Psoriatic Arthritis

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Latest Edit: General 2014-02-19 (EDT)

Psoriatic arthritis is an autoimmune condition that is characterized by the presence of both psoriasis and inflammatory arthritis. It involves the spine and peripheral joints and has been found to occur in 5-10% of the population who have psoriasis.[1],[2]


Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With psoriatic arthritis, the causes are variable and include lifestyle and environmental factors. A detailed assessment is required to determine which factors are contributing to psoriatic arthritis.


Lifestyle

  • Food allergies and sensitivities can contribute to the development of this disease. In particular, gluten-containing products, dairy products, and beef.[1]
  • Among 5-30% of individuals with psoriasis have been found to develop psoriatic arthritis.[3]

Social

  • Mental Emotional Health
  • Emotional stress may exacerbate and increase the risk of psoriasis[4]

Environmental

  • Bacterial infection such as a streptococcal infection has been found to be a trigger[5]

External

  • Trauma
  • Injury to the skin such as a skin infection, skin inflammation, or excessive scratching has been found to be associated with psoriasis

Medical Interventions

  • Prescription Medications
  • Drugs such as Lithium, beta-blockers, and antimalarials can aggravate psoriasis[6]

Physiology

  • Immune system
  • Certain changes to the immune system, such as a decrease in the number of helper T cells in people with AIDS (HIV infection) can play a role in the development and progression of psoriasis[7]

Diagnostic Testing

  • A diagnosis of psoriatic arthritis requires the presence of psoriatic skin disease. However, the arthritis may precede or occur at the same time as the akin disease.
  • The Classification Criteria for Psoriatic Arthritis (CASPAR criteria) may assist in making a diagnosis.[2]
  • diagnostic laboratory tests currently exist specifically for psoriatic arthritis. The tests that are done are mainly to rule out other possible diagnoses. These test include Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid factor (RF), HLA-B*27 test, and Uric acid test.[2]
  • Radiologic findings may also suggest inflammatory arthritis, some of which are particular to psoriatic arthritis.[2]

Related Symptoms and Conditions

Conditions associated with Psoriatic arthritis or that predispose a person to the disease include:[2]

Characteristics

Psoriatic arthritis is an inflammatory disease that involves the spine and the peripheral joints. It is characteristically asymmetric and can involve five or more joints, displaying 'sausage digits' or dactylitis.

Symptoms associated with psoriatic arthritis include:[2]

  • Rash; skin or scalp lesions
  • Morning stiffness and lethargy
  • Pain, heat, and joint tenderness (often restricting hand dexterity)
  • Back stiffness and pain
  • Nail lesions (occur in 90% of patients with psoriatic arthritis)
  • Complaints of hand or foot deformity
  • Painful, red eyes

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Psoriatic arthritis is typically a chronic disease.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Moisturizing: This prevents the skin from dyring, cracking, and bleeding.
  • Bathing: Immersing yourself in water or applying a wet compress to affected areas can help rehydrate dry skin and reduce itching and redness of lesions. As well, it can help ease joint stiffness.
  • Humidifying: Dry indoor air is associated with dry skin. Therefore, having a humidifier indoors can help prevent humidity.
  • Avoiding personal care products: Avoid harsh soaps or irritating skin products that can exacerbate Psoriasis

Lifestyle

Lifestyle recommendations include:

  • Engage in low intensity exercises with awareness of joint preservation techniques. Be advised to not use a painful joint or to overuse a fatigued joint. During remissions, ensure joints are kept as active as possible.
  • Breathing Deep breathing or meditation can help reduce stress and in turn, reduce flareups
  • Sleep Adequate sleep is necessary to maintain a robust immune system
  • Rest and Relaxation are important to prevent overexertion and progression of psoriatic arthritis

Naturopathic Therapies

The prescribing of naturopathic therapies requires the guidance of a naturopathic doctor as it depends on a number of factors including the causal factors, a person's age, prescription medications, other conditions and symptoms and overall health. It is always advisable to work with a naturopathic doctor prior to taking any natural therapies.

Naturopathic Therapies for Psoriatic arthritis include:[1]

  • Herbs such as Curcuma longa, Urtica dioica

References

  1. 1.0 1.1 1.2 Gaby, Alan R. (2011)Nutritional Medicine, Fritz Perlberg Publishing, Concord, NH
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Psoriatic arthritis: MD Consult, Retrieved February 13, 2014 from http://ezproxy.ccnm.edu:2066/das/pdxmd/body/437832117-2/0?type=med&eid=9-u1.0-_1_mt_1014911&tab=P
  3. 3.0 3.1 Boehncke, W.H., Boehncke, S.(2013)Comorbidities in psoriatic arthritis,Zeitschrift fur Rheumatologie;72(8):779-783
  4. Harvima, R.J., Viinamaki, H., Harvima, I.T., Naukkarinen, A., Savolainen, L., Aalto, M.L., Horsmanheimo, M.(1996)Association of psychic stress with clinical severity and symptoms of psoriatic patients,Acta dermato- venereologica;76(6):467-71.
  5. Muto, M., Date, Y., Ichimiya, M., Moriwaki, Y., Mori, K., Kamikawaji, M., Kimura, A., Sasazuki, T., Asagami, C.(1996)Significance of antibodies to streptococcal M protein in psoriatic arthritis and their association with HLA-A*0207,Tissue Antigens;48(6):645-650
  6. Wolf, R., Ruocco, V.(1999)Triggered psoriasis,Advances in Experimental Medicine and Biology;455:221-225
  7. Arnett, F.C., Reveille, J.D., Duvic, M.(1991)Psoriasis and psoriatic arthritis associated with human immunodeficiency virus infection,Rheumatic Diseases Clinics of North America;17(1):59-78
  8. Wu, S., Li, W.Q., Han, J., Sun, Q., Qureshi, A.A.(2014)Hypercholesterolemia and Risk of Incident Psoriasis and Psoriatic Arthritis in US Women,Arthritis & Rheumatology;66(2):304-310
  9. Love, T.J., Zhu, Y., Zhang, Y., Wall-Burns, L., Ogdie, A., Gelfand, J.M., Choi, H.K.(2012)Obesity and the risk of psoriatic arthritis: a population-based study,Annals of the Rheumatic Diseases;71(8):1273-1277
  10. Murray Michael (1996) Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing