Psoriatic Arthritis FAQs: Questions to Ask Your Rheumatologist

From healthcentral.com

Newly diagnosed? Brief yourself on these PsA must-knows, and then bring this list of questions to your doctor 

A diagnosis of chronic illness can leave you with more questions than answers and a complex disease like psoriatic arthritis (PsA) can be especially confusing. Psoriatic arthritis isn’t a condition people know much about, unless they have it or someone close to them does. If psoriatic arthritis has made an appearance in your life, you’re going to want to know what to ask your doctor. Read on to get a briefing on the major FAQs for this condition, and then bring this list, plus any other questions that pop up, to your rheumatologist appointment so that you can get answers.

                                                                                GettyImages/AndreyPopov

What Caused My Psoriatic Arthritis?

Psoriatic arthritis is an autoimmune condition that causes the body to attack healthy cells in the joints, as if they were a bacteria or virus that needs to be fought. The exact cause of psoriatic arthritis is unknown, but experts think a combination of genetics (a family history and specific inherited genes) and environmental factors (stresses to the body like infection, injury, psychological stress, and obesity) ultimately come together to trigger the condition, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

“Autoimmune conditions tend to be more common in females, but PsA affects females and males equally in adults,” says Dori Abel, M.D., a paediatric rheumatologist in Philadelphia.

How Will You Diagnose My Condition?

Since no single test can diagnose the condition, your doctor will take several steps to determine if psoriatic arthritis is causing your symptoms. These steps can include:

Taking a Full Family History

You are more likely to have psoriatic arthritis if a family member has psoriasis or psoriatic arthritis.

Performing a Physical Exam

“The most important test is a clinical exam, as there are certain signs and symptoms which are very typical for psoriatic arthritis,” says Lisa Mandl, M.D., a rheumatologist at Hospital for Special Surgery in New York City. During this exam, your doctor will ask about what symptoms you’ve been experiencing and examine your joints (looking for swelling and tenderness), skin, and nails to look for changes consistent with PsA and psoriasis.

Doing Lab Work

You may also have blood drawn and tested. Some biomarkers found in the blood, like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) signify inflammation, and that can tell your doctor that you likely have an autoimmune condition, per the Arthritis Foundation. However, they don’t automatically mean you have psoriatic arthritis. Other substances in the blood, like rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies, can rule out rheumatoid arthritis. Even if blood tests are negative, they can help determine what conditions you don’t have, Dr. Mandl notes.

Ordering Imaging Tests

X-rays, MRIs, and ultrasounds can find changes in the joints and surrounding tissues that signify psoriatic arthritis inflammation and damage.

Taking a Sample of Synovial Fluid

Synovial fluid is a lubricating liquid found in the joints that keeps bones from rubbing against each other and allows the joints to function smoothly. A synovial fluid analysis, which involves removing some of this fluid from a swollen joint and sending it to a lab to test for signs of inflammation, can also help rule out other conditions such as gout or an infection, says Dr. Mandl.

What Are the Most Common Symptoms of Psoriatic Arthritis?

Psoriatic arthritis symptoms and the order in which they show up, can vary from person to person. Most people with psoriatic arthritis have psoriasis first, but it’s also possible to have joint pain before experiencing any skin symptoms, per NIAMS. (It’s also possible to have PsA without psoriasis, Dr. Abel notes.) The most common symptoms of psoriatic arthritis include:

Joint Issues

Joint-related symptoms may include:

• Stiffness, pain, and swelling of one or more joints that’s often worse in the morning or after periods of inactivity

• Painful, sausage-like swelling of an entire finger or toe (dactylitis)

• Tenderness in the areas where tendons or ligaments attach to bones, like the back of the heel and sole of the foot

The joints of the fingers—and specifically, the distal interphalangeal joints (DIPs), which are the last knuckles before your nail beds – are most often affected by psoriatic arthritis, says Dr. Abel. However, she adds, it can also affect other joints, including the knees, ankles, elbows, wrists, spine, neck, and hips. Psoriatic arthritis is often asymmetric (meaning it doesn’t necessarily impact matching joints on both sides of the body), but when it affects many joints (more than five), it is likely to become more symmetric, Dr. Abel says.

Other Symptoms

Non-joint-related symptoms of psoriatic arthritis can include:

• Fatigue

• Scaly, inflamed patches of skin, commonly on the scalp, elbows or knees

• Nail changes, such as pitting (tiny dents), crumbling, or separation from the nail bed

• Eye inflammation that causes pain, redness, and blurry vision

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• How Will You Treat My Condition?

• "There are two types of initial treatment for psoriatic arthritis: treatment to improve your symptoms quickly so that you feel better, and treatments to stop psoriatic arthritis from getting worse over time and damaging your joints,” says Dr. Mandl. Factors like which body parts are affected, the severity of your symptoms, which ones bother you the most, other health problems you have, and your health insurance will all influence what treatment your doctor starts you on, per the Arthritis Foundation.

For example, “If someone only has a joint or two involved, we may just inject that joint with steroids,” Dr. Abel says. But when it’s more than a couple of joints, or if the arthritis keeps coming back in the same joint and you need repeat injections, “you want to be considering systemic therapy,” she says. Many people with psoriatic arthritis should expect to be on long-term therapy that keeps their disease under control and prevents progression and joint damage.

Treatments for psoriatic arthritis include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs like ibuprofen, naproxen, aspirin, and nabumetone treat mild psoriatic arthritis by reducing inflammation and improving joint pain.

Corticosteroids

Steroids—most commonly prednisone—are used to quickly reduce inflammation and get symptoms under control. They can be helpful during a flare or as a bridge until a new treatment starts to work, which can take a few months, Dr. Abel says. Steroids can be taken orally or via injection.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

These drugs lower inflammation, reduce symptoms, and prevent joint damage by suppressing the body’s overactive immune system. Examples include:

• Arava (leflunomide)

• Azulfidine (sulfasalazine)

• Rheumatrex (methotrexate)

Biologics

A biologic is a type of DMARD made from a living microorganism or cell. These medications target specific proteins in the immune system to control psoriatic arthritis; most are taken by injection or IV. They’re classified according to what part of the immune system they zero in on. A few examples:

• Tumour necrosis factor (TNF) inhibitors. Remicade (infliximab), Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab), Simponi (golimumab)

• Interleukin-17 (IL-17) or interleukin 12 and 23 (IL-12/23) inhibitors. Cosentyx (secukinumab), Tremfya (guselkumab), Siliq (brodalumab), Stelara (ustekinumab)

• T-cell inhibitors. Orencia (abatacept)

Are There Side Effects to Treatments?

All medications come with potential side effects and psoriatic arthritis drugs are no exception. The side effects that you might experience depend on the type of medication you’re taking.

• NSAIDs: Using NSAIDs long-term can cause stomach irritation and ulcers, internal bleeding, kidney problems, and heart problems.

• Corticosteroids: Steroids are meant to be used only short term because they can cause some pretty rough side effects with long-term use, including osteoporosis, high blood pressure, adrenal insufficiency, diabetes, mood problems, and glaucoma.

• DMARDS and biologics: DMARDs and biologics are the strongest and most effective medications for PsA. “They work to quiet the inflammation in joints and skin by lowering the immune system, which also puts you at a slightly increased risk of infection,” says Dr. Abel. Depending on the medication, side effects can include fever, mouth sores, hair loss, stomach upset, fatigue, and liver and kidney damage. When taking one of these medications, your doctor will send you for regular bloodwork to make sure you’re tolerating it well and that they catch any changes in the liver and kidneys early, Dr. Abel says.

If you’ve started a new medication recently, it’s important to let your doctor know if you’re experiencing any new symptoms, even if they seem unrelated, especially fever or any other significant illness, notes Dr. Abel.

What Lifestyle Changes Do You Recommend?

A few lifestyle shifts can help improve psoriatic arthritis symptoms and overall health.

Exercise

“It is important to be active, especially if you have not been because your joints have been hurting,” Dr. Mandl says. Exercise has been shown to reduce pain and improve physical function in people with PsA, according to research on optimal lifestyle management of PsA in Rheumatic & Musculoskeletal Diseases Open. The reason is unclear, but it could be because exercise has anti-inflammatory effects, helps with weight management, and improves mobility and strength in the muscles and tissues that support the joints. Increased physical activity also helps prevent associated conditions such as heart attack, stroke, and diabetes, Dr. Mandl notes.

Weight Management

Maintaining a healthy weight is an important part of living better with psoriatic arthritis. “People with psoriatic arthritis can be at increased risk of weight gain as they get older,” Dr. Mandl notes. Excess weight not only increases the risk of comorbidities like heart disease, stroke, metabolic disease, and diabetes, but fat tissue also contains inflammatory cells, so reducing it can be beneficial, per the RMD Open research. People who are overweight may also not respond as well to psoriatic arthritis medications, per research on obesity and PsA in Rheumatology and Therapy.

“Eating a healthy diet, such as a Mediterranean diet high in omega fatty acids, is also a good idea,” says Dr. Mandl. There’s not one best diet for PsA, but focusing on good nutrition and a healthy diet can help with weight maintenance and reduce the risk of cardiovascular disease and metabolic disease—both of which people with psoriatic arthritis have a higher risk of developing, per the RMD Open review. Some research also suggests that eating more anti-inflammatory foods can help promote lower levels of inflammation in the body, though there’s not a lot of strong evidence, the review notes. “The best evidence is for the Mediterranean diet,” says Dr. Abel. “That means focusing on whole grains, legumes, fruits, vegetables, lean meats, and proteins.”

Sleep

Getting good quality sleep may also help with disease management. For one, sleep deprivation affects the hormones that control hunger and satiety, and makes you more likely to overeat and choose unhealthy foods, per the RMD Open review. It also increases cortisol and promotes inflammation.

Do I Still Need to See My Other Doctors?

Short answer: Yes! Your rheumatologist will be your point person for all things psoriatic arthritis, but your other doctors still play an important role in your overall healthcare. For example, you’ll want to see your usual providers for age-appropriate cancer checks, like a pap smear, mammogram, and colonoscopy, Dr. Mandl says.

“You should also see a dermatologist yearly for a skin check, as many of the medications used for psoriatic arthritis increase your risk of non-melanoma skin cancers, including basal cell and squamous cell carcinoma,” Dr. Mandl notes.

Is It Normal to Feel Tired?

Unfortunately, yes. Fatigue is common among people with psoriatic arthritis. One study on fatigue in psoriatic arthritis in the Annals of Rheumatic Diseases found that almost half of all study participants experienced at least moderate fatigue, with over 27% experiencing severe fatigue. Another study on fatigue in psoriasis and PsA in Advances in Dermatology and Allergology also found that 28% of participants with PsA reported severe fatigue compared to 17% of those with psoriasis and 1.6% of the control group with neither condition.

Psoriatic arthritis may cause fatigue directly—constantly fighting inflammation drains your body’s resources—and indirectly, as a result of medication side effects, inactivity, anaemia, depression, and lack of sleep (due to pain). Since fatigue seems to be partially caused by inflammation and pain, getting the disease under control with the proper treatment can help improve your energy levels.

Exercise is also beneficial for combatting fatigue, Dr. Mandl says. “You have to wait until your inflammation is under control, and there is often a lag time between getting the inflammation under control and fatigue getting better,” she notes. “Once you start exercising, ramp up slowly, and don’t be discouraged if you are more tired initially.” Once you adjust to the activity and make it a regular part of your routine, it can be energizing.

“Taking care of one’s mental health is also really important,” says Dr. Abel. “There’s a lot of work being done in rheumatology in general and in psoriatic arthritis specifically about mental health because there’s a lot of overlap between depressive symptoms, fatigue, and psoriatic arthritis,” she explains. “If you’re depressed and don't want to move, that’s going to stiffen the joints. You also get endorphins from exercising, so if you don't do it, you can get depressed, and it’s this vicious cycle.” Seeing a therapist and being treated—either with therapy, medication, or both—for depression symptoms can help with overall psoriatic arthritis symptoms, especially fatigue, Dr. Abel says.

Remember, psoriatic arthritis is a systemic disease, so shoring up your overall health, both physically and mentally, is a great way to improve the condition and help you feel better day-to-day.

https://www.healthcentral.com/condition/psoriatic-arthritis/questions-to-ask-your-doctor

How Do You Advocate for Yourself During Doctor Appointments?

From healthcentral.com

Meaghan Quirin shares how she makes the most of the brief time she has with her rheumatologist 

                                                                                                      Courtesy of Meaghan Quirin

It took me a while to realize that I’m not just a passive participant in my medical care, I’m an active member of the team. When you live with psoriatic arthritis (PsA), you see a lot of doctors, and not every provider is going to check all of the boxes of what you need. That’s why I’ve learned to come prepared and advocate for myself clearly and confidently.

Before any appointment, I jot down a few notes. That might be symptoms I’ve noticed, side effects from a new medication, questions I want to ask, or even just how I’ve been feeling emotionally. I then look back through and prioritize them. Ideally, we’ll get through all of it, but sometimes that’s just not the reality. This way, I get to my most pressing questions or concerns first.

It’s surprising how easy it is to suddenly forget what’s been going on once you’re in the exam room, pair that with brain fog and a bit of jitters, and you’ve got a recipe for not getting what you needed from the appointment. Having a list in front of me helps keep the conversation focused and ensures I don’t leave thinking about what I forgot to mention!

I also try to strike a tone that’s kind but assertive. Two things can be true: I want to be respectful, and I also deserve to be heard. I’ve found that you do catch more flies with honey than vinegar, but that doesn’t mean sugarcoating my symptoms or downplaying what I’m experiencing. I speak honestly, and if something doesn’t feel right, I say so.

Most importantly, I remind myself that doctors work with me, not above me. If a provider dismisses my concerns, brushes me off, or makes me feel small, that’s a red flag, not a reflection of my worth or lived experience. I’m not afraid to ask follow-up questions, push for clarity, or seek more opinions. That’s not being “difficult”, that’s being thorough and protective of my health.

Advocating for yourself takes practice. It can feel uncomfortable at first, especially if you’re used to minimizing your symptoms or being told “it’s just stress” or “you’re too young to be this sick.” But your voice matters. You know your body better than anyone else, and your experience deserves to be part of the conversation.

https://www.healthcentral.com/condition/psoriatic-arthritis/how-do-you-self-advocate-during-doctor-appointments

How to Make the Most of Your Psoriasis Checkups

From everydayhealth.com

Your doctor’s time is precious — and so is yours. Take these steps to speak confidently with your dermatologist and better manage your psoriasis 

If you feel like doctor’s appointments are short, it’s not your imagination. Research shows the average length of a primary care visit is around 18 minutes — hardly enough time to address your health concerns in depth.

But when you’re managing a chronic condition like psoriasis, every minute counts. You want to make sure you have time to share and get all your questions answered. 

Unfortunately, people with psoriasis don’t always get equal face time with their doctors. Research shows that the amount of time dermatologists spend with psoriasis patients may fluctuate based on the individual’s racial and ethnic background. And the findings suggest Asian people with psoriasis receive significantly less time with dermatologists.

Howard Chang, a psoriasis patient advocate and long-time Everyday Health blogger based in California, isn’t surprised by these findings. The son of Chinese immigrants, Chang recalls when both of his parents were diagnosed with psoriasis in 2014. When seeing a dermatologist, “They wouldn't really engage too much,” he notes. “It’s a very cultural thing. Just listen to the doctor, and the doctor is the authority.” 

Language barriers may also be a factor if someone isn’t comfortable speaking English, Chang adds. A lack of communication can lead to worse health outcomes if your doctor doesn’t know how you really feel or how closely you’re following your prescribed treatment regimen. 

That’s why it’s important to take steps to make the most out of every minute you get with your dermatologist.

What to Expect at a Psoriasis Checkup

To maximize each psoriasis check-up, you need to know what to expect.

During each visit, your dermatologist will ask how much of an impact psoriasis has on your day-to-day quality of life. They’ll also ask whether you have any new or worsening symptoms, including joint pain, which can be due to psoriatic arthritis. 

Your dermatologist will likely examine all of your skin. “We’re looking at the psoriasis — not just at the distribution or how much is involved, but also how thick the individual plaques are,” says Marisa Garshick, MD, an assistant clinical professor of dermatology at Weill Cornell Medical Center and dermatologist at MDCS Dermatology in New York City. 

What’s also important is a head-to-toe exam to check for skin cancer, which you may be at higher risk for if you’ve undergone phototherapy for psoriasis. 

If you have ongoing psoriasis symptoms, you’ll also discuss whether you may benefit from a change in treatment. You may even get in-office treatments, such as cortisone injections, to help calm any active psoriasis flares. 

          Developing a good relationship with your dermatologist can help you stay on top of the condition. Adobe Stock

Strategies to Try at Your Next Psoriasis Checkup

Now that you know what to expect, use these steps to get the most out of your next doctor’s appointment for psoriasis:

1. Check in online. Many healthcare systems now offer an online check-in process that you can fill out a day or so before your appointment. This gives you the chance to make any necessary updates to your contact info, pharmacy details, and insurance information. You’ll also be able to review any copays or balances owed to your dermatologist. Filling out this information before your visit can help make your life easier once you get to the appointment. “That way, there are no surprises when you check in,” says Chang.
2. Write down what you want to get out of the visit. This might include asking for medication refills, going over new symptoms, or talking about new treatment options. Chang uses a checklist in the Notes app on his iPhone to keep a running list of questions and answers from his dermatologist visits. “As I go through the appointment, I’ll check things off,” he says. “And the doctor, she knows now about my list, so she’ll point at my phone and say, ‘Anything else?’” 
3. Bring a friend or family member. An extra set of eyes and ears can be a big help. Your loved one can help remember what questions you wanted to ask and what the doctor says, Dr. Garshick notes. If there’s a language barrier, it can be especially helpful to bring along someone who is fluent in English — or ask for an interpreter — to make sure you understand all of the information, she adds.
4. Arrive early. Even if you’ve completed the check-in process online, it can still be helpful to arrive 15 minutes early for your appointment. Having downtime beforehand can be extra beneficial if doctor’s visits tend to stress you out. “If they’re going to do a blood pressure check, it’s nice to get there a little early, so you’re calm by the time they take the measurement,” Chang says.
5. Tell your doctor about every medication you’re taking. That includes any that aren’t for psoriasis, as some treatments for other conditions can actually worsen psoriasis. “Beta-blockers (which are sometimes used for blood pressure or heart rate), some antimalarial medications, and coming off of steroids can all trigger psoriasis,” says Garshick. Also, tell your dermatologist if you’ve just had an infection or were recently on antibiotics, which can contribute to psoriasis.
6. Be honest about how you’re feeling. Your dermatologist can’t help you if they don’t know what’s going on — even if it doesn’t seem related to your skin. “Reflect on anything that feels new or different for you,” says Garshick. That includes whole-body symptoms, such as fatigue, or joint pain. “Your dermatologist may not be able to address all your symptoms, but they might be able to guide you on whether or not certain things are connected to psoriasis or not,” she notes.
7. Speak up if something isn’t working for you. “I used to be ashamed if I wasn’t following the doctor’s orders perfectly,” says Chang. “Let’s say I was supposed to apply an ointment twice a day, and I was doing it every other day instead. I didn’t want the dermatologist to be upset with me, so I might not tell her. But in the end, it’s your health. If you’re not able to follow instructions, there may be something else you can do.” So, speak up and be honest with your doctor. 
8. Get your to-dos in writing. Ask for a written summary of the visit, so you can confirm exactly what you’re supposed to do, including your treatment plan and when to schedule your next visit. “If you’re just learning about psoriasis medicines, ask for brochures,” Garshick says. You can also research medication options on the National Psoriasis Foundation (NPF) website, she adds.
9. Take advantage of the patient portal between visits. If you need time to process what your dermatologist says or to ask questions after the visit, you can often do so through your healthcare system’s online patient portal. “Sometimes, in the moment, you forget something you want to ask, or you feel like it’s hard to say something,” says Chang. Sending your doctor a message through the patient portal is a good way to follow up.
10. Follow your treatment plan. Chang has found that following his psoriasis treatment plan exactly as prescribed allows him to see if a specific treatment really works for him. It’s also helped strengthen his relationship with his dermatologist. “If something’s not working out, I can say, ‘Hey, I did this, and I’m thinking of trying that now,’” he says. “Your doctor is likely more willing to consider what you want when you’ve already built trust by doing what you’ve agreed to do before.”
11. Take time after your visit to think about what feels best to you. “Remember that psoriasis is a chronic condition. So find a doctor that you feel comfortable with, so you can establish a long-term relationship,” says Garshick. If you aren’t seeing results or you feel uncomfortable with your doctor, don’t be afraid to try someone else. “Not all dermatologists are specialized in certain kinds of psoriasis or are up on the latest medications,” says Chang. “If you can’t work with your doctor, or they don’t have the expertise you need, then you might need to make a change.” The NPF has a directory of doctors who specialize in treating psoriasis. 

For more tips on how to make the most of your check-up, download the NPF Appointment Prep Kit.

https://www.everydayhealth.com/psoriasis/how-to-make-the-most-of-your-psoriasis-checkups/

What Kind of Doctor Treats Psoriatic Arthritis?

From healthcentral.com

Rheumatologists and dermatologists are the primary doctors for this condition, but you may require additional experts to treat PsA complications

You may know psoriatic arthritis (PsA) as a joint and skin condition, but this disease can cause symptoms from head to toe. The unpredictable nature of psoriatic arthritis symptoms that can come and go without explanation is frustrating. So it’s no surprise that managing your condition may require a team of health care experts with varying skills. Rheumatologists and dermatologists may end up being your go-to PsA providers, but you may recruit others to your team in order to reach your wellness goals.

Some of the various psoriatic arthritis doctors and other experts you may work with to treat this complex condition include:

• General Practitioner (overall health care)

• Cardiologist (heart specialist)

• Dermatologist (skin specialist)

• Gastroenterologist (gut specialist)

• Nutritionist (diet specialist)

• Occupational Therapist (everyday activity specialist)

• Ophthalmologist (eye specialist)

• Physical Therapist (movement specialist)

• Psychologist (mental health specialist)

• Rheumatologist (autoimmune specialist)

Let’s take a closer look at the professionals you’ll be relying on most and how they may be able to help you better manage your psoriatic arthritis.

Primary Care Providers

It’s likely that before your PsA diagnosis, you had a general practitioner (a.k.a. GP or family doctor) who you saw on a regular basis. With a psoriatic arthritis diagnosis, it’s important to continue your relationship and not to lose contact with your GP, says Eric Ascher, M.D., a family medicine physician at Northwell Lenox Hill Hospital in New York City.

“Your general practitioner will keep a large and detailed history so they are able to ensure your other medical conditions are being monitored and be sure your medications will not interact with psoriatic arthritis treatment plans from specialists, like a rheumatologist,” he explains. Your general practitioner will likely see you in closer intervals than you see your specialists, Dr. Ascher adds, so they will able to keep close tabs on your treatment.

Research suggests that strong communication with your doctor improves treatment outcomes, and that starts with your primary care doctor. “One of the most important reasons to follow up with a primary care doctor is for the physician-patient relationship,” says Dr. Ascher. “Patients will likely feel comfortable sharing and opening up.”

Rheumatologists

Rheumatologists are medical doctors who completed extra training in the diagnosis and treatment of musculoskeletal and autoimmune diseases (a.k.a. rheumatic diseases). Their role in the care of your psoriatic arthritis is to diagnose what type of disease you have and then treat it with nonsurgical methods, according to the American College of Rheumatology. Because psoriatic arthritis medications often require a trial-and-error process, your rheumatologist will follow your progress throughout the year to determine if any change in your treatment is needed.

Dermatologists

Psoriatic arthritis affects about one in three people with the skin condition psoriasis. This means that there is a good chance your skin is involved in your PsA symptoms. A dermatologist is a medical doctor who specializes in skin, hair, and nail issues, so if you had psoriasis first, your dermatologist may also have been the first to diagnose your psoriatic arthritis. If you start a new treatment for your psoriatic arthritis, you’ll want to keep your dermatologist in the loop to monitor your skin, hair, and nails.

Other Doctors Who Treat Psoriatic Arthritis

Along with your core team of medical experts, you may need to branch out and include one of these providers in the mix, depending on your psoriatic arthritis symptoms.

Cardiologist

The inflammation that you feel in your joints may also impact your cardiovascular system. That’s why individuals with psoriatic arthritis have a greater risk of cardiovascular disease and more cardiovascular risk factors such as hypertension, diabetes mellitus, and obesity. This means that even if you are relatively young with PsA, a regular check-in with a cardiologist, or heart doctor, may be necessary.

Gastroenterologist

People with psoriatic disease have a up to a four-fold increased risk of inflammatory bowel disease (IBD) compared to the general population, according to the journal Frontiers. The likely reason: The same inflammatory response that is triggered by your immune system to cause PsA symptoms is also responsible for aggravating your digestive system in conditions like Crohn’s or ulcerative colitis. A gastroenterologist is trained to diagnose and treat digestive diseases, including these types of IBD.

Ophthalmologist

Ophthalmologists are medical doctors who treat conditions of the eye. Bringing an ophthalmologist onto your health care team may be beneficial. Over 40% of people with psoriatic disease develop uveitis (a.k.a. inflammation of the eye) during their lifetime. So it’s important when you go for your regular eye exam to let your eye doctor know that you have PsA.

Who Helps With Daily Psoriatic Arthritis Challenges?

Beyond regular check-ups with your general practitioner and specialty health care providers, there are resources available to help you manage the day-to-day challenges of your condition.

Psychologist

“Mental health providers can make a big difference for those with chronic diseases like psoriatic arthritis,” says Naomi Torres-Mackie, M.D., a clinical psychologist at Northwell Lenox Hill Hospital in New York City. Dr. Torres-Mackie says that adjusting to a chronic medical diagnosis can be difficult, and therapy is known to be effective in this area. “Psychotherapists can help those with PsA learn coping skills to manage social or generalised anxiety, depressive feelings, and/or low self-image associated with their diagnosis,” she explains.

Who should you look for to join your team? Dr. Torres-Mackie recommends social workers, mental health counsellors, psychologists, and psychiatrists who have training in psychotherapy for mental health symptoms related to chronic illness.

Physical Therapist

Physical therapists can help you improve your movement and manage pain. A 2022 review of physical therapy for psoriatic arthritis concluded that physical therapy helped people with PsA improve their strength, cardiovascular condition, and range of motion, while decreasing pain associated with the chronic disease. Your general practitioner may have a recommendation for a physical therapist. The American Physical Therapy Association also has a locator option on their website.

Nutritionist

Gut conditions, intestinal inflammation, and psoriatic arthritis are linked together, says Megan Hilbert, R.D.N., with Top Nutrition Coaching in Madison, WI. “If you have PsA, a registered dietitian can help you determine what foods can promote inflammation in your body—like added sugars, fried foods, refined carbohydrates—and what foods can help reduce inflammation, like dark leafy greens, nuts or seeds, and berries,” she says.

Changes in eating habits can be an overwhelming thought for many people, which is why a registered dietitian may be useful on your team. “A registered dietitian can also help come up with an individualized diet for you that can help remove trigger foods and promote a healthy gut microbiome,” Hilbert explains. How do you get started? Hilbert suggests reaching out to your general practitioner for a referral or checking out the Academy of Nutrition and Dietetics locator to find an expert who may be a good match for you.

Why Do You Need More Than One Doctor for Psoriatic Arthritis?

Psoriatic arthritis is a chronic and progressive condition that can extend beyond your skin and joints. That’s why a multidisciplinary approach is essential for the best health outcomes. From dermatologists to cardiologists, each provider can bring the latest knowledge in their field to ensure that all of your concerns are being addressed.

How to Choose the Right Doctors

Your go-to providers will be the first resources to help you build your health care team. Talk with your GP, rheumatologist, and dermatologist about your needs: They will know your medical history and personal preferences better than anyone. And don’t forget to ask the nurses in their offices for recommendations—they often have their ears to the ground and can tell you what they have heard. Your insurance provider may also be a good resource to determine which specialty providers are both nearby and participate in your plan.

https://www.healthcentral.com/condition/psoriatic-arthritis/doctor-psoriatic-arthritis