Psoriatic Arthritis (PsA): What is it and how can we help it?

24 May

Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune condition. You might be wondering how this differs from arthritis. The answer to this is that PsA specifically affects individuals with psoriasis, a skin disorder characterised by red, scaly patches. Not all individuals with psoriasis have PsA and the cause of this is still being researched.

Let’s discuss what PsA means…

As an inflammatory condition, it presents with inflammation in the joints, causing pain, stiffness, and swelling. The joints usually affected are the fingers, toes, knees, and spine. However, PsA can also cause inflammation in the tendons and ligaments causing further swelling and discomfort. On a typical day this may look like your joints being swollen and painful, feeling very stiff (especially in the mornings) and feeling fatigued. However, this will likely vary from day to day.

This condition is chronic meaning it will continue, so management is very important. Management typically involves a combination of medication, lifestyle modifications, and sometimes surgery. Lifestyle modifications can include maintaining a healthy weight, exercising regularly, and managing stress levels to improve overall well-being as poor health behaviours are well-known stressors for the condition.

What does all this have to do with physiotherapy?

Having a team of health professionals including a rheumatologist that you know and trust can be very beneficial as there may be periods you feel you need to lean on these people. Physiotherapy plays a crucial role in managing PsA by focusing on improving joint mobility, strength, and function. The evidence in this space suggests that it reduces the number of flare-ups, improves quality of life and minimises fatigue.

Typically you would meet with your physiotherapist who would ask many questions to gain a sense of your lifestyle, medications, stress, exercise regime and goals. Together we will then do an assessment of your movement (ie can you touch your toes) and then your physio will design a program tailored to you to suit your individual needs, life and goals.

Here are some typical recommendations we make in clinic;

Range of motion exercises: These help maintain/improve joint movement and reduce stiffness. Examples include gentle stretches and movements that involve rotating the joints through their full range of motion.
Strength training: Strengthening exercises help build muscle around the affected joints, providing them with more support and stability. This can help reduce pain and improve function. Exercises may involve using resistance bands, light weights, or body-weight exercises and should be completed 2-3 times per week.
Low-impact aerobic exercise: This can include swimming, cycling, or walking which help to improve cardiovascular health, manage weight and contribute to positive mental wellbeing.
Mental wellbeing exercises: Exercise for the mind, as well as the body, are an excellent strategy to manage stress and monitor your wellbeing. This could be for as little as 5 minutes a day - checking in with yourself and taking the time to value self-care, learning to pace oneself, listening to the body, and taking breaks when needed thereby preventing overexertion and flare-ups.