From healthcentral.com
Specialists give their checklist of advice they want people with psoriatic arthritis to follow between appointments
If you have psoriatic arthritis (PsA), you might not see your doctor all that often—and that’s a good thing. “We see patients routinely every six months if their disease is pretty stable,” says Alexis Ogdie-Beatty, M.D., an associate professor of rheumatology at the Hospital of the University of Pennsylvania in Philadelphia. PsA can be unpredictable, but following doctor’s orders helps keep visits to a minimum—leaving you to get on with life! It goes without saying that you should continue taking your prescribed meds. Here's what else your PsA team wants you to do to stay on track.
Keep Moving
Exercise does several things to improve quality of life with PsA. “It helps reduce stress, anxiety, and depression, and improves sleep. All of these factors affect the way people experience their PsA,” says Dr. Ogdie-Beatty. “Finally, exercise builds the muscles around the joints, creating less ‘wiggle’ within the joint such that you potentially get less inflammation. As the commercial says, ‘a [joint] in motion stays in motion.’” Do what you can to stay active, she adds. If a short walk each day is all you can manage, start with that and try to build up gradually.
Manage Stress
Stress triggers the immune system’s inflammatory response, resulting in joint damage in people with PsA, says the Arthritis Foundation. “In practice, we often see patients coming in with flares of their joints and/or skin during times of big life stressors/events,” says Rebecca Haberman, M.D., an assistant professor of medicine and the associate director of the psoriatic arthritis centre at NYU Grossman School of Medicine in New York City. “So it’s important to try to manage stress, but it’s also often the hardest thing to control.” The National Psoriasis Foundation (NPF) recommends relaxation techniques—try using a mindfulness meditation app like Headspace.
Eat Well
No diet will “cure” PsA, but many experts believe that an anti-inflammatory diet, such as the Mediterranean diet, may be a good choice. “There are several advantages of the Mediterranean diet for chronic diseases associated with inflammation, including the focus on healthy omega-3 fatty acids for skin health,” says Seattle-based registered dietitian nutritionist, Ginger Hultin, R.D.N. Hultin recommends including whole grains, fish, colourful fruit and berries, and leafy greens in your diet to help fight inflammation. Cut back on alcohol, ultra-processed foods, and foods with large amounts of added sugar—all of which can have inflammatory effects.
Use Home Remedies
If you have PsA in your hands, moist heat may help. “We use warm heating pads in our clinic to relieve symptoms,” says occupational therapist Michele Pasqualetto Milano, the owner of Hand + Physical Therapy NYC in New York City. “There are good ones to use at home that can be heated in your microwave (such as this set of two pads, or these therapy mittens that you can heat up then pop on).” Also, try using heat pads before exercise to increase blood flow and circulation and prepare the tissue for the workout, Milano adds.
Look After Your Skin
Most people with PsA also have psoriasis, which affects the skin. Psoriasis usually comes first and around 30% of people with this (also chronic) condition later develop PsA, according to the NPF. If you’re on a treatment plan for psoriasis, don’t neglect this even if your PsA symptoms are causing the most discomfort. Psoriasis treatment options depend on the type of psoriasis you have and the severity of your symptoms. The most common type, plaque psoriasis, may be treated with topical ointments or creams, such as cortisone cream, synthetic vitamin D3, and vitamin A, says the NPF.
Prioritise Your Mental Health
If your PsA affects your mental health, you’re not alone. A review in Rheumatology and Therapy suggests that one in five people with PsA have symptoms of depression. “We know depression and anxiety are tied to PsA flares,” says Dr. Ogdie-Beatty. Sometimes, professional support is needed to tackle mental health issues. But that isn’t something that always slots into place overnight. “Finding a therapist can be hard,” Dr. Haberman admits. She suggests enlisting the help of your rheumatologist or primary care doctor to get connected to someone within your network.
Stay Connected
Anxiety and depression can lead to loneliness if you don’t feel up to socializing—and this is totally understandable. And then there’s the fatigue that’s estimated to affect about 50% of people with PsA. When you’re feeling low on energy, going out to socialize can feel like a huge obstacle. At those times, the best people to connect with may be those who just get it. “The National Psoriasis Foundation provides great resources and peer connections that may be helpful,” says Dr. Haberman. For instance, their One to One program offers peer support by phone, email, or text.
Get the Help You’re Entitled To
Your PsA can legally be considered a disability if it affects your performance at work, and you may be able to receive benefits from the government or a private insurance policy. You can also ask your employer to make certain adjustments in the workplace, such as providing a hands-free phone headset, replacing a mouse with a trackpad, adjusting the height of your chair and desk, or allocating additional breaks to let you move around. You can learn more about your employment rights under the Americans with Disabilities Act (ADA) at the Equal Opportunity Employment Commission.
Never Struggle in Silence
We’ll say it one more time: PsA is unpredictable! You can be doing everything right: eating anti-inflammatory foods, embracing all the relaxation tools at your disposal, having regular check-ins with a therapist, leaning on your support system—and still have an unexpected exacerbation of symptoms that knocks you for a loop. If that happens, don’t wait until your next scheduled appointment. “If one of our patients has a flare of symptoms, we always have them come in,” Dr. Ogdie-Beatty says. With your doctor involved, you can make any necessary tweaks to your treatment plan, or maybe try something new altogether.
https://www.healthcentral.com/slideshow/top-things-your-psa-doctor-wants-you-to-do-this-month
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