There's no denying that psoriatic arthritis is a challenge. But you don't have to let it become a roadblock. Here are some strategies to help you take back your life!
Exercise can make a big difference in your quality of life with psoriatic arthritis. Movement keeps your joints and tendons looser and limber, and help you reduce the inflammation and pain of psoriatic arthritis. Building up your muscles decreases the workload on your joints.
It's not uncommon for people with psoriatic arthritis to develop comorbidities such as cardiovascular disease, diabetes and Crohn's disease. Exercise—anything that gets your heart pumping and your joints moving—can help you lower the risk of developing a comorbid condition.
When you set out on an exercise program, you don't have to aim for Olympic gold. If you were active before you had psoriatic arthritis, try to maintain a regimen as close to your old normal as possible. If you've been inactive, start small. In general, people with psoriatic arthritis can enjoy all of these activities:
- Walking is an excellent exercise choice; it builds strength and maintains joint flexibility. Try walking in short bursts, say 10 minutes each. Build to half an hour, then a full hour. Break up your workout throughout the day. A gradual approach will help prevent injuries and make it easier to start a new habit (and keep that habit going).
- Cycling—both indoor and outdoor—is a good, low-impact option. Pay close attention to proper bike fit and pedaling technique.
- Yoga can relieve pain, relax stiff muscles and ease sore joints. Yoga uses controlled movements, stretches and deep-breathing relaxation, all of which helps improve your range of motion.
- Swimming or warm-water exercise builds strength, eases stiff joints and relaxes sore muscles. Water helps support your body while you move your joints.
- Tai chi is a gentle martial arts exercise with origins in ancient China. While performing fluid and flowing circular movements, you can relax, maintain mobility and work on range of motion.
A physical therapist or a qualified fitness or health professional can help you create an exercise plan that makes sense for you.
Whichever exercises you choose, your muscles will work extra hard at the beginning. After exercising you might experience soreness. You might have a hard time cooling down. You might feel worse the next day. This is your body telling you to ease up! (The opposite can also happen. As soon as any type of activity becomes less than challenging, it's safe to assume your body has adapted and that it's time for a new challenge.) Listen to your body to help you learn about the types of activities that tend to induce pain.
The inflammation caused by psoriatic arthritis can have short-term effects such as pain and swelling. Inflammation can also cause long-term damage to your joints. Stress is another aggravator. The combination of inflammation and stress can make you even more sensitive to pain.
You might not be able to banish stress from your life, but there are things you can do to manage the pain it causes.
An NSAID is a nonsteroidal anti-inflammatory drug. NSAIDs include over-the-counter meds such as aspirin and ibuprofen as well as prescription products. These drugs help to decrease inflammation, joint pain and stiffness. They can also make it easier for you to move. Talk to your doctor about NSAIDs, their interactions with other treatments for psoriatic arthritis, and their possible side effects.
A doctor considers stronger medications when NSAIDs and aspirin fall short in their results.
Biologics are protein-based drugs derived from living cells cultured in a laboratory; in the last decade, modern techniques have made them widely available. They are given by injection or intravenous infusion for moderate to severe psoriatic arthritis.
Biologics only target specific parts of the immune system (unlike traditional systemic drugs, which impact the entire immune system). The biologics used to treat psoriatic disease block the action of a specific type of immune cell called a T cell, or they block proteins in the immune system, such as tumor necrosis factor-alpha (TNF-alpha), interleukin 17-A, or interleukins 12 and 23. These cells and proteins all play a major role in the inflammation of psoriatic arthritis.
Although biologics interfere with the process that causes the painful psoriatic arthritis inflammation, you might have to wait at least three months until a biologic begins to reduce your pain. However, recent studies show that biologics very quickly demonstrate a positive effect on your mood. This is important. People with psoriatic arthritis are at greater risk of depression, and depression can heighten your sensitivity to pain.
As with all treatment options, always consult with your doctor about the risks of taking these drugs and the possible short- and long-term side effects.
Reducing your sensitivity to pain
When the pain of psoriatic arthritis is severe or when it does not go away with traditional psoriatic arthritis treatments, you may want to talk to your doctor about medication that helps reduce your sensitivity to pain.
Prescription pain medications such as Gabapentin and Pregabalin are used to treat neurological pain. Certain anti-depressants called noradrenergic and specific serotonergics (NaSSAs) can reduce your sensitivity to pain as well. Capsaicin, a compound found in chili peppers, has a numbing effect on pain receptors. Applying a local anesthetic like prilocaine can help minimize the initial burning sensation of capsaicin.
Your doctor may prescribe a pain medication when you first begin on a biologic, to compensate for the biologic's lag time, and then transition you off the pain med once the biologic takes effect.
Other ways to manage pain
Some studies show acupuncture as a valuable option for pain relief. There are no side effects, either. Learn more about acupuncture as a possible pain reliever for people with psoriatic arthritis.
Researchers have not studied the impact of meditation on people with psoriatic arthritis, but there is some evidence that practicing what's called mindfulness meditation can relieve stress, which is a common trigger for psoriatic disease flare-ups.
Managing symptoms of psoriatic arthritis
Managing your psoriatic arthritis while holding on to a job can seem overwhelming at times. It's important to understand your disease, your rights and the resources available to you. Here are some tips:
Meet with your manager
Schedule a meeting with your supervisor at a time when neither of you is under pressure. Describe how your psoriatic arthritis may affect your performance, including scheduling doctor appointments and the use of assistive devices (more on those in a moment). Be upfront and specific. The goal of this talk is to find ways to resolve the problem that will benefit the company, your co-workers and yourself. It's better to ask for support or adaptations from your employer than to try to work through your pain and risk a flare-up.
If pain ramps up through the week, and if you constantly find yourself wishing it was Saturday, it's probably past time to talk to approach your boss about making some workplace adjustments.
Make your workspace comfortable
Keep in mind that your employer may not be required to purchase expensive equipment for you. However, the accommodations you need may be as simple as taking breaks during the day to walk and reduce the pain and stiffness in the joints.
"Assistive devices" covers everything and anything you need to be comfortable on the job (and therefore more productive). For example, if you work at a desk most of the day, good posture and an ergonomically correct workspace will help minimize the strain on your joints. A writing bird may help you to write on the days when your hands are swollen or stiff.
Explaining that a certain task, such as reaching for a computer mouse, not only causes pain, but also slows productivity, can justify the request for a new piece of equipment such as a track pad. It helps to research options ahead of time (including prices) and perhaps try new equipment at home.
Some common workplace adaptions for those living with psoriatic arthritis:
- Switching from a mouse to a track pad
- Moving a keyboard or using a different type of keyboard
- Changing the position of a computer monitor to between 18 and 22 inches away
- Using computer glasses (which are different than reading glasses)
- Adjusting the monitor height so that that the top 25 percent of the screen is at eye level
- Standing to get items located on shelves instead of reaching up
- Altering the height of your desk or chair
- Asking for help when lifting heavy items
Tax deductions and/or tax credits may be available to certain employers who provide accommodations and/or jobs for people with disabilities.
Consider scheduling your doctor appointments first thing in the morning or toward the end of the day. This helps reduce the amount of time you will miss from work. If you have several upcoming doctor visits or need to go in for tests, consider taking the day off and scheduling all your visits that day. If you take several medications during the day, keep a pill organizer in your desk. That way you have a backup supply at the office in case you forget to bring your pills to work.
Maintain a positive attitude
It OK to have low-energy days, but you're in control of how you relate to the disease. You might find it helpful to talk with other people with psoriatic arthritis on the National Psoriasis Foundation's message boards.
It's important for people with psoriasis to understand their disease, their employment rights and their resources in the workplace. If you are experiencing discrimination in the workplace, we can help. You can also apply for disability if you can't work.
Talk to your doctor about chronic pain
NPF's helpful fact sheet will inform you on what you should be discussing with your doctor when it comes to your pain associated with psoriatic arthritis.