What Are the Best Treatments for Psoriatic Arthritis?


If you or a loved one has just received a diagnosis of psoriatic arthritis (also known as PsA), you may have concerns about the available therapies. Even though there is no known treatment for PsA, there are many therapeutic choices that can aid in easing common symptoms such joint pain, stiffness, and edema. We’ll examine some of the typical PsA therapy options, which range from conventional therapies like NSAIDs (or nonsteroidal anti-inflammatory medicines) and biologics to natural cures and dietary modifications.
Remember: You should always consult your doctor before pursuing treatment.

Medications Used to Manage Psoriatic Arthritis

  • NSAIDs – NSAIDs are among the most popular conventional treatments for treating PsA-related pain and discomfort. NSAIDs can be used to manage swelling, relieve pain and morning stiffness, and increase the range of motion in troubled joints, in addition to reducing musculoskeletal symptoms.
  • This can be the only drug required in milder cases to treat the symptoms. Ibuprofen (Advil, Motrin IB) and naproxen are examples of over-the-counter NSAIDs (Aleve). Additionally, stronger NSAIDs are only accessible with a prescription.
  • Steroids – Corticosteroids can also aid in reducing PsA-related discomfort and swelling. An injection of a steroid may be given straight into the affected joint if it is one of your joints that is significantly impacted. To treat swelling, discomfort, and inflammation, steroids can also be given as tablets. Steroid medications, however, can have considerable negative effects, thus long-term use is not advised.
  • DMARDs –Disease-modifying anti-rheumatic medicines, or DMARDs, are a family of medications that are used often to treat psoriatic arthritis. DMARDs function by targeting the aberrant immune response that is the body’s underlying cause of psoriatic arthritis. Due to this reaction, the immune system of the body attacks healthy joint tissues as well as other healthy tissues and cells. DMARDs delay the evolution of PsA, help stop future joint damage, and inhibit the molecules that produce this inflammation. As a result, they relieve symptoms.
  • DMARDs are often swallowed whole, like a pill. Methotrexate (Trexall, Otrexup), leflunomide (Arava), sulfasalazine (Azulfidine), azathioprine (Imuran, Azasan), and cyclosporine are some examples of DMARDs (Gengraf, Neoral, Sandimmune).
  • It may take several weeks before you can tell whether a DMARD is effective, so even if you don’t see improvements right away, it’s still crucial to continue taking the drug. DMARDs may have side effects such bone marrow suppression, liver damage, and an elevated risk of infection, in addition to having an impact on the entire immune system.
  • Other Medications –PDE4 inhibitors, such apremilast (Otezla), have just been approved for psoriatic arthritis patients who have not responded well to a prior DMARD. This medication, which comes in tablet form, works by reducing the activity of one of the inflammatory enzymes in the body.
  • Biologics – A relatively recent form of treatment for psoriatic arthritis is biologics. Biologics specifically target the immune system’s molecules or chemicals that cause psoriatic arthritis. These medications are typically only prescribed to those with severe psoriatic arthritis or in cases where other treatments have failed.
  • Biologics can be used alone or in conjunction with other treatments, and are often administered via injection or drip into a vein (such as older DMARDs). Adalimumab, abatacept, infliximab, apremilast, certolizumab, etanercept, tofacitinib, golimumab, ixekizumab, secukinumab, and ustekinumab are some examples of biologics. Adalimumab is found in the medications Humira, Orencia, and Orencia CR (Stelara).
  • You might need routine blood or urine tests to track this potential because biologics might have side effects, including liver and kidney issues. Your vulnerability to infection may also rise as a result of biologics. Since biologics take time to take effect, it is typically advised that you continue your treatment for at least three months before determining whether the medication is working as intended.

Non-Pharmacological Therapies

The symptoms of psoriatic arthritis can be made more manageable by maintaining a healthy lifestyle.

Lifestyle Changes to Consider

  • Weight: Maintaining a healthy weight reduces the load on your joints. If you are overweight, losing weight may help reduce symptoms of joint pain.
  • Exercise: Regular gentle exercise can help to keep the joints flexible, and keep the muscles strong, which in turn supports the joints. Additionally, exercise has also been shown to reduce overall inflammation, increase energy levels, and improve mood.
  • Diet: Keeping a healthy and balanced diet ensures your body has the right nutrients and vitamins to support joint health. In particular, having a diet low in processed and fatty foods has been shown to improve most health conditions.
  • Smoking: This activity is known to have a pro-inflammatory effect on the body. Additionally, those who smoke have a higher risk of developing psoriatic arthritis and are more likely to experience severe symptoms. Smoking can also reduce the effectiveness of some of the medications used to treat psoriatic arthritis.
  • Alcohol: Alcohol can increase the risk of developing psoriatic arthritis, and can make your symptoms worse. In addition, some medications should not be taken alongside alcohol.
  • Physiotherapy: Physiotherapy may be useful in some people with psoriatic arthritis to maintain joint flexibility and build strength.
  • Home Aids: Use of home aids, such as jar openers, can help to maintain independence while reducing strain on the joints.
  • Stress Management: High levels of psychological stress can have a detrimental effect on physical diseases. It may be helpful to engage in stress reduction activities such as yoga, meditation and mindfulness.

Surgery

A medical expert might advise surgery for people with severe psoriatic arthritis. When a damaged joint needs to be removed and replaced with a prosthetic one, this is often the course of therapy.

Alternative Therapies

Regarding the usefulness of the following treatments on PsA symptoms, there is scant clinical evidence. On the other side, they don’t hurt you and occasionally even enhance your wellbeing. These complementary treatments and therapies include:
  • Turmeric: Curcumin, a naturally occurring ingredient in turmeric, is thought to exhibit anti-inflammatory properties.
  • Epsom Salt and Spa Therapy: Use of thermal baths and Epsom salts have been used since ancient times to treat rheumatological diseases. These may have a dual effect of both loosening joint stiffness and combating psychological stress.
  • Massage: Massage may be useful in loosening the tight muscles that might accompany joint pain. Massages may also improve blood flow. However, it is not recommended to massage areas that are in pain.

REFERENCES:

By: Miss Cherry May Timbol – Independent Reporter

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