Psoriatic Arthritis -- Treatment
Are there other psoriatic arthritis treatments that help stop inflammation?
Disease modifying antirheumatic drugs (DMARDs) have been shown to slow the progress of psoriatic arthritis. It is hoped that by stopping disease progression, patients with psoriatic arthritis will function at their best. Available only by prescription, DMARDs are more powerful, yet slower acting, than NSAIDs. Your doctor will monitor you closely if you take a DMARD to make sure you do not have serious side effects.
Methotrexate is a commonly used DMARD for treating psoriatic arthritis. Other DMARDs used to treat psoriatic arthritis include sulfasalazine, leflunomide, and the newer biologic drugs Enbrel, Humira, Remicade, and Simponi.
These drugs work by targeting the protein messengers of the immune system that cause the symptoms and joint destruction of psoriasis, preventing the joints from becoming inflamed. Biologic drugs must be injected or administered intravenously. They can also make the immune system more susceptible to infections.
Depending on the severity of your psoriatic arthritis, your doctor may prescribe medications such as retinoids, PUVA (a light-sensitizing medication), cyclosporine, or azathioprine.
Is exercise important in treating psoriatic arthritis?
Yes. Moderate, regular exercise can relieve the joint stiffness and pain associated with psoriatic arthritis. A tailored program of range-of-motion and strengthening exercises, combined with cardiovascular exercise, can help:
- Relieve arthritis symptoms
- Maintain normal joint movement
- Increase flexibility and muscle strength
- Maintain weight to reduce pressure on joints
- Improve endurance and cardiovascular fitness
What about water therapy in easing the pain of psoriatic arthritis?
Water therapy (hydrotherapy or aqua therapy) is a program of exercises performed in a large pool. Water therapy may be easier on painful joints from psoriatic arthritis because the water takes some of the weight off the affected areas. Appropriate recreational exercise also may be beneficial, but only if it is preceded by a program of range-of-motion, strength, and aerobic exercises to reduce the chance of injury. Regardless of the exercise program you select, it's important to choose one you enjoy so that you maintain it.
Before beginning any new exercise program, discuss options with your doctor. Also, begin new exercise programs under the supervision of a physical therapist or qualified professional, preferably one who has experience working with psoriatic arthritis patients. Furthermore, it's important to know that improper exercise programs may worsen psoriatic arthritis. Check with your doctor or therapist before starting an exercise program and adjust your program if you experience any of the following:
- Unusual or persistent fatigue
- Increased weakness
- Decreased range of motion
- Increased joint swelling
- Continuing pain (lasting more than an hour after exercising)