Between appointments with your healthcare provider and online research, you feel confident in your knowledge of psoriatic arthritis (PsA). You might be surprised to learn that some popular beliefs about the disease, which affects up to 30% of the 7.5 million Americans living with psoriasis, are not true at all.
“There is a lack of understanding about the nature of this disease,” explains Eric L. Matteson MD, professor of medicine in the division of rheumatology at Mayo Clinic in Rochester, MN.
Learn the truth behind five popular psoriatic arthritis myths.
Myth: If you have psoriasis, you will get psoriatic arthritis.
Fact: Fewer than one-third of those with psoriasis are diagnosed with psoriatic arthritis.
While psoriasis – which causes red, scaly patches (called plaques) on the skin – and psoriatic arthritis are both inflammatory conditions, there is no guarantee that being diagnosed with the skin condition will cause your immune system to start attacking the joints. In fact, it’s possible to be diagnosed with PsA even if you don’t have skin psoriasis.
“If you have psoriasis, it’s important to get screened for psoriatic arthritis,” says Joseph F. Merola, MD, co-director of the Center for Skin and Related Musculoskeletal Diseases at Brigham and Women’s Hospital and assistant professor at Harvard Medical School in Boston. “Psoriatic arthritis is a risk but it’s not inevitable.”
Myth: There is a test to diagnose PsA.
Fact: It’s not that simple.
Doctors often make a diagnosis based on a physical exam and description of the symptoms, which can include joint stiffness, psoriasis/skin disease and blood work to detect elevated inflammatory markers. In some cases, x-rays of the joints and spine (to assess joint damage or disease progression) are also used to diagnose PsA.
It’s important to get screened because, as Dr. Merola notes, “Early diagnosis is associated with better outcomes.”
Myth: Psoriatic arthritis affects mostly women and older adults.
Fact: The disease can develop at any age. Most people with PsA are diagnosed between the ages of 30 and 50.
“It can be especially debilitating because it affects people in their prime,” says Dr. Merola.
Although a midlife diagnosis is most common, children and seniors can also be diagnosed with psoriatic arthritis. Unlike other autoimmune diseases, which affect a disproportionate number of women, PsA affects men and women in equal numbers.
Myth: PsA is a severe, debilitating disease.
Fact: Psoriatic arthritis is a chronic condition but there is no typical presentation. Some people have occasional, mild flares while others experience more severe symptoms.
Testing might offer a clue: Dr. Merola notes that those with elevated inflammatory markers or severe cases of psoriasis – especially plaques on the nails, scalp or in body folds like the armpits or groin – may be more prone to severe PsA.
Although there may be a correlation between the severity of the skin disease and the severity of PsA, Dr. Merola notes, “Unfortunately, it’s not easy to predict who’s going to have a mild course and who will have a more severe course.”
Myth: PsA only affects the joints.
Fact: PsA affect the joints but it may also cause a range of other symptoms, including fatigue, swelling of the fingers and toes and inflammatory eye disease, called uveitis. Although PsA can have widespread impact on the body, a diagnosis doesn’t have to mean lifelong poor health.
“It’s untrue that having PsA invariably leads to joint destruction and disability,” Dr. Matteson adds. “Even though there is no cure, there are effective treatments for this disease.”
Myth: Medication is the only treatment for PsA.
Fact: There are several effective medications for PsA, including traditional disease-modifying antirheumatic drugs and biologics, such as methotrexate, etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira). But there are also lifestyle modifications that can help manage the disease, according to Dr. Matteson.
“As with all forms of arthritis, exercise keeps the muscles strong, which supports the joints,” he notes. “Diet is also important [because] being overweight is a major stressor for joints.”
A 2014 study published in Annals of Rheumatic Diseases found that overweight patients with PsA who lost at least 5% of their body weight while taking immune-blocking meds reduced the severity of their PsA symptoms.
- What is Psoriatic Arthritis?
- Psoriatic Arthritis and Eye Complications
- How Common is Psoriatic Arthritis in People With Arthritis?