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Psoriatic Arthritis: A Quick Guide to Understanding Joint Inflammation

Here’s what’s happening inside your joints when you have an inflammatory form of arthritis like psoriatic arthritis.

Psoriatic Arthritis: A Quick Guide to Understanding Joint Inflammation

The word arthritis refers to inflammation in the joints. There are many different diseases and disorders that are classified as arthritis.

Psoriatic arthritis is one such disorder. Also called PsA, psoriatic arthritis is a type of inflammatory arthritis associated with psoriasis, which is a chronic inflammatory skin disorder.

Like other forms of arthritis, psoriatic arthritis can cause symptoms like pain, swelling, tenderness, stiffness, and a reduction in mobility.

Here, we look at what is happening inside the joints when a person has psoriatic arthritis.

Joints
Joints are the points on your body where bones attach to other bones. The joints are made up of numerous different tissues including muscles, cartilage, tendons, ligaments, and membranes that help position, stabilize, and lubricate the joints.

Inflammation
Inflammation is the result of an immune response in the body. Swollen glands due to an infection, the redness and tenderness around an injury like a paper cut, and the swelling of a sprained ankle are all examples of inflammation—and are normal responses by the body’s immune system.

However, sometimes the body’s immune system does not behave normally. Psoriasis and psoriatic arthritis have been referred to as “autoimmune diseases” and “immune-mediated disorders.” While the exact cause of these conditions is unclear, both are associated with abnormal immune system activity that results in high levels of inflammatory proteins.

When a person has psoriasis, an abundance of these inflammatory proteins act on the skin, causing skin symptoms. With psoriatic arthritis, these inflammatory proteins act on the joint tissues. This causes these tissues to become inflamed, resulting in the pain, stiffness, tenderness, and swelling that are common symptoms of the disease.

As the disease progresses, this inflammation may cause damage to the joint tissues. This could lead to a permanent loss of joint function, and in some instances, disability.

Disease-modifying antirheumatic drugs
Some therapies for psoriatic arthritis work by acting on the immune system. These therapies are referred to as disease-modifying antirheumatic drugs (DMARDs).

There are a number of different DMARDs, which work in different ways inside the body. DMARDs can be divided into two broad categories, non-biologic and biologic. Some DMARDs are used to treat psoriasis as well as psoriatic arthritis.

It is important to remember that psoriatic disease varies from person to person, and treatment plans vary accordingly. When deciding on the best approach to treatment at a particular time, a healthcare provider will take into account the joints that are affected, the severity of the symptoms, and how psoriatic arthritis is impacting a person’s life.

If you have psoriasis or psoriatic arthritis, the best thing you can do is work with a healthcare provider who understands psoriatic disease, who can help you come up with a treatment plan that works for you.

Medically reviewed in December 2020.

Sources:
MedlinePlus. "Arthritis."
Arthritis Foundation. "What Is Arthritis?"
Centers for Disease Control and Prevention. "Arthritis Types."
UpToDate. "Patient education: Psoriatic arthritis (Beyond the Basics)."
Cleveland Clinic. "Arthritis."
MedicineNet. "Medical Definition of Joint."
University of Rochester Medical Center. "Anatomy of a Joint."
Vinay Kumar, Abul K. Abbas, and Jon C. Aster. "Inflammation and Repair." Robbins Basic Pathology. Tenth Edition, 2018.
informedhealth.org. "What is Inflammation?"
Centers for Disease Control and Prevention. "What is Psoriasis?"
Jacqueline E. Greb, Ari M. Goldminz, et al. "Psoriasis." Nature Reviews Disease Primers, 2016. Vol. 2.
Elsevier Point of Care. "Clinical Overview: Psoriasis."
Harvard Health Publishing. "Psoriasis: More than skin deep."
Adriana Rendon and Knut Schakel. "Psoriasis Pathogenesis and Treatment." International Journal of Molecular Sciences, 2019. Vol. 20, No. 6.
National Psoriasis Foundation. "Oral Treatments."
National Psoriasis Foundation. "Biologics."
Onecia Benjamin, Pankaj Bansal, Amandeep Goyal, Sarah L. Lappin. "Disease Modifying Anti-Rheumatic Drugs (DMARD)." StatPearls, 2020.

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