If you are over age 30, you’ve probably experienced some joint pain. Your chances of developing age-related “wear and tear” osteoarthritis (OA) or even flare-ups of old injuries continue to increase as you get older.
At the same time, hormone flux may trigger joint swelling and discomfort during midlife. Along with irregular menstrual periods and vaginal dryness, joint and muscle pain is a common symptom of perimenopause, the years leading up to menopause. But sometimes, joint pain is a sign of a serious progressive disease, such as psoriatic arthritis. Known as PsA, this inflammatory disease of the joints is a chronic autoimmune condition. Early treatment will help manage symptoms, but the disease cannot be cured.
“With psoriatic arthritis, the sooner you diagnose and treat, the better it is long term,” says Vinicius Domingues, MD, a rheumatologist based in Daytona Beach, Florida. Most of the time, psoriatic arthritis develops in people who have an autoimmune skin disorder known as psoriasis.
How to Know If You Have Symptoms of Psoriatic Arthritis
Unlike most other forms of arthritis, psoriatic arthritis impacts the skin as well as the joints. The majority of people who get diagnosed with PsA also have psoriasis, a disorder characterized by thick, red skin with itchy white scales that appear on the elbows, scalp, trunk, palms, knees and soles of the feet. Psoriasis can make fingernails and toenails become thick and ridged, and look pitted or indented.
Psoriatic Arthritis Risk Factors
- Age: PsA often appears in individuals between the ages of 30 and 50.
- Psoriasis: There are several different types of this autoimmune skin disease; most involve a rash or plaques on the skin, scalp, and nails.
- A family history of psoriatic arthritis (PsA): Genetics are known to play a role in this disease.
Symptoms that may warrant an evaluation by a rheumatologist include multiple swollen or painful joints, multiple areas with tendonitis, and joint pain that interferes with function, according to Eric M. Ruderman, MD, professor of medicine and Associate Chief, Clinical Affairs for the Division of Rheumatology at Northwestern University Feinberg School of Medicine and a spokesperson for CreakyJoints. If you are having pain and you fit some of the PsA criteria, get evaluated by a rheumatologist, who can do further testing and rule out other issues.
How to Get a Psoriatic Arthritis Diagnosis
No single test can diagnose psoriatic arthritis, and doctors look for patterns of symptoms rather than one tell-tale sign. The diagnosis process may not be immediate. In fact, it can take several doctor visits to get a definitive diagnosis of psoriatic arthritis, according to the National Psoriasis Foundation.
Because there’s a shortage of rheumatologists, you may have to wait to get an appointment with this type of specialist. “Talk to your primary care physician,” urges Dr. Domingues. They might be able to call the rheumatologist and expedite care, he says.
Board-certified dermatologist Rosalyn George, MD, who treats people with psoriasis, agrees that a workup with a rheumatologist is wise. “We may catch it, but the rheumatologist can really figure out what is going on,” she says, noting that rheumatologists are more knowledgeable about new treatments.
What Else a Rheumatologist Will Consider About You and Your Symptoms
- Location of joint pain, and the number of joints affected. PsA may cause joint pain in one or more medium-to-small-sized joints, such as those found in the fingers or toes.
- If you have morning stiffness when you wake up, and if it lasts for more than 45 minutes.
- If you experience fatigue that does not improve with rest or sleep.
- If you have swelling of fingers and toes, known as dactylitis, along with pitting of your nails.
- Your body weight. Extra pounds can cause stress in weight-bearing joints.
- If you have pain and swelling in places where the tendons and ligaments attach to bones (entheses).
- If you have back pain or other symptoms of conditions related to PsA, such as inflammatory bowel disease (IBD) or uveitis (a type of eye inflammation).
Treatment for Psoriatic Arthritis
In recent years, there has been a boom in FDA approvals for new PsA treatments. That’s good news: the disease is progressive, and it can quickly lead to irreversible joint damage if it isn’t treated early. Arthritis experts recommend early and aggressive treatment, usually with a class of medication known as DMARDs or disease-modifying antirheumatic drugs. You can’t cure PsA, but you can manage it, and prevent the disease from permanently damaging your body.
Natural Treatments for Joint Pain & Swelling
Lose weight and quit smoking if you smoke, stresses Dr. Domingus. Other soothing moves to consider include many self-care strategies, such as the following:
- Try hot and cold therapies on achy joints. Heating pads, hot water bottles, hot paraffin wax treatments, warm compresses, showers, or soaks can help soothe various body parts. For cold relief, try applying ice packs, cold compresses, or a bag of frozen vegetables.
- Exercise and stretch regularly. Swimming, yoga, and cycling are especially good workouts for people with joint problems.
- Manage your stress levels and how you respond to stress. Consider mindfulness classes, or relaxation techniques such as breath work or meditation.
- Get adequate sleep.
- Try massage therapy. This can relieve stiffness in muscles around joints.
- Opt for anti-inflammatory foods. These include fruits and vegetables, whole grains, olive oil and lean meats rather than highly processed foods.
- Supplements such as turmeric have shown some benefits; consult your doctor before starting these or any supplements.