While there is no official classification, psoriatic arthritis does progress through distinct stages. However, not everyone will experience all stages or phases, and even the severity of the disease can vary. To learn more about this condition and what to expect, here’s everything to know about the stages of psoriatic arthritis.
Pre-Psoriatic Arthritis
Psoriasis can serve as one of the first signs of psoriatic arthritis, says WebMD. Approximately three out of every 10 individuals who suffer from psoriasis may eventually develop psoriatic arthritis, as per estimates, adds the source.
Although not a prerequisite, psoriasis frequently precedes psoriatic arthritis. However, there is a bright side to this correlation. If a patient already has psoriasis, it simplifies the process of diagnosing psoriatic arthritis, which can mimic other medical conditions.
Early Stages of Psoriatic Arthritis
The first signs of psoriatic arthritis usually appear several years after the initial presence of psoriasis symptoms. According to Healthline, the risk of developing psoriatic arthritis increases for people with psoriasis on their fingernails, scalp, a family history of psoriatic arthritis, and if they are between the ages of 30 and 50.
Similar to other types of arthritis, psoriatic arthritis typically begins with pain and swelling in one or more joints, primarily the smaller joints on the fingers and toes, explains Healthline. Although larger joints such as the knees and ankles may also be affected. Individuals might also notice swelling in their fingers or toes, both the joint and the entire digit.
How it Progresses
The first signs of psoriatic arthritis can vary from person to person, and the condition progresses differently. If left untreated, it typically begins to impact more joints, potentially affecting the same joints on both sides of the body, says Heatlhline.
Sometimes individuals experience complete remission even without treatment, but this is rare. As the condition progresses, periodic flare-ups of symptoms are common. If left untreated, the source warns that psoriatic arthritis can cause permanent bone damage. This is a result of prolonged inflammation that erodes the bones. Additionally, the joint space may narrow, ultimately making movement more challenging.
Long-Term, Active Disease
As time progresses, WebMD warns that psoriatic arthritis can inflict lasting harm on joints. Chronic inflammation leads to joint deformity in small joints, such as fingers and toes and has the potential to impose significant limitations on activities. This is not only distressing but can also increase pain. Insufficient physical activity leads to joint stiffness and muscle weakness.
Apart from joint issues, psoriatic arthritis raises the likelihood of developing other medical conditions, including anemia (low red blood cell count), high blood pressure, high cholesterol, and obesity, adds the source.
Later Stages
Psoriatic arthritis can progress to later stages that entail various complications, such as flare-ups affecting daily activities, says Medical News Today. For example, one complication individuals may develop is axial spondyloarthritis of psoriasis. This is when spinal joints become inflamed and may eventually fuse, leading to a fused spine.
They can also develop permanent bone damage and structural deformities that limit joint mobility. Medical News Today also warns about metabolic syndrome, characterized by obesity, high blood pressure, and unhealthy cholesterol levels.
Lastly, psoriatic arthritis has been linked to cardiovascular disease. In fact, a 2017 meta-analysis found that individuals with psoriatic arthritis may have a 43-percent higher risk of developing heart disease compared to the general population.
Remission
Thanks to the availability and effectiveness of medications, managing this disease is easier than ever. According to WebMD, the most common medications are disease-modifying antirheumatic drugs (DMARDs), immunosuppressants, TNF-alpha inhibitors, and newer drugs for plaque psoriasis, such as apremilast and secukinumab.
It is possible to find a medication that works right away, but sometimes people have to try different ones before noticing a difference. Once on an effective treatment plan, improvements typically happen within a year, explains the source. In fact, some research indicates that up to 60-percent of psoriatic arthritis patients can achieve “minimal disease activity” after taking biologic drugs for a year.
It’s important to note that remission does not mean the disease is cured. Doctors will still recommend taking some medications in the long term. WebMD warns that studies show individuals with psoriatic arthritis who cease taking disease-modifying drugs during remission often have a relapse of symptoms within a few months.
How to Slow Progression
Treatment of psoriatic arthritis focuses on various aspects which include maintaining joint mobility, relieving pain, lowering inflammation, slowing disease progression, and reducing skin symptoms. According to Medical News Today, some individuals may experience mild symptoms that are manageable without treatment while others need to explore various strategies.
Doctors customize treatments depending on the affected body part and symptom severity because certain medicines are more effective for specific areas of the body than others. For this reason, Medical News Today explains that a combination of treatments may be recommended, and doctors may need to test various medications. The source suggests developing a treatment plan with a rheumatologist, primary care physician, and a dermatologist.