Heart disease, back pain and 4 other health risks linked to psoriatic arthritis

If you have psoriatic arthritis, you can see the way the autoimmune disease attacks your skin, and you can feel it in your bones. But the inflammation fueled by the condition is more than skin deep. Psoriatic arthritis may increase the risk of other problems that can affect you from head to toe.

Maybe you’re working with a dermatologist to treat your skin and a rheumatologist to relieve your joint pain. That’s a great start—but you need a complete care team to manage your total health. You also need to be aware of the signs of potential trouble, so you can get the care you need.

Before you blame your aching back on age or the lumpy desk chair you should have thrown out years ago, know that back pain is a common issue for people with psoriatic arthritis. In fact, it is sometimes the first symptom.

The inflammation can pinpoint the lower back, the area between the shoulder blades, the neck, or all of the above. People with psoriatic arthritis frequently have back pain in the middle of the night—often severe enough to wake them up—and stiffness that lasts for more than 30 minutes in the morning. Sitting in one place for too long can worsen the pain. In severe cases of psoriatic arthritis, the vertebrae can fuse together, making it hard to bend your back.

Exercise is often recommended to relieve back pain from psoriatic arthritis. The same medications used to treat psoriatic arthritis can also help relieve the pain and prevent join and cartilage damage. These include corticosteroid injections, nonsteroidal anti-inflammatory drugs (NSAID), and disease-modifying anti-rheumatic drugs (DMARDs).

If you have psoriatic arthritis, your heart health should be top of mind, since people with the condition have close to double the risk of heart disease. It’s also associated with an increased chance of developing metabolic syndrome, a group of five risk factors that raise your odds for heart disease, diabetes, and stroke.

The connection is all down to inflammation, experts believe. The same inflammation that attacks your skin and joints also causes damage that clogs your arteries, increases your blood pressure and worsens other heart disease risk factors.

Treating psoriatic arthritis seems to lessen that danger. Experts say it’s especially important to take care of yourself by making heart-healthy lifestyle choices, such as getting regular physical activity. Another wise step is adopting a plan for wholesome, balanced eating, such as a Mediterranean-style diet. Packed with fruits, vegetables, whole grains, legumes, nuts, and seeds—and low in added sugars and saturated fats—it can help lower your risk of heart disease and many other chronic illnesses. 

Enthesitis is one of the most characteristic symptoms of psoriatic arthritis, affecting one in three people with the condition. It occurs when the areas where tendons, ligaments, and synovium attach to bones (enthesis) become inflamed, causing them to feel tender to the touch, stiff, or painful when you move them. 

Trouble areas include the back of the heel (Achilles tendinitis), sole of the foot, the elbows (tennis or golfer’s elbow), and the knee (patellar tendinitis). Enthesitis is usually managed with the same nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and DMARDs used to treat psoriatic arthritis.

Psoriatic arthritis is one of several autoimmune diseases—Crohn’s disease and rheumatoid arthritis are others—that are linked to a type of eye inflammation called uveitis. This condition, which may come on suddenly or be gradual and long-lasting, can cause pain and redness in the eyes, and sometimes even blurred vision or light sensitivity. About 7 percent of people with psoriatic arthritis will have uveitis at some point compared to the general population, which has a risk near 0.1 percent. It’s important to tell your healthcare provider as soon as possible if you develop any eye pain or blurred vision. Regular eye checkups are also a must. 

Type 2 diabetes affects about one in nine Americans. But for people with psoriatic arthritis, the chances of developing type 2 diabetes may be as high as one in five. Why the difference? 

Psoriatic arthritis can contribute to two of the main risk factors for diabetes: obesity and insulin resistance. And certain drugs used to treat psoriatic arthritis can make it harder to keep your blood sugar in check. 

People with psoriatic arthritis should be screened for diabetes, according to the American College of Rheumatology. Watch out also for symptoms like frequent urination, excessive hunger or thirst, fatigue, and unexplained weight loss.

On one hand, it’s easy to see how the pain and limitations of psoriatic arthritis—plus the stigma people may feel due to their skin disease—can lead to depression. One in five people with psoriatic arthritis report having mild depression. The low mood, in turn, can make it even harder to cope with your symptoms. But there’s some evidence that the condition has a direct effect on the brain, too. 

Whatever the reason, it’s important to be honest with your healthcare provider about your feelings. Especially let them know if you have trouble sleeping or concentrating, lack energy, have appetite changes, or feel less interested in things you enjoy. The good news: Getting control of the psoriatic arthritis appears to be the best cure.