Like many chronic conditions, psoriatic arthritis (PsA) isn’t something you manage just once. Your psoriatic arthritis treatment journey might be more of a marathon than a sprint, with a few unexpected twists and turns along the way. In fact, nearly half of people with psoriatic arthritis describe the process of finding the right treatment as either somewhat or very difficult, according to an April 2021 survey by SELF and Olson Research Group of 203 people who live with the condition.
But keeping your psoriatic arthritis well managed is both possible and crucial. “PsA is an auto-inflammatory destructive musculoskeletal condition,” Ronald Yglesias, MD, a rheumatologist based in Aventura, Florida, tells SELF. “If not treated properly, it can lead to permanent damage of the ligaments, tendons, and joints, which can further progress to chronic pain, osteoarthritis, disability, and a decreased quality of life.”
That may sound intimidating, but the good news is that treatment options are out there. In our survey, 32% of people said they were very satisfied with their treatment plan, while another 44% said they were somewhat satisfied. So if you haven’t found the right fit just yet, try not to lose hope.
It can take time to find the right medication that works for you, Clifford Stermer, MD, a rheumatologist with Presbyterian Medical Group, tells SELF. In fact, he says he meets with his PsA patients every 90 days until they find a treatment plan that works for them.
“Often we try one and need to switch because the medication doesn’t work or isn’t tolerated due to side effects,” he says. “The good news is we have many medications and combinations of medications to use.”
If it’s been a while since you spoke with your rheumatologist, or you’re experiencing a flare and wondering if it’s time to rethink your psoriatic arthritis treatment plan, here are some questions to help you figure out if your psoriatic arthritis is well managed—or if it’s time to schedule an appointment to discuss your options.
1. Do you have more “bad” symptom days than “good” ones?
You’re probably familiar with the main symptoms of psoriatic arthritis: joint pain and stiffness, swollen and painful fingers and toes, limited mobility, and fatigue. Because not everyone experiences psoriatic arthritis the exact same way, the severity of your symptoms and where they happen can vary. But the ultimate treatment goal for people with PsA is low disease activity and, if possible, remission, says Dr. Stermer. To that end, rheumatologists expect to gradually see your unique symptoms improve when you’ve found the right psoriatic arthritis treatment.
Everybody with PsA has “good” days and “bad” days, even when the disease is being treated, says Dr. Yglesias. He frequently asks people with PsA about their joint symptoms on a spectrum of severity to determine how well their current treatment is working for them. “As a general guideline, joint symptoms should improve with less joint and back pain, swelling, and stiffness.”
2. Is your skin or nail disease flaring up?
When you have psoriatic arthritis, managing joint pain and stiffness might be at the top of your to-do list. But skin or nail changes are also something to pay attention to and bring up with your doctor. The experts SELF spoke to agree that psoriatic history is always important, which is why they ask their patients if they’ve had recent skin flares or nail changes.