometimes replaced with artificial prostheses made of metal and plastic. Homeopathic medicines are best treatment for psoriatic arthritis without side effects and steroids.


MANAGEMENT


  • Add exercise to your daily routine: Keeping your joints moving can ease stiffness.

 Biking, walking, swimming, and other water exercises are gentler on the joints than high-impact exercises like running or playing tennis.

  • Relieve stress: Tension and stress can make arthritis flares even worse. Meditate, practice yoga, or try other stress-relief techniques to calm your mind and body.

  • Use hot and cold packs: Warm compresses and hot packs can ease muscle soreness. Cold packs can also reduce pain in your joints.

  • Consider natural supplements and spices: Omega-3 fatty acids have anti-inflammatory properties. These healthy fats, found in many supplements, reduce inflammation and stiffness in joints.

Turmeric, also have anti inflammatory action and so may help reduce inflammation and psoriatic arthritis flare-ups.


HOMOEOPATHIC MANAGEMENT


Homeopathic treatment works very efficiently for people suffering from psoriatic arthritis. Some homoeopathic medicines that can given in cases of PsA are rhus tox, rhus venerat, urtica urens, ledum pal, medorrhinum, syphilinum, thuja occidentalis etc. It is to be noted that these remedies are to be taken after consulting a registered homoeopath only.  

Homeopathic medicines are quiet effective in treatment of psoriasis and psoriatic arthritis without steroids and side effects.


 DO’S AND DONT’S


DO’S


  • get medical help as soon as symptoms appear
  • get enough rest and sleep
  • do low-impact exercise, unless it worsen symptoms
  • following a healthy diet
  • limiting alcohol intake
  • limiting stress

DONT’S

  • Quit smoking and restrict alcohol intake
  • avoid scratching scaly areas of skin.
  • Avoid food items that will make you obese.





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