Psoriatic Arthritis is an inflammatory joint disease that affects up to 30% of people that have had psoriasis. It generally starts between ages of 35-55 and affecting the smaller joints such as fingers and toes. Early signs and symptoms of psoriatic arthritis are inflamed and swollen joints but this does not always happen overnight, so becomes hard to diagnose.
Because the inflammation and pain appears in smaller joints, initially, then it may seem there is an injury to the joint rather than arthritis, so it can take longer to be diagnosed. There does not have to be psoriasis on the skin for there to be psoriatic arthritis present. Compared to Rheumatoid arthritis which occurs is joints such as the wrist, Psoriatic arthritis occurs in the joints that are furthest away, such as the tips of the fingers. Because the inflammation occurs at the insert points of the tendons and ligaments rather than inside the joint it can be classified as as a type of arthritis spondylarthropathy, so it can also be seen in the lower spine and hips.
So what triggers psoriatic arthritis ? It has both a genetic and an environmental factors. Just because we have the genetics does not mean we will end up with arthritis but if we have the environmental factors such as gut microbiome issues this will lead to the activation of the psoriatic arthritis. Some of the dietary triggers can be gluten, dairy and eggs but the elimination of these foods is not always necessary.
There are some medications that can trigger psoriatic arthritis and especially if these affect the gut microbiome, such as antibiotics, or affect liver function such as methotrexate.
One way to diagnose is to look at the nails. The nails will often be thicker and look like a fungal nail infection, even without skin being affected. The other feature is 'sausage like fingers'. They look swollen and the skin can be taut.
It is very common that people with psoriatic arthritis have liver issues, one study showed that 32% of people with psoriatic arthritis had non-alcoholic fatty liver disease. When taking medications to help with pain and inflammation this can affect both the gut microbiome (good bacteria) as well as the liver.
Treatment of psoriatic arthritis is not always easy as most anti-inflammatory drugs do not help with the pain. Looking at what is driving the inflammation and treating the triggers is the best line of treatment. This may involve some testing of the gut microbiome, looking at things like stress, diet and what medications the person is on along with looking at the liver.
Psoriatic arthritis is a painful condition that is best treated as early as possible to avoid too much damage to the joints. If the joint is damaged over time from that inflammation it is something that can not be reversed easily (if at all) and so early diagnosis and treatment is paramount.
In health & happiness,
Kirsty