{"id":18126,"date":"2018-03-05T14:45:01","date_gmt":"2018-03-05T12:45:01","guid":{"rendered":"http:\/\/www.hygeia.gr\/%cf%88%cf%89%cf%81%ce%b9%ce%b1%cf%83%ce%b9%ce%ba%ce%ae-%ce%b1%cf%81%ce%b8%cf%81%ce%af%cf%84%ce%b9%ce%b4%ce%b1\/"},"modified":"2018-03-05T14:46:24","modified_gmt":"2018-03-05T12:46:24","slug":"%cf%88%cf%89%cf%81%ce%b9%ce%b1%cf%83%ce%b9%ce%ba%ce%ae-%ce%b1%cf%81%ce%b8%cf%81%ce%af%cf%84%ce%b9%ce%b4%ce%b1","status":"publish","type":"page","link":"https:\/\/www.hygeia.gr\/en\/%cf%88%cf%89%cf%81%ce%b9%ce%b1%cf%83%ce%b9%ce%ba%ce%ae-%ce%b1%cf%81%ce%b8%cf%81%ce%af%cf%84%ce%b9%ce%b4%ce%b1\/","title":{"rendered":"Psoriatic arthritis"},"content":{"rendered":"

What is psoriatic arthritis?<\/strong><\/p>\n

\"\"
\nPsoriatic arthritis can cause painful inflammation in any of your joints and it\u2019s often associated with a scaly skin condition called psoriasis.<\/p>\n

Psoriatic arthritis causes painful inflammation in and around your joints. It usually affects people who already have psoriasis, a skin condition that causes a red, scaly rash, especially on your elbows, knees, back, buttocks and scalp. However, some people develop the arthritic symptoms before the psoriasis, while others will never develop the skin condition.<\/p>\n

Psoriasis can affect people of any age, both male and female, but psoriatic arthritis usually only affects adults.<\/p>\n

What are the symptoms of psoriatic arthritis?<\/strong><\/p>\n

You may notice some of the following symptoms:
\n\u2022 red, scaly skin rash (psoriasis)
\n\u2022 stiff, painful joints
\n\u2022 sausage-like swelling (daktylitis) of fingers or toes
\n\u2022 thickening, discoloration and pitting of your nails
\n\u2022 pain and swelling at the back of your heel
\n\u2022 eye inflammation (less frequent)
\nSymptoms of psoriatic arthritis can include:
\n\u2022 pain and stiffness in and around your joints
\n\u2022 swelling of your fingers or toes (dactylitis), caused by inflammation occurring simultaneously in joints and tendons
\n\u2022 buttock pain, a stiff back or a stiff neck, which is caused by inflammation in your spine (spondylitis)
\n\u2022 pain and swelling in your heels, caused by inflammation where your Achilles tendon attaches to the bone
\n\u2022 pain in other areas where tendons attach to bone (enthesitis), such as your knee, hip bones and chest
\nPsoriatic arthritis can affect any of the joints on your body, although some joints are more likely to be affected than others.
\nAbout 1 in 3 people who have psoriatic arthritis will have pain and stiffness in their neck or back.<\/p>\n

Does psoriatic arthritis affect other parts of the body?<\/strong><\/p>\n

You may develop itchiness and redness in your eyes (which is caused by inflammation of the membrane that covers the front of your eye), the inside of your eyelids (conjunctivitis) or around your pupils (iritis\/uveitis).
\nPeople with psoriasis or psoriatic arthritis may also have a slightly greater risk of developing heart disease, so it\u2019s important to tackle anything that could add to this risk, such as:
\n\u2022 smoking
\n\u2022 drinking a lot of alcohol
\n\u2022 being overweight
\n\u2022 blood pressure problems
\nPsoriatic arthritis doesn\u2019t usually affect other major organs, such as your kidneys, liver or lungs.<\/p>\n

What causes psoriatic arthritis?<\/strong><\/p>\n

The arthritis and the skin condition are both caused by inflammation. The processes of inflammation are very similar in your skin and your joints. We don\u2019t yet know exactly what triggers the inflammation, although a particular combination of genes makes some people more likely to develop psoriasis and psoriatic arthritis.
\nResearch suggests that something \u2013 perhaps an infection \u2013 acts as a trigger in people who are already susceptible to this type of arthritis because of the genes they\u2019ve inherited from their parents. No specific infection has yet been found \u2013 it may be that a variety of infections can trigger the condition, for example bacteria that live in patches of psoriasis.
\nSometimes the arthritis can follow an accident or injury, particularly if it affects a single joint.<\/p>\n

How is psoriatic arthritis diagnosed?<\/strong><\/p>\n

Your doctor will examine you and ask if you have a family history of psoriasis. You may also have blood tests to rule out other conditions, and X-rays can sometimes help to confirm the diagnosis.
\nIt\u2019s important that psoriatic arthritis is diagnosed early so you can start treatment as soon as possible. There\u2019s no specific test for psoriatic arthritis, but the diagnosis will be based on your symptoms, a physical examination or the existence of psoriasis.
\nIt can be difficult to distinguish between psoriatic arthritis and rheumatoid arthritis. Your doctor will consider which of your joints are affected and may want to take a blood test for rheumatoid factor, while X-rays of your back, hands and feet can also be helpful, as psoriatic arthritis can affect the bones and joints in these areas in a distinctive way.<\/p>\n

What treatments are there for psoriatic arthritis?<\/strong><\/p>\n

\u2022 non-steroidal anti-inflammatory drugs (NSAIDs)
\n\u2022 disease-modifying anti-rheumatic drugs (DMARDs)
\n\u2022 steroid injections, tablets or ointments
\n\u2022 ointments or light therapy for skin symptoms
\n\u2022 exercise and physiotherapy to keep your joints mobile
\n\u2022 surgery to repair damaged tendons or replace badly damaged joints \u2013 this is rarely needed
\nA team of healthcare professionals are likely to be involved in your treatment. You may also see:
\n\u2022 a physiotherapist, who can give you advice on exercises to help maintain your mobility
\n\u2022 an occupational therapist, who can give you advice on protecting your joints from further damage, for example, by using splints or altering the way you perform tasks to reduce the strain on your joints
\n\u2022 a podiatrist, who can assess your foot-care needs and offer advice on special footwear.<\/p>\n

Drugs<\/strong><\/p>\n

Non-steroidal anti-inflammatory drugs (NSAIDs)<\/strong>
\nAnti-inflammatory drugs can be very effective in controlling pain and stiffness. Usually you\u2019ll find your symptoms improve within hours of taking these drugs, but the effect will only last for a few hours, so you have to take the tablets regularly.
\nSome people find that NSAIDs work well at first, but become less effective after a few weeks. In this situation, it sometimes helps to try a different NSAID. There are about 20 available, including ibuprofen, diclofenac, indometacin, nimesulide and naproxen.<\/p>\n

Like all drugs, NSAIDs can sometimes have side-effects, but your doctor will take precautions to reduce the risk of these, for example, by prescribing the lowest effective dose for the shortest possible period of time, e.g. they may prescribe the lowest possible dose or shorter treatment.<\/p>\n

NSAIDs can cause digestive problems (stomach upsets, indigestion or damage to the lining of the stomach), so in most cases NSAIDs will be prescribed along with another drug which will help to protect the stomach.<\/p>\n

NSAIDs also carry an increased risk of heart attack or stroke. Although the increased risk is small, your doctor will be cautious about prescribing NSAIDs if there are other factors that may increase your overall risk, for example, smoking, circulation problems, high blood pressure, high cholesterol or diabetes.<\/p>\n

Disease-modifying anti-rheumatic drugs (DMARDs)<\/strong><\/p>\n

Disease-modifying drugs help by tackling the causes of inflammation. They change the way the condition progresses and hopefully will stop your arthritis from getting worse. It may be several weeks before DMARDs start to have an effect on your joints, so you should keep taking them even if they don\u2019t seem to be working. Sometimes these drugs are given by injection.<\/p>\n

DMARDs aren\u2019t usually used as a first-choice treatment, and the decision to use them will depend on a number of factors, including how much effect NSAIDs have had, how active your arthritis is and how likely it is that you\u2019ll have further joint damage.<\/p>\n

Examples of DMARDs include:
\n\u2022 methotrexate
\n\u2022 sulfasalazine
\n\u2022 cyclosporine
\n\u2022 leflunomide<\/p>\n

Biological therapies are a newer group of disease-modifying drugs that may be used if other DMARDs aren\u2019t working well enough. These are given either by injection or through a drip into a vein. Biological therapies used for treating psoriatic arthritis include:
\n\u2022 adalimumab
\n\u2022 etanercept
\n\u2022 infliximab
\n\u2022 golimumab<\/p>\n

When taking almost all DMARDs, you\u2019ll need to have regular blood tests and in some cases a urine test. The tests allow your doctor to monitor the effects the drug has had on your condition, but also to check for possible side-effects, including problems with your liver, kidneys or blood count.<\/p>\n

You can take NSAIDs along with DMARDs, and sometimes you might need to take more than one DMARD.
\nSteroid injections (cortisone)<\/p>\n

Your doctor might recommend steroid injections if your joints are particularly painful or your ligaments and tendons have become inflamed.<\/p>\n

Surgery<\/strong><\/p>\n

You probably won\u2019t need surgery, although very occasionally a damaged tendon may need surgical repair. Sometimes, after many years of disease, a joint that has been damaged by inflammation is best treated with joint replacement surgery.<\/p>\n

If your psoriasis is bad in the skin around the affected joint, your surgeon may recommend a course of antibiotic tablets to help prevent infection. Sometimes psoriasis can appear along the scar left by the operation, but this can be treated in the usual way.<\/p>\n

Treatments for the skin<\/strong><\/p>\n

Your skin will usually be treated with ointments. There are 5 main types:
\n\u2022 tar-based ointments
\n\u2022 dithranol-based ointments (it\u2019s very important not to let these come into contact with normal skin)
\n\u2022 steroid-based creams and lotions
\n\u2022 vitamin D-like ointments, such as calcipotriol and tacalcitol
\n\u2022 vitamin A-like (retinoid) gels, such as tazarotene<\/p>\n

If the creams and ointments don\u2019t help your psoriasis, your doctor may suggest:<\/p>\n

\u2022 light therapy, involving short spells of exposure to high-intensity ultraviolet light carried out in hospital
\n\u2022 retinoid tablets<\/p>\n

Many of the DMARDs used for psoriatic arthritis will also help your skin condition. Similarly, some of the treatments for your skin may help your arthritis.<\/p>\n

Treatments for nail psoriasis are usually less effective than the skin treatments. Many people use nail varnish to make the marks less noticeable.<\/p>\n

Self-help and daily living<\/strong>
\nKeeping to a healthy weight reduces the strain on your joints. Exercising will help, but you\u2019ll need to find the right balance between rest and activity so you don’t overdo it.<\/p>\n

Exercise<\/strong><\/p>\n

Inflammation can lead to muscle weakness and stiffness in your joints. Exercise is important to prevent this and to keep your joints working properly. However, inflammation can also make you feel unusually tired so you may find you need to take more rests than usual. You\u2019ll need to find out for yourself the right balance between rest and exercise.
\nYour doctor or a physiotherapist will be able to give you advice on suitable forms of exercise, depending on which of your joints are most affected.<\/p>\n

Diet and nutrition<\/strong><\/p>\n

No specific diets have been found to be very effective for psoriatic arthritis, although some people find that fish body oils (not fish liver oils) from salt-water fish reduce their need to take NSAIDs.
\nBeing overweight will put extra strain on your joints, particularly your leg and back joints. It\u2019s also important to control your weight because of the increased risk of heart disease. We recommend a healthy, balanced diet with plenty of fresh vegetables and fruit.<\/p>\n

Complementary medicine<\/strong><\/p>\n

There\u2019s no scientific evidence that suggests any form of complementary medicine helps to ease the symptoms of psoriatic arthritis. Generally speaking, complementary and alternative therapies are relatively well tolerated, but you should always discuss it with your doctor if you want to try them. There are some risks associated with specific therapies, but in many cases the risks associated with them are more to do with the therapist than the therapy. This is why it\u2019s important to go to a legally registered therapist, or one who has a set ethical code.
\nIf you decide to try therapies or supplements you should be critical of what they\u2019re doing for you, and base your decision to continue on whether you notice any improvement.<\/p>\n

Sex and pregnancy<\/strong><\/p>\n

Sex can sometimes be painful, particularly for a woman whose hips are affected. Try experimenting with different positions to find one that\u2019s suitable.<\/p>\n

Psoriatic arthritis won\u2019t affect your chances of having children or a successful pregnancy. You may find that your arthritis improves during your pregnancy, although your symptoms may return after your baby is born.<\/p>\n

Some of the drug treatments given for psoriatic arthritis should be avoided when you\u2019re trying to start a family. For instance, sulfasalazine can temporarily cause a low sperm count, and you shouldn\u2019t try for a baby if you or your partner are on methotrexate or have been using it recently (some doctors say within the last 6 months).<\/p>\n

If you\u2019re thinking about starting a family, you should discuss your drug treatment with your doctor well in advance so that your medications can be changed if necessary.
\nBoth psoriasis and psoriatic arthritis do tend to run in families to some extent. If there\u2019s a history of psoriasis or psoriatic arthritis in your family, then your children may be more likely than most to get psoriatic arthritis, but the risk of passing it on directly is still low.<\/p>\n

Living with psoriatic arthritis<\/strong><\/p>\n

Any long-term condition can affect your moods, emotions and confidence, and it can have an impact on your work, social life and relationships. Talk things over with a friend, relative or your doctor if you find your condition is getting you down. You can also contact support groups if you want to meet other people with psoriatic arthritis.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

What is psoriatic arthritis? Psoriatic arthritis can cause painful inflammation in any of your joints […]<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-18126","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/pages\/18126","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/comments?post=18126"}],"version-history":[{"count":0,"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/pages\/18126\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.hygeia.gr\/en\/wp-json\/wp\/v2\/media?parent=18126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}