Psoriatic arthritis is a type of arthritis that often occurs along with the skin condition psoriasis. It does not currenlty have a cure, but there are many treatment options.

Psoriatic arthritis (PsA) is a painful type of arthritis that causes joint pain, swelling, and stiffness. If you have psoriasis, it’s possible that you may also develop PsA — this occurs in about 30% of people with psoriasis.

If you have PsA, treating it early can be key to help soothe pain and prevent joint damage down the road.

Several types of medication can effectively treat PsA symptoms. Certain over-the-counter (OTC) medications, such as ibuprofen, may help reduce symptoms.

If OTC drugs don’t reduce your joint pain and swelling, your doctor may need to prescribe stronger medications such as:

  • traditional disease-modifying antirheumatic drugs (DMARDs)
  • biologics
  • enzyme inhibitors

Nonsteroidal anti-inflammatory drugs (NSAIDs)

One of the first treatments that your doctor may recommend is an OTC medication.

NSAIDs are commonly used to treat the pain and inflammation that PsA can cause.

Ibuprofen (Motrin, Advil) and naproxen (Aleve, Anaprox) are popular OTC NSAIDs.

NSAIDs are also available in prescription forms, which are more potent than OTC versions. Examples of prescription NSAIDs that can be used for PsA include:

  • celecoxib (Celebrex)
  • diclofenac (Arthotec, Voltaren)
  • nabumetone (Relafen)

The most common side effects of NSAIDs are digestive problems such as stomachaches, nausea, and diarrhea.

Traditional DMARDs

Your doctor may prescribe traditional DMARDs to help reduce inflammation and slow down the potential joint damage that PsA can cause.

These drugs have broad effects on your immune system. They also take effect much more slowly than NSAIDs and can cause more serious side effects related to your lungs and kidneys.

Examples of traditional DMARDs used to treat PsA include:

  • methotrexate (Trexall)
  • sulfasalazine (Azulfidine)
  • cyclosporine (Neoral, Sandimmune)
  • leflunomide (Arava)

These drugs may be used alone or in combination, depending on your doctor’s recommendations.

Immunosuppressants

Immunosuppressants can help reduce the effects of the immune system in people with PsA.

Azathioprine (Imuran) is an immunosuppressant that’s frequently used if other traditional drugs don’t work.

Because of the risk of side effects, you must take immunosuppressants with extreme caution and under the direction of a doctor.

These drugs can lead to side effects such as:

  • anemia
  • infections
  • liver and kidney dysfunction

Doctors generally prescribe these drugs to people with moderate to severe PsA.

Biologics

Biologics are a newer type of DMARDs. They target the specific parts of your immune system that cause the inflammation and joint damage associated with PsA.

There are several classes of biologics. These classifications are based on the specific part of the immune system that the biologic targets.

Biologics that may be used to treat PsA include:

  • tumor necrosis factor (TNF)-alpha inhibitors, such as:
  • interleukin-12 (IL-12) and IL-23 inhibitors, such as ustekinumab (Stelara)
  • IL-17 inhibitors, including:
    • ixekizumab (Taltz)
    • secukinumab (Cosentyx)
  • IL-23 inhibitors, such as guselkumab (Tremfya)
  • T-cell inhibitors such as abatacept (Orencia)

In addition to treating PsA, biologics can treat psoriasis symptoms. It’s possible that you’ll be prescribed a biologic in combination with a traditional DMARD.

You’ll receive biologics either as an injection or as an infusion (an injection into a vein over a period of time). The most common side effect is pain or swelling at the injection site.

Biologics might also increase your risk of infections or affect your kidneys, liver, or blood counts.

Enzyme inhibitors

Some newer prescription medications have recently been approved for treating PsA. These drugs block the activity of enzymes that are important for an overactive immune response.

One advantage of these medications is that you can take them orally (by mouth) rather than receiving them by injection or infusion. There are currently two enzyme inhibitors available:

  • Tofacitinib (Xeljanz, Xeljanz XR): This drug works to block the activity of an enzyme called a Janus kinase, helping to reduce inflammation. The most common side effects are headache and upper respiratory infection.
  • Apremilast (Otezla): This drug blocks an enzyme called phosphodiesterase 4, which is also involved in inflammation. Common side effects include nausea, diarrhea, and upper respiratory infection.

Oral steroids

Oral steroids can help reduce pain and inflammation associated with PsA.

These drugs are typically prescribed only in small doses over a short period of time. This is because there is a risk of significant side effects after you stop taking them.

The surgical treatment for PsA is arthroplasty (joint replacement surgery). Your doctor might recommend this if your joints become severely damaged by PsA.

During a joint replacement procedure, surgeons replace the damaged joint with a prosthetic made from metal or plastic.

Yes. If you’re experiencing pain and inflammation in a specific joint, your doctor might use a steroid injection to relieve those symptoms. Relief can last for weeks to months. But because of the risk of side effects, steroid injections can be given a limited number of times.

Some complementary therapies may be used for PsA. These therapies are generally used along with your standard PsA treatments.

Research into the effectiveness of many types of complementary and alternative therapies is limited.

If you’re interested in making any of these therapies a part of your PsA treatment plan, be sure to talk with your doctor first.

Acupuncture

Acupuncture involves inserting thin needles into your skin to stimulate certain areas of your body.

According to the National Psoriasis Foundation, although no studies have investigated acupuncture for psoriasis or PsA, it may be effective for some.

Massage

Massage involves manipulating your body’s soft tissues. A massage therapist typically uses their fingers, hands, or elbows to do this. Massage therapy can provide relief from some types of pain, such as osteoarthritis pain.

Although evidence to support its use for PsA is lacking, some may find it helpful.

Curcumin

Curcumin is the active ingredient in the spice turmeric.

Curcumin has anti-inflammatory properties, which may ease the symptoms of PsA. Curcumin supplement pills are available for purchase.

Vitamin D

Vitamin D is important in skin health and has anti-inflammatory effects. For these reasons, it may be used as a dietary supplement to help with psoriasis or PsA.

Additionally, some research has associated these conditions with low vitamin D levels.

Yoga

Yoga involves a combination of specific postures, breathing techniques, and meditation. It may be an effective tool for easing stress and promoting relaxation.

Also, yoga can help people with PsA improve their flexibility and range of motion while easing pain.

Tai chi

Tai chi is a form of exercise that involves gentle, flowing movements. Like yoga, it’s a low impact activity that may promote relaxation and help relieve pain in some people with PsA.

Reiki

Reiki is a type of therapy in which a practitioner places their hands on or above your body, aiming to direct your internal energy to promote healing.

According to the National Center for Complementary and Integrative Health, Reiki has not been found to be effective for any health conditions.

Certain lifestyle strategies, such as those below, can reduce PsA pain and slow the progression of the disease.

Protecting your joints

Your doctor might suggest heat or cold therapy using an ice pack or a heating pad to protect your joints and provide temporary relief.

Additionally, it’s a good idea to avoid overdoing movements such as lifting, pushing, and twisting. Be sure to pace yourself, rest often, and take precautions when carrying out your daily tasks.

Eating a nutritious diet

In addition to any drug treatments your doctor may recommend, eating a nutrient-dense, balanced diet that includes plenty of fresh fruits and vegetables (whenever possible) can help prevent joint pain from PsA.

Getting regular exercise

Regular physical activity is an important part of a healthy lifestyle and can help prevent joint stiffness and muscle weakness.

If you have overweight or obesity, you might experience additional strain on your joints, which could worsen PsA symptoms. In that case, your doctor might recommend exercise as part of a weight management plan.

Ask your doctor about appropriate types of exercise for you.

Quitting smoking

If you smoke, it’s important to consider taking steps to quit. Smoking is associated with PsA development and a less favorable response to treatment.

Clinical trials are important for developing new treatments for PsA. Participating in a clinical trial can provide valuable information to researchers and healthcare professionals and help people with PsA access the latest treatments.

The National Psoriasis Foundation has resources on clinical trials to help you learn more. And the National Institutes of Health has a search tool you can use to find clinical trials in your area.

PsA currently has no known cure, but there are a variety of effective treatments.

Any type of treatment for moderate to severe PsA aims to help you better manage symptoms such as inflammation and pain while preventing further joint damage. Approaches such as medications and lifestyle strategies can help.

If you have PsA, it’s important to talk with your doctor about your potential treatment options. Your doctor can work with you to create a treatment plan that best addresses your needs.