What is psoriatic arthritis (PsA)?
Psoriatic arthritis is an autoimmune condition. Autoimmune conditions occur when the body’s immune system mistakes its own tissues for foreign invaders, such as bacteria or viruses. The confused immune system springs into action, seeking out to destroy the “invaders” in the tissues.
In the case of psoriatic arthritis, the immune system attacks healthy cells and tissue. This results in chronic joint pain and inflammation and the overproduction of skin cells.
Psoriatic arthritis is a form of arthritis that affects people who have psoriasis, which is a skin condition that involves your white blood cells mistakenly attacking your skin cells. This attack results in your body’s overproduction of skin cells, which is what causes the common symptom of psoriasis: red, scaly patches on the skin.
Who is affected?
Anyone can be diagnosed with psoriatic arthritis. The condition is generally diagnosed between the ages of 35 and 45. 
Doctors aren’t sure about what causes psoriatic arthritis, but believe that a combination of genetics and environment are responsible. Other factors like family history, physical trauma, and medical conditions like psoriasis may influence your level of risk as well. 
What happens in your body?
Common symptoms of psoriatic arthritis include: 
- Stiffness, pain, and tenderness in one or more joints
- Swollen fingers and toes, which can resemble sausages
- Lower back pain
- Small depressions in the nails or detachment from the nail bud
Symptoms of psoriatic arthritis can resemble other conditions, such as rheumatoid arthritis. But some aspects of psoriatic arthritis that are different from other conditions are pitting or flaking nails and tenderness in the soles or heels of your feet.
The condition can affect joints on one or both sides of the body. 
How do I know if I have psoriatic arthritis (PsA)?
It is important to get an accurate diagnosis as quickly as possible to make sure that the condition does not worsen. The best way to do this is by visiting your doctor and, if possible, getting a referral to visit a rheumatologist, a doctor with specialized training in treating psoriatic arthritis.
Some ways that your doctor can assess whether you have the condition is through a physical examination or lab tests (such as imaging tests).
How is it treated?
There is no known cure for psoriatic arthritis (PsA), but integrative interventions have shown to reduce pain and discomfort and improve quality of life by slowing the condition’s progression and easing the severity of symptoms. 
Integrative interventions offer a holistic approach to treatment. Instead of just conventional medicine, integrative treatments combine conventional medicine with nutritional tools, mind-body medicine, and manual medicine for a holistic approach to treating psoriatic arthritis (PsA).
For those new to integrative medicine, learn more here.
Many people with psoriatic arthritis find that certain medications work for them and others do not. So, in order to find an effective conventional treatment, people with psoriatic arthritis often work with their doctors to determine which medication works best with their body and needs.
With the right medication, it is possible to manage symptoms and prevent the rapid worsening of the condition. Before starting to take any medication, be sure to ask your doctor about possible side effects. And if you notice any of the side effects once you start your treatment, let your doctor know as soon as possible.
Examples of conventional treatments:
Research shows that gentle, low-intensity mind-body treatments can help PsA patients with mobility, mood, decreased pain, and more. There are a wide variety of mind-body treatments for psoriatic arthritis, ranging from deep breathing to aqua-therapy.
When living with chronic pain, engaging in regular movement and exercise may feel difficult and unnecessary. But doing so can actually improve your symptoms.
Before starting a physical exercise regimen, consult with your doctor about what might be the best activities for you and your body.
Examples of mind-body medicine:
Tai chi, a mind-body exercise that originated from China, incorporates slow, gentle movements with breathing exercises. Research conducted by the Hartford Hospital found that tai chi brings emotional wellbeing, improved strength, and improved balance to individuals with chronic pain.
Yoga comes in many different styles, often engaging both the body and the mind through controlled breathing and stretching. Researchers have concluded that yoga therapy may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health.
Relaxation therapies like deep breathing techniques, meditation, and biofeedback can help patients ease anxiety and better manage chronic pain. A study demonstrated that mindfulness programs produced significant improvements in anxiety, depression, cognitive psychosocial abilities, and overall functioning.
Manual treatments are administered by certified therapists, using physical pressure and stimulation on the body to reduce psoriatic arthritis symptoms. Treatments can vary in intensity and incorporate other elements such as heat and aromatherapy to enhance relief.
Examples of manual medicine:
Licensed massage therapists use different techniques, like shiatsu, hot stone, and Swedish massage, to provide temporary pain relief. A Mayo Clinic study concluded that massage therapy is particularly helpful for muscle pain, and that it can also help reduce anxiety.
Physical therapy can help with physical strengthening, mobility, and overall functionality. A study conducted by researchers in Sweden found that physical therapy techniques were suitable for addressing musculoskeletal conditions as well as with chronic back pain.
Osteopathic manipulative treatment, or OMT, is a form of manual therapy used by osteopathic physicians (DOs). A study published in The New England Journal of Medicine demonstrated that osteopathic manual care had similar clinical results to standard medical care, but required fewer medications.
Nutrition plays a crucial role in your overall health, and is a tool you can use to combat joint damage, reduce inflammation, and manage other psoriatic arthritis symptoms.
Just like with conventional, mind-body, and manual medicines, there is not one ideal treatment for every PsA patient. When selecting nutritional tools to treat your condition, it is best to consult with your doctor or work with a dietitian, naturopath, or nutritionist to find out the best diet for you.
Examples of nutritional tools:
Vegetarian and vegan diets have shown to promote gut health, which may have an anti-inflammatory impact. A study conducted by the Physicians Committee for Responsible Medicine demonstrated that plant based diets improve joint pain, tenderness, and swelling.
While some foods can help reduce symptoms, other foods may trigger them. An elimination diet, which is an eating plan that eliminates certain foods or food groups believed to be causing negative bodily reactions, can help you figure out which foods are triggering those symptoms and bring you closer to your ideal diet.
Fruits and Vegetables
Beans (like red, pinto, navy, and black beans) are rich in fiber and protein, and are full of both antioxidants and anti-inflammatory properties.
This heart-healthy ingredient contains healthy fat, antioxidants, and oleocanthal, an anti-inflammatory compound.
These simple, flavor-rich vegetables are packed with antioxidants and may help reduce inflammation, improve heart health, and help control cholesterol levels.
-  About Psoriatic Arthritis. https://www.psoriasis.org/about-psoriatic-arthritis. Accessed July 27, 2020.
-  Psoriatic arthritis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076. Published September 21, 2019. Accessed July 27, 2020.
-  Roger-Silva D, Natour J, Moreira E, Jennings F. A resistance exercise program improves functional capacity of patients with psoriatic arthritis: a randomized controlled trial. Clin Rheumatol. 2018;37(2):389-395. doi:10.1007/s10067-017-3917-x
-  Arthritis Foundation. Arthritis By the Numbers. 2019; v3; 4100.17.10445
The information on this page is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.