Psoriatic arthritis is a disease strongly associated with psoriasis. Although affect people of any age, its incidence is highest between the ages of 35 and 55 years of age.
The psoriatic arthritis is a form of arthritis that affects some people who have psoriasis. Psoriasis is an autoimmune disease (diseases in which the immune system, which is responsible for protecting the body, attacks the own body) which leads to the appearance of spots protruding from the skin, look red, and squamous. Most people develop psoriasis first being diagnosed later with psoriatic arthritis, but the problems of the joints may sometimes begin before skin lesions.
Psoriatic arthritis is within the category of arthritis and inflammatory. The term arthritis refers to pain or joint disease, in which inflammation is present leading to its increase of volume, morning stiffness and difficulty in mobilization.
As is the case in rheumatoid arthritis, it is not clear why the immune system attacks its own healthy tissues, but there seems to be also a link with genetic and environmental factors. Many people with psoriatic arthritis have in your family history cases of psoriasis or psoriatic arthritis. The researchers also found certain genetic markers that seem to be associated with psoriatic arthritis.
The causes are not known, but it is believed that certain factors can act as “trigger” and wake up the disease in people with this hereditary tendency. Within these factors include physical trauma, stress and environmental factors – such as a viral infection or bacterial.
PSORIATIC ARTHRITIS: SIGNS AND SYMPTOMS
Psoriatic arthritis can develop slowly with mild symptoms, or may develop a more rapid and severe. The early recognition helps prevent or limit the damages that occur in the joints in a more advanced stage.
The symptoms and signs the most common are:
- Generalized fatigue;
- Swelling, pain and increased sensitivity in the area of the tendons;
- The fingers of the hands and feet swollen and red, with a look similar to a “sausage”;
- Stiffness, pain, swelling and tenderness in one or more joints;
- Morning stiffness and tiredness;
- The decrease in the amplitude of movements;
- Changes in the nails;
- Redness and pain in the eye, as in a conjunctivitis.
Psoriatic arthritis usually affects the joints most distal (closest to the nail) in fingers of hands and feet, but can reach also the spine, wrists, knees, hips and ankles.
This disease can manifest itself through the involvement of only one joint (monoartrite), less than five joints (oligoartrite) or more than five joints (polyarthritis). Can arise on only one side or on both sides of the body. Inflammation of the tendons or of the places where these and the ligaments are fixed, it is also very common.
The severity of psoriasis is not connected with the severity of psoriatic arthritis. A person may have few cutaneous lesions, but have many joints affected by arthritis. The opposite can also happen.
PSORIATIC ARTHRITIS: TREATMENT
Since there is no cure for this disease the treatment focuses mainly on symptom control, so that the person can maintain their quality of life. The treatment is essentially by medication, physical therapy and certain lifestyle changes.
Within the medicines may be used anti-inflammatory drugs (Nsaids), corticosteroids, anti-rheumatic drugs modifiers of the evolution of the disease (DMARDs) and biologics. These aim to control the effects of inflammation, as well as the slow evolution of the disease and its complications.
In most cases the surgery is not an option, but when the other treatments are not enough to relieve the pain and joint deformities are already very advanced, the surgery can be helpful. The synovectomy (removal of the lining of the joint that is inflamed), and arthroplasty (replacement of a joint by a prosthesis), and arthrodesis (fixation of a joint) are some of the possible interventions.
Physiotherapy is especially useful in the times when the disease is more active and demands the greatest periods of rest. In this phase, the techniques of prevention of muscle atrophy and joint stiffness are the most indicated. When you are in a phase of more controlled of the disease, it is essential to implement a program of physical exercise suitable to his condition, that does not cause pain, fatigue or exertion in the joints. The physical exercise will help reduce the pain and joint stiffness, as well as stress.
As mentioned earlier, stress is a factor that can trigger or intensify arthritis psoriatic. So knowing ways to manage stress is a skill particularly important for people with this disease.
In addition to the physical exercise, the meditation and the guidance of a professional in the area of mental health are some of the alternatives. Taking into account that this is a chronic illness, psychotherapy can also help you accept this new condition.
On a day-to-day, certain strategies may be adopted to reduce or prevent the pain and the limitations, as for example:
- Adopt a healthy diet;
- Maintain an ideal weight;
- Avoid postures prolonged;
- Avoid carrying weights in excess;
- Respect the pain;
- Maintain a good posture throughout daily activities;
- Divide the tasks to accomplish for the day.