How to manage pain and live better with psoriatic arthritis

Living with psoriatic arthritis is a challenge. This autoimmune disease with no known cause can have both short-term and long-term effects causing pain and swelling in joints.  Normally when we hear the word “psoriasis” we think of the skin condition that causes itchy, scaly rashes and it’s true, this disease does affect the skin.  But around 30 percent of people with psoriasis also develop this form of inflammatory arthritis called psoriatic arthritis (PsA). 

The lifelong condition of PsA is when the body’s immune system mistakenly attacks healthy tissue in both joints and skin.  This faulty immune system response causes inflammation that triggers joint pain, stiffness and swelling.  The inflammation can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively. 

The pain of PsA can range from mild to severe. Although there is no cure for psoriatic arthritis, a person can do certain things to help manage the pain associated with this disease. 

Here are 8 ways that may help easing the pain and suffering of psoriatic arthritis:

1. Prescription pain medication

Over-the-counter medications such as ibuprofen and naproxen can be a first line of medications to use in controlling pain. If these do not bring relief, then it is time to consider prescription pain medication.  There are non-narcotic medications that include traditional disease-modifying anti-rheumatic drugs (DMARDs) that can change the way the brain’s pain center processes certain proteins that trigger pain by changing the pain threshold.  Even though these prescription pain medications are not narcotics, there can be side effects of upset stomach and bad dreams.

2. Stretching and strengthening moves

Being in pain can also lead to inactivity which leads to weak muscles. When muscles become tight and weak this can put extra pressure on joints intensifying pain.  To increase range of motion and to build muscle helping to take pressure off of joints, stretching and strengthening are a must.  The key is to work with a physical therapist who can determine which muscles to work and how much to work them.  A person needs to start stretching to a tolerable limit and then gradually increase the stretch over time.  The same thing applies to strength training – the use of free weights, resistance bands, or body weight itself can help build muscle.

3. Exercise daily

Keeping oneself active is vital for maintaining a healthy body weight and to preserve muscle mass both which help reduce pressure on joints.  The National Psoriasis Foundation recommends at least 30 minutes of moderate exercise at least five days a week.  Depending on how much pain a person is having will determine what form of exercise they can do.  If joint pain is too much to do walking, running or biking, then swimming or water aerobics should be considered. 

4. Use heat or cold therapy

Temperature can play an important role in treating chronic pain associated with PsA.  Many people with PsA respond best to heat but others may find better relief from cold.  Try taking a hot shower or bath in the morning to relax joints.  Or use a hot pad or cold pack for up to 20 minutes several times a day but be careful not to place heat or ice directly on the skin or open sores – use a towel or other barrier between the hot or cold pack and direct skin contact.

5. Acupuncture and acupressure

Rooted in ancient Chinese medicine, both acupuncture and acupressure are two alternative therapies that may bring pain relief by relieve muscle tension and helping with relaxation.  There is limited scientific evidence for either one but for some people, they do help.  It is best if they are used in conjunction with traditional therapies but anyone with PsA should consult with their doctor first on their use.

6. Stress relief with meditation

One of the factors that may intensify PsA pain is the tendency for people with chronic pain to tense their muscles.  This will only tighten the joints making the pain worse.  Practicing stress relief by doing deep, abdominal breathing and guided imagery – such as closing the eyes and imagining a relaxing place – can help quiet muscles reducing tension. 

7.  Wear comfortable shoes

A common complaint of PsA is pain in the toes making it difficult to walk or exercise.  Supportive shoes with plenty of toe room and using orthotics, can relive foot pain.  By wearing orthotics this can redistribute pressure on the foot while supportive or cushioned shoes can provide comfort and better skeletal alignment.  It is also recommended for anyone with PsA to see a rheumatologist of foot specialist (podiatrist) if foot pain is related to PsA.

8.  Electrical stimulation

Electrical stimulation is done using a device called a transcutaneous electrical nerve stimulation (TENS) unit.  The electrodes of the TENS unit are placed at the location of the pain to gently stimulate the nerve cells.  A possible side effect can be skin irritation.