Psoriatic arthritis (PsA) is related to psoriasis, but they’re not the same thing. Psoriasis is a chronic skin condition that causes red, scaling skin. PsA, on the other hand, typically shows up as joint pain. It’s possible to have both conditions, or to have one without the other.
If you’re dealing with PsA, it’s helpful to know what kind you have so you can get the right treatment. Here’s how to recognize the five main types of PsA and treatment tips for each.
What are the 5 types of psoriatic arthritis?
Psoriatic arthritis is a type of arthritis that affects about 20 to 30 percent of peeps who have psoriasis. It comes in five types, including:
- Asymmetric psoriatic arthritis
- Symmetric psoriatic arthritis
- Distal interphalangeal predominant (DIP) psoriatic arthritis
- Spondylitis psoriatic arthritis
- Psoriatic arthritis mutilans
FYI: There are some things that can clue you in on which type you have. But your doctor will take all of your symptoms into account when developing a medical diagnosis.
1. Asymmetric psoriatic arthritis
Asymmetric PsA is the most common type of PsA. It accounts for at least 60 percent of cases. It affects your joints individually rather than in pairs. That means you could experience pain in the joints of your right hand without your left being affected.
But your symptoms won’t necessarily only stick to one side. For example, your left knee and right foot might have symptoms at the same time, even if you’re experiencing asymmetric PsA. According to a 2019 study, this type of PsA is more common in men.
How to spot it
Common symptoms of asymmetric PsA include:
- fatigue
- blurred vision
- swollen fingers or toes
- pitting or cracking nails
- swollen, tender, stiff, or painful joints
- swollen or painful ligaments or tendons
How it’s treated
PsA doesn’t currently have a cure. But there are some ways to show your symptoms who’s boss. Your doctor can help you figure out which one (or combination or treatments) is right for you.
Potential treatments include:
- physical therapy
- occupational therapy
- oral corticosteroids (like prednisone)
- biologic drugs (like adalimumab or etanercept)
- nonsteroidal anti-inflammatory drugs (NSAIDS) like aspirin or ibuprofen
- intra-articular joint injections (like hyaluronic acid or cortisone)
2. Symmetric psoriatic arthritis
With symmetric PsA, symptoms tend to pop up on both sides of your body at the same time. This type of PsA represents 15 to 61 percent of cases. It’s more common in women.
How to spot it
Symmetric PsA symptoms are a lot like asymmetric PsA symptoms. Symmetric PsA tends to affect the smaller joints of the feet or hands, though, rather than larger joints like your knees or elbows.
FYI: Symmetrical PsA is sometimes confused with rheumatoid arthritis (RA). A simple blood test can help you know if you’re dealing with RA instead.
How it’s treated
The treatments for symmetric PsA are often similar to asymmetric PsA. The ideal exact treatment plan can depend on your:
- age
- weight
- mobility
- pain level
- overall health
PsA PSA: Studies show that smoking cigarettes can make PsA symptoms worse. It might reduce some of the positive results from treatment, too.
3. Distal interphalangeal predominant (DIP) psoriatic arthritis
An estimated 10 percent of peeps with PsA have distal interphalangeal predominant (DIP) PsA. It targets the DIP joints which are located near the tips of your toes and fingers, so you may notice some changes to your nails. It can show up in a single joint or it may affect a bunch of them.
How to spot it
Common distal interphalangeal predominant (DIP) symptoms include:
- swollen fingers or toes
- ligament or tendon pain
- reduced range of motion
- joint stiffness in your fingers or toes
Nail probs are also super common in DIP PsA. You may notice:
- pitting
- crumbling
- white spots
- discoloration
- nail cracking
- detachment
How it’s treated
Your doc might suggest nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections to help treat mild inflammation and discomfort. For more severe cases, you might be given tumor necrosis factor (TNF) inhibitors. These might slow disease progression.
For temporary relief, you can try a DIY treatment. Here are a few possible options:
- Cold therapy. Place an ice pack on the affected area for up to 10 minutes to calm inflammation.
- Nail care. Avoid trimming your cuticles and applying nail polish to reduce your risk of irritation. You can also keep your nails moisturized with cuticle oils and creams.
- Soak it up. Give your hands or tootsies a relaxing bath. Just keep your soak relatively short to avoid drying out your skin. You should also follow up with a top-notch moisturizer.
- Keep your hands and feet dry. Gently pat your skin dry after each shower. You should also opt for sweat-wicking socks that pull moisture from the skin.
Just remember to talk with your doc before trying an at-home PsA remedy. It’s important to double-check that it won’t interfere with your prescription treatments or worsen your unique symptoms.
4. Spondylitis psoriatic arthritis
Around 7 to 32 percent of peeps with PsA have spondylitis PsA (aka axial arthritis). This type of PsA tends to target the joints between your spinal vertebrae.
How to spot it
Spondylitis PsA can cause pain, stiffness, and swelling in your neck and back. But these symptoms can also affect your:
- feet
- hips
- arms
- legs
- hands
How it’s treated
According to the Spondylitis Association of America, spondylitis treatments can include:
- NSAIDs
- physical therapy
- occupational therapy
- immunosuppressants
- sulfasalazine (Azulfidine)
- biologic medications (like TNF inhibitors)
- disease-modifying antirheumatic drugs (DMARDs)
5. Psoriatic arthritis mutilans
PsA mutilans is a rare but severe form of PsA. It only affects about 5 percent of peeps with PsA. It typically causes severe pain — usually in the hands, feet, or wrists.
How to spot it
PsA mutilans can cause extreme inflammation which can lead to joint damage. You may also have:
- deformities to affected joints
- bone loss in the affected joints
- loss of movement or reduced range of motion
- pain that radiates to other areas of the body
How it’s treated
Psoriatic arthritis mutilans is a progressive condition. It can get worse and worse over time, so it’s important you manage symptoms as soon as they pop up.
Treatments can include anti-TNF inhibitor, DMARDs, or biologic medications. One 2011 study also found that a drug called etanercept (Enbrel) may help restore joint function. But we def need more research to prove whether this is legit.
The takeaway
Psoriatic arthritis (PsA) is a type of arthritis that affects up to 30 percent of folks with psoriasis. It isn’t a one-size-fits-all condition and can affect everyone differently.
Treatment plans depend on your unique symptoms and other lifestyle factors. Your doc may suggest medications that can help reduce inflammation and pain while slowing the disease’s progress.
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