5 Ways to Manage the Emotional and Physical Toll of a Psoriatic Arthritis Diagnosis
Receiving a diagnosis of psoriatic arthritis (PsA) can be life-changing and deeply overwhelming. An autoimmune condition that causes joint pain, inflammation, fatigue, and skin symptoms like psoriasis, psoriatic arthritis affects both the body and mind. The physical discomfort and long-term implications can lead to feelings of uncertainty, stress, and anxiety, creating an emotional toll that may feel impossible to navigate. For many, the journey from diagnosis to disease management is marked by navigating sudden lifestyle adjustments, grappling with self-image shifts, and finding ways to cope with the unpredictability of flare-ups. “Patients may look fine on the outside but they struggle with daily pain and stiffness, and the invisible nature of psoriatic arthritis leads to feelings of isolation,” says Dr. Anna Lafian, a rheumatologist based in California.
While psoriatic arthritis is a chronic condition with no cure, there are strategies to help manage both its physical and psychological challenges. Cultivating a toolkit of effective coping mechanisms can promote better outcomes for the body and overall well-being. Remembering that whether you’re newly diagnosed or have been living with psoriatic arthritis for years, you are not alone. Small, consistent efforts can also lead to meaningful improvements. Below, read what our experts had to say on how to approach life with psoriatic arthritis.
Sleep
Sleep helps the body heal. Dr. Lafian notes that it has been well-documented that poor sleep increases inflammation, increases pain sensitization in the nervous system and disrupts immune function. “Unfortunately, many patients with psoriatic arthritis struggle with sleep due to pain and discomfort,” Dr. Lafian says. To combat this, she suggests creating a calming nighttime routine using gentle stretches, a warm bath, reading, and optimizing sleep hygiene by keeping the bedroom room cool and dark.
“You’ll also want to avoid blue light from tech devices up to two hours before bed and manage your pain before bed with heating pads, medications, or magnesium glycinate.”
Mindfulness
The mind-body connection is vital in managing physical and mental aspects of psoriatic arthritis. In psoriatic arthritis specifically, stress can worsen inflammation and drive a chronic state of fight-or-flight by activating the sympathetic nervous system, increasing cortisol and other stress hormones, making it more difficult to heal.
Because psoriatic arthritis can cause a significant impact on one’s mental health and patients with psoriatic arthritis can suffer with increased mood disorders, according to Dr. Lafian, she ensures her patients make space to acknowledge the emotional weight of the disease. “Addressing both the mind and the body helps with treatment significantly more than just treating the body,” she says. “Practices like mindfulness, yoga, breath work, progressive muscle relaxation, guided meditation, and grounding, cognitive behavioral therapy are integral adjuncts to managing psoriatic arthritis in addition to western modalities.”
Exercise and Healthy Diet
Exercise is very powerful but, Dr. Lafian notes, needs to be individualized. “Each person’s fitness level is very different,” she says. “But a good starting point is low impact aerobic activity, strength training, mobility and stretching.”
“It is best to listen to your body, and start slow and gradually build up to avoid injuries and setbacks,” she adds.
Dr. Jonathan M. Greer, a rheumatologist based in Florida, agrees, adding dietary changes are also beneficial in helping manage psoriatic arthritis. He suggests following the Mediterranean diet. “Eating a clean diet makes such a difference,” he says. “In addition to avoiding tobacco and excessive alcohol use. These are all good things that patients can do themselves.”
Assemble a Care Team
Patients with psoriatic arthritis have a higher burden of cardio-metabolic comorbidities like obesity, hypertension, diabetes, and cardiovascular disease compared to the general population. Dr. Greer emphasizes the importance of having a good healthcare team, which may include a primary care physician, rheumatologist, dermatologist, and clinical psychologist. “A obesity medicine specialist can also help patients work to make health lifestyle choices,” he says.
“I view my work with my patients as a partnership,” he adds. “I listen to their concerns and their thoughts. I understand what their wishes may be, and I give them different choices based on what medicines I think may be appropriate for them. In turn, they make a decision with me. It’s called shared decision making, which is extremely important in rheumatology, and it allows the patient to feel empowered in taking control of their life.”
Compliance and Actionable Changes
“We have patients who are more afraid of the side effects than the disease,” Dr. Greer says, highlighting the fact that being compliant with your medical regimen is crucial in management. “Before we physicians decide to use a medication, we always weigh the benefits and the risks.”
There’s a high chance of relapse for psoriatic arthritis patients if they stop taking their prescribed medication, but the medications available now are much safer and effective than in prior years. “The newer medications can provide a much better quality of life and improve your lifespan,” says Dr. Greer.
Small, actionable changes make a big difference as well, according to Dr. Lafian. These include: implementing morning movement rituals such as gentle stretching or light yoga, ergonomic tools such as workspaces that reduce strain on joints, meal prepping and hydration, and scheduling rest to help prevent flare ups from overexertion. “Tracking symptoms in a journal can also help identify triggers, making it easier to prevent flares,” he says.
