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If you have psoriatic arthritis (PsA), you might worry that your painful, swollen joints will never be normal again. But the good news is, with the right treatment many people with PsA can achieve remission. One study showed that nearly two-thirds of subjects had minimal symptoms with 12 months.
What is remission?
Remission means “the disease is controlled” says rheumatologist Paula Rackoff, MD, associate professor of clinical medicine at NYU School of Medicine. “Patients in remission have minimal joint pain and stiffness. They’re able to do all their daily activities with minimal symptoms and minimal morning stiffness.”
Dr. Rackoff says that most people achieve remission from PsA within about six months. Once remission is achieved, Rackoff says that doctors usually “try and see the least amount of medications that control the symptoms.” Corticosteroids and disease-modifying antirheumatic drugs (DMARDs) are most often prescribed by doctors to control symptoms.
Between 5 and 10 percent of people can come off medication entirely, according to Rackoff, and she adds that doctors generally won’t start tapering medication until after about a year.
Making it stick
If you’re not part of that lucky 5- to 10 percent, you might have to take medication for the rest of your life to keep the condition at bay. “But many times we can minimize the amount of medication,” Rackoff says. Unfortunately, “Psoriatic arthritis doesn’t go away on its own,” according to Rackoff. But eating a healthy diet and exercising can help make your medication more effective.
“We always encourage people to exercise and strengthen the muscles around the joints that are affected,” says Rackoff. “The stronger the muscles are around a joint, the less the joint has to do.”
It’s important to get to a doctor right away if you think you’re developing PsA because “people who are treated earlier on and more aggressively early on have more success with being on less medication later,” says Rackoff. “When people are first diagnosed, they’re hesitant to start medication.” Some people wait up to two years to start treatment.
There’s one more thing you can do to improve your chances of remission from PsA—as well as improve your health overall—and that’s lose weight. Up to 40 percent of people with PsA are obese. A 2014 study published in Annals of the Rheumatic Diseases showed that eating fewer calories was associated with a decrease in disease activity. A more than 10 percent drop in weight had the best results.
About a third of people with psoriasis also develop PsA. If you have psoriasis, Rackoff says to watch for three symptoms in order to catch PsA early and therefore have a better chance of achieving remission. “If you have joint swelling along with joint pain, you need to see a doctor,” she says. “If you have more than 20 minutes of morning stiffness, you need to see a doctor. If joint pain and stiffness interferes with daily activities, you need to see a doctor.”
