Pain is a key symptom of psoriasis and psoriatic arthritis (PsA). Part of successfully treating psoriatic arthritis means lowering pain levels so that a person can function as best as possible. To find the best solution for you or your loved one, it’s important to understand why psoriatic arthritis causes pain and learn about your treatment options.

Pain in Psoriatic Arthritis

Many people diagnosed with psoriatic arthritis experience joint pain. In some cases, this pain interferes with daily tasks and affects quality of life.

As one MyPsoriasisTeam member wrote, pain can be accompanied by other joint symptoms, like stiffness: “I woke up in lots of pain. My wrists are very tight, and my hand is stiff,” they said. “I can barely make a fist.” Another member shared that their pain was particularly difficult to manage, writing, “I’ve been in a lot of pain for weeks now, and nothing — as in painkillers — seems to take away the pain.”

Psoriatic arthritis can affect any part of the body where you have a joint or where connective tissues (ligaments and tendons) connect to your bones. As a result, PsA pain can strike in many different locations.

Members on MyPsoriasisTeam experience psoriatic arthritis pain throughout their bodies. As one wrote, “I didn’t recognize that the pain running from the tops of my shoulders down my biceps was because of inflammation. I couldn’t figure out why they hurt all the time.” One member shared that they had pain in their lower back and hips, while another described experiencing pain in their fingers, toes, knees, wrists, and neck.

What Causes Pain in Psoriatic Arthritis?

Like other psoriatic arthritis symptoms, pain from psoriatic arthritis occurs because of inflammation, which can be systemic, meaning it occurs throughout the body. With inflammatory arthritis like psoriatic arthritis, this pain is especially notable in the joints and, in some cases, may cause the joints to become extremely swollen.

The inflammation in psoriatic arthritis is caused by an abnormal immune system response. In people with PsA, the body attacks its healthy tissues (called an autoimmune response) instead of just foreign invaders, like viruses and bacteria. These immune attacks cause the inflammation — and subsequent pain — that people with PsA experience.

Managing Pain With Psoriatic Arthritis

There are many ways of managing pain related to psoriatic arthritis. Some of these strategies involve lifestyle changes or at-home remedies. Others involve taking medications under the supervision of your doctor or rheumatologist.

Medications

Your doctor may recommend or prescribe medications to help manage your pain and treat the underlying disease.

Systemic PsA Medications

One of the first steps to manage pain with PsA is treating underlying arthritis. Treatment of psoriatic arthritis often involves systemic medications, including disease-modifying antirheumatic drugs (DMARDs), immunosuppressants, and biologics.

These medications work in a variety of ways to suppress all or part of the immune response that is causing your inflammation. Some options include:

• Methotrexate
• Sulfasalazine
• Humira (adalimumab)
• Enbrel (etanercept)
• Stelara (ustekinumab)

You may need to try several treatments before finding the one that works for you with the fewest side effects.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) are often the first line of defense against pain associated with psoriatic arthritis. These medications work by reducing inflammation throughout your body. Both over-the-counter and prescription options are available.

Steroid Injections

If you have a particular joint that is causing a lot of pain, your doctor may recommend steroid injections into the affected joint. Corticosteroids reduce inflammation in painful, swollen joints quickly and effectively, but they are typically only used in the short term.

At-Home Management and Lifestyle Changes

There are several ways you can manage your PsA pain at home without medication or alongside the medications you take.

Exercise

It might be hard to exercise with psoriatic arthritis, but there are many ways you can move your body. Physical activity can help reduce or manage pain by keeping your painful joints mobile even when they are inflamed, which makes moving easier.

Exercise can also help improve your sleep and reduce your stress, both of which make psoriatic arthritis easier to bear. Even if you are hurting, you may feel better if you are getting more rest and easing your stress.

Sometimes, exercise makes a major difference. As one member shared, “I’ve improved my diet, and I’m still getting plenty of exercise. As a result, I’ve been condition-free for the best part of a year now.”

Hot and Cold Therapy

Applying heat, cold, or both to your joints may help reduce inflammation and pain. The two have different benefits: heat can help loosen stiff muscles and joints, whereas cold can help reduce pain and inflammation. You may need to experiment to find out what works for you.

Weight Loss

Being at a healthy weight could make you feel quite a bit better. A 10 percent weight loss in people who are overweight or obese could be as beneficial as adding a brand new treatment to their arsenal. Conversely, carrying extra weight may increase the activity of PsA and makes it less likely that you will respond well to medications for PsA.

One member wrote, “Weight loss has made a huge difference to me and how I cope with this condition.”

Other Pain Management Therapies

Acupuncture and physical or occupational therapy may help you manage and reduce pain associated with psoriatic arthritis.

Acupuncture

Several studies have shown that acupuncture can be an effective complementary way of managing PsA-related pain. In addition to working well for some people, this treatment generally has no negative side effects to worry about.

Acupuncture has helped some members. As one explained, “I am doing acupuncture treatment and [Eastern] medicine. It seems to be helping.”

Physical and Occupational Therapy

Physical and occupational therapists can help you learn to move differently to reduce your pain. Physical therapists focus on finding exercises and stretches that make you feel better. Occupational therapists help you learn to do everyday tasks in ways that don’t cause you as much pain.

Joint-Protection Devices

If PsA-related joint damage is causing you pain, braces, splints, and other forms of joint support could help you feel better. They can help stop a joint from moving in ways that are painful for you.

Make sure you get the right fit for any device you choose to use. Your health care provider may want to fit you themselves or have a physical therapist assist with fitting.

Surgery

A variety of surgical procedures — including joint replacement surgery — may be considered when other treatments have failed or when joint damage has become severe.

Get Support Today

MyPsoriasisTeam is the social network for people with psoriatic disease and their loved ones. Here, more than 91,000 members from across the globe come together to ask questions, share stories, and find support from others who understand life with psoriasis and PsA.

How do you manage PsA-related pain? Share your thoughts and tips in the comments below or by posting on MyPsoriasisTeam.