Psoriatic Arthritis Treatment: A Complete Guide
Psoriatic arthritis is an autoimmune disease that causes inflammation of the skin, joints, tendons, and nails. It can cause pain, swelling, stiffness, and reduced range of motion.
Treatment of psoriatic arthritis is aimed at relieving symptoms, reducing inflammation, and preventing damage to the joints.
Medication is the mainstay of treatment for psoriatic arthritis, and your doctor will recommend which medication to try first according to the severity of your disease, any drugs you have tried in the past, your overall health, and your personal preferences.
Finding the right treatment can involve some trial and error, and even once you’ve found a medication that works well, it may become less effective over time, leading to symptom flares and difficulty with daily activities.
You’ll need to work with your rheumatologist to make sure that you’re on the treatment regimen that best meets your needs — and if what you’re taking isn’t doing the job, it may be time to try something else.
Using a treat-to-target approach to achieve remission can require frequent doctor visits and many changes in your drug regimen. It’s important to discuss your personal goals and priorities for treatment with your rheumatologist to make sure that you’re on the same page and that you understand what’s involved in reaching those goals.
Several classes of medications are used to treat psoriatic arthritis. Most require a prescription from a medical professional. Psoriatic arthritis treatments may be taken as a pill, applied topically, injected subcutaneously (beneath the skin), or given as an IV infusion.
While NSAIDs can help control symptoms of psoriatic arthritis, they don’t prevent joint damage.
Both over-the-counter and prescription NSAIDs are available. Some common NSAIDs include:
When taken long term, oral NSAIDs can cause stomach irritation or bleeding, and they can increase the risk of heart attack and stroke. Topical NSAIDs may be an option for people who can’t take oral NSAIDs.
Steroids, also known as glucocorticoids, can be used in a few ways in psoriatic arthritis treatment.
They may be taken orally to reduce inflammation and alleviate pain, swelling, and stiffness, particularly during a symptom flare.
They may be injected directly into a joint to reduce pain and stiffness in that joint.
Steroids may be injected into fingers or toes affected by dactylitis, the swelling sometimes known as “sausage fingers.”
Topical steroids may be applied to fingernails or toenails when psoriatic arthritis causes pitting or flaking of the nails, or steroids may be injected into the nail matrix, at the base of the nail.
The risks of long-term systemic steroid use include increased appetite, weight gain, high blood sugar, osteoporosis, and others.
Disease-modifying anti-rheumatic drugs (DMARDs) work by suppressing inflammation-causing chemicals in the body. They can slow the progression of psoriatic arthritis and prevent permanent joint damage.
Most are taken by mouth. It can take a month or more before you'll know whether a DMARD is working for you, according to the Cleveland Clinic.
Potential side effects of methotrexate and leflunomide include liver damage, so liver function tests must be done before starting these drugs, several weeks after starting them, and periodically for as long as a person is taking the drug. Less serious but common side effects include diarrhea and nausea or upset stomach. A common side effect of sulfasalazine is upset stomach.
Janus kinase (JAK) inhibitors are a new type of DMARD that blocks certain enzymes that can cause inflammation. They are taken as pills. JAK inhibitors approved to treat psoriatic arthritis include:
Because JAK inhibitors can raise the risk of infections, testing for tuberculosis or other infectious diseases may be required before starting treatment. Periodic blood tests for liver function and other measures are also needed while taking the drug.
Phosphodiesterase-4 (PDE4) inhibitors are another new DMARD. They work by selectively targeting small molecules inside immune cells to correct the overactive immune response that causes inflammation in psoriatic arthritis. They are taken as pills.
Biologics target specific cells or proteins in the immune system that play a role in the development of psoriatic arthritis. They can slow or stop the inflammatory processes in the body that lead to joint damage.
The classes of biologics with approved drugs for treatment of psoriatic arthritis include:
If one class of biologics doesn’t control an individual’s psoriatic arthritis symptoms, another might. Only one biologic is prescribed at a time, although they may be used in combination with nonbiologics to control symptoms and progression.
All of the biologics are administered as either a subcutaneous injection, which can be taken at home, or as an IV infusion, done in a medical office.
These biologics are approved for treatment of psoriatic arthritis:
Many of the medications used to treat psoriatic arthritis may also control psoriasis. Traditional DMARDs, JAK inhibitors, PDE4 inhibitors, and biologics all decrease the inflammatory processes that lead to psoriatic arthritis and psoriasis.
For people whose psoriasis is not adequately controlled with their psoriatic arthritis medication, additional treatments include topical medications, light therapy, and systemic medications other than those used for psoriatic arthritis.
Several types of surgery may prevent damage or may be needed in response to damage caused by psoriatic arthritis.
A synovectomy is the removal of the synovium, the connective tissue that lines the insides of joints that involve two bones moving together. Normally, the synovial membrane protects the joint and helps keep it lubricated and moving smoothly.
For some people, drug treatment controls the inflammation and abnormal synovial growth, but for those who don’t respond to medication, a synovectomy is an option.
Depending on the amount of inflammation in the joint, the entire synovium may be removed, or only a portion of it.
Joint replacement surgery, or arthroplasty, may be done when psoriatic arthritis has done significant damage to a joint, limiting its functionality.
Surgeons can replace the damaged portions of the joint with metal or plastic replacements.
Another type of surgery for joints damaged by psoriatic arthritis is joint fusion, or arthrodesis. Joint fusion can relieve pain and discomfort in the joint, but it also eliminates any movement in the joint.
Joint fusion is generally done as a last resort, when other approaches haven’t succeeded at controlling pain.
Physical or occupational therapy is needed after joint fusion therapy to regain strength and learn to perform tasks of daily living with reduced mobility in the joint.
Few if any large studies have evaluated the safety and effectiveness of complementary therapies for psoriatic arthritis, but that doesn’t mean that all such therapies are necessarily unsafe or unhelpful. However, you should talk to your doctor before trying any new therapy, because there are some risks.
Here are a few popular methods that may have benefits:
Some people with psoriatic arthritis find that their symptoms improve after a massage. A massage can relieve muscle tension and help you feel more relaxed.
Supplements, such as fish oil, turmeric, and glucosamine, are thought to reduce inflammation and protect the joints. However, studies looking at their effects on psoriatic arthritis are limited at best.
If you want to try taking a supplement to help manage your symptoms, talk to your doctor first.
When your joints start to ache, treatment with an ice pack or a hot pad can help reduce the pain naturally. Which you use is up to you.
When using heat, make sure the heating pad or hot water bottle is warm but not scalding hot. Place a towel or cloth on your skin first to prevent direct contact with the heat source.
Similarly, when using cold, place a towel or cloth on your skin before applying ice or cold packs, and apply for only 15 minutes at a time, letting your skin return to its normal temperature before reapplying.
Maintaining a healthy lifestyle is good for your general health, and it may help you manage the symptoms of psoriatic arthritis. If your current lifestyle could use some changes, try taking small steps toward a healthier lifestyle. According to the American Psychological Society, breaking large goals into smaller tasks, and changing one health habit at a time raises the likelihood that you’ll stick with the lifestyle changes you’re attempting to make.
Regular exercise can help strengthen muscles and keep your joints strong and flexible, which can reduce joint pain and swelling. It’s also good for your cardiovascular health.
Walking, biking, and swimming are good low-impact aerobic activities. Strength training — using weights, resistance bands, or your body weight — is also good for building strong muscles and bones.
No matter what exercise you do, it’s important to pace yourself and rest when you need to. It’s also important to get expert instruction from a physical therapist or certified trainer if you’re not sure how to do exercises, particularly strength training, with proper form.
Following a healthy diet helps you feel better now and prevent chronic diseases such as diabetes and heart disease. That means eating plenty of whole foods, which include vegetables, fruits, whole grains, nuts and seeds, legumes, lean meats, and dairy foods such as milk and yogurt, and avoiding highly processed foods like fast food and packaged snacks.
Cutting back on processed foods can help you achieve and maintain a healthy weight, which may improve your joint health and reduce fatigue.
Elevated stress levels are associated with more pain and symptom flares in psoriatic arthritis. Taking steps to manage your stress may help you manage your disease.
Basic self-care like getting enough sleep, exercising regularly, following a healthy diet, and maintaining social ties can go a long way toward managing day-to-day stressors.
Practicing mindfulness, which can be done in a variety of ways, has also been shown to reduce stress. Mindfulness is simply nonjudgmental, moment-to-moment awareness, whether you’re focused on breathing, the thoughts going through your brain, or the sensations in your body.
Stopping smoking has myriad benefits, including reducing psoriatic arthritis and psoriasis symptoms.
Even if you see your doctor at regular intervals, there may be times you need to seek their advice between checkups. Some of the health concerns that should prompt you to call your doctor include:
Any of these could call for a change in your drug regimen or overall treatment plan. But don’t stop any prescribed drugs on your own. Discuss your concerns with your doctor first.
Additional reporting by Ingrid Strauch.
©2025 sitename.com All rights reserved