People with psoriatic spondylitis may experience pain, inflammation, and stiffness in their neck and lower back. It can also affect the sacroiliac joints in the pelvis. Over time, the condition may make it more difficult for a person to move their spine.
How common is it?
Psoriasis is one of the most common autoimmune diseases in the United States, affecting more than 8 million people in America, according to the National Psoriasis Foundation (NPF).
Psoriatic spondylitis causes symptoms that are similar to other forms of arthritis that affect the spine and the sacroiliac joints in the pelvis, such as ankylosing spondylitis and reactive arthritis.
stiffness in the back or neck that improves when moving around
stiffness made worse by periods of staying still, such as sleep
trouble bending or moving the back
Medical treatments aim to keep inflammation under control and prevent long-term joint problems and damage. Medication can also reduce a person’s risk of heart disease that can occur due to inflammation.
The condition tends to run in families.
Blood tests can detect whether a person carries the HLA-B27 gene. However, testing positive for the HLA-B27 gene does not mean a person will get psoriatic spondylitis. Other genes may cause psoriatic spondylitis.
inflammation of the eyes, known as uveitis
Not every person who has psoriatic spondylitis will experience these complications. The best way to prevent complications occurring is to receive prompt treatment and follow a doctor’s recommendations.
The NPF website has an online quiz that people can do to help them work out whether they may have psoriatic arthritis. Anyone who thinks they may have the condition can visit their doctor to find out more.
They may also use a variety of other tests to determine whether a person has psoriatic spondylitis. Firstly, they rule out other types of arthritis and other causes of back pain. This is important because treatment for psoriatic spondylitis and other types of arthritis are different.
Doctors may also use imaging tests, such as X-rays, MRI scans, ultrasounds, and CT scans to look at the bones and joints in the spine.
Doctors also do blood tests to help diagnose psoriatic spondylitis because people with this condition can have high levels of inflammation in the blood. People who have psoriatic spondylitis also may have lower red blood cell counts.
The aim of treatment for psoriatic spondylitis treatment is to prevent damage to the bones and joints, help a person manage symptoms, and achieve remission. Remission means a person has no symptoms and the disease is not getting worse.
However, people will need to use medications long-term to stay symptom-free.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve mild psoriatic spondylitis pain, reduce inflammation, and relieve stiffness. However, NSAIDs can have side effects, such as stomach bleeding and kidney impairment, especially when a person takes them for long periods. Talk to a doctor about how to use NSAIDs safely.
NSAIDs include ibuprofen, naproxen, and aspirin, as well as prescription options.
Disease-modifying antirheumatic drugs
Disease-modifying antirheumatic drugs (DMARDs) control inflammation or the body‘s overactive immune response. They can help relieve symptoms of psoriatic spondylitis and prevent damage to joints. A person may take them as a pill or get an injection.
DMARDs include the following classes of drugs:
drugs that suppress the immune system response, such as methotrexate, azathioprine, leflunomide, and cyclosporine
biologics, which target specific immune cells to reduce inflammation
Biologics are a newer, more targeted therapy than DMARDs. Doctors administer this medicine through injections. Biologics work by interfering with natural immune pathways, mimicking the natural molecules, and reducing inflammation.
tumor necrosis factor-alpha (TNF) inhibitors, including etanercept, adalimumab, and infliximab
T-cell inhibitors, such as abatacept
other inhibitors target specific inflammatory proteins, such as ustekinumab, secukinumab, and ixekizumab
Not everyone will need biologics as a primary treatment. Biologics may increase a person’s risk of infection or cause specific side effects, such as flu-like symptoms or airway infections. Rarely, they can cause blood disorders, cancer, and other autoimmune symptoms. Talk to a doctor about the benefits, risks, and costs of biologics.
Corticosteroids are powerful anti-inflammatory drugs. A person may take a corticosteroid pill such as prednisone, or a doctor may inject the medicine directly into the affected joint. These can provide short-term relief.
Doctors usually prescribe corticosteroids to treat severe severe flares until other medication, such as biologics or DMARDs, start to work.
Corticosteroid medication can have side effects that include weight gain, osteoporosis, and high blood pressure. Psoriasis may flare up when a person stops using steroids.
Small molecule medications
Exercise helps lessen the inflammation around the joints and helps to relieve pain. Stronger muscles also help support the joints, putting less stress on them.
A physical therapist can recommend specific stretches and exercises to help a person who has psoriatic spondylitis. An occupational therapist can recommend ways that a person can prevent joint stress and suggest how they can adapt their work environment to reduce pain and injury.
Some home remedies may also be useful for milder cases.
Partaking in low-impact exercise, such as biking, can help keep joints flexible.
Using home remedies for psoriatic spondylitis can help ease symptoms. These remedies work alongside a doctor’s treatment plan. Follow a doctor’s advice on medications or other treatments to avoid future bone and joint damage.
Exercise. Being active can help keep joints flexible. It can also help people maintain a healthful weight, which can take pressure off painful joints. Exercise boosts endorphins, which may help improve a person’s emotional well-being. Walking, biking, yoga, and Tai Chi are good low-impact choices. Some people find swimming to be easier on painful joints.
Follow a regular sleep schedule. Fatigue can make psoriatic spondylitis symptoms feel worse. It can also trigger more inflammation in the body. Focus on getting enough sleep and maintaining a regular bedtime.
Know the triggers. Keep a journal with foods, activities, and life events and write down when the psoriatic spondylitis gets worse. This can help identify the causes of flares so that people can avoid them in the future.
Try acupuncture. A recent meta-analysis found that acupuncture was an effective option for reducing chronic musculoskeletal pain.
Get a massage. A licensed massage therapist may use a variety of techniques to relieve tension and loosen stiff joints. Make sure the massage therapist has experience in treating people with psoriatic spondylitis or arthritis.
Eat an anti-inflammatory diet. Nutritious whole foods can help fight fatigue. A Mediterranean Diet can help fight inflammation. Learn more about anti-inflammatory foods here.
Many people find the symptoms of psoriatic spondylitis challenging, but with the variety of treatments available today, many people can manage their symptoms, prevent further joint damage, and carry out normal activities.
While there is no cure for psoriatic spondylitis, a person can keep symptoms under control with the help and guidance of their healthcare team. Following an effective treatment plan can help people with psoriatic spondylitis lead healthy and active lives.