The Stages of Psoriatic Arthritis: How Does It Progress?

Here are the signs that your PsA might be worsening.

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Like many autoimmune diseases, psoriatic arthritis may progress in stages. Some people experience rapid progression of psoriatic arthritis. Others may maintain mild symptoms for years or decades. It’s tough to predict whether someone will progress quickly or not. However, there are signs to look for that psoriatic arthritis is worsening.

What are the signs of psoriatic arthritis progression?

No matter what stage of psoriatic arthritis you are at, you may have similar signs of progression. This means the condition may be worsening to a more severe state. Signs that your PsA is worsening include:

  • More frequent flares, which are periods when symptoms become worse
  • New or worsening joint damage on X-rays or other imaging
  • Worse quality of life due to PsA symptoms

What is mild PsA?

Defining the stages of psoriatic arthritis isn’t always simple. Generally speaking, someone with mild PsA may have joint pain and stiffness, but they have little or no joint damage on X-rays. They may be able to manage their condition with lifestyle changes and/or over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs). This includes aspirin, ibuprofen, and naproxen. NSAIDs are also available in stronger doses by prescription.

What is moderate-to-severe PsA?

People with moderate-to-severe PsA may have joint damage that appears in X-rays and other imaging. They may have severe symptoms that affect their ability to do everyday tasks. These symptoms may be tough to control with lifestyle changes and NSAIDs alone.

Treatment for moderate-to-severe PsA may include:

  • DMARDs (disease-modifying antirheumatic drugs)
  • Biologics, such as TNF inhibitors

These medications are more aggressive and may help control inflammation and joint damage.

Can you prevent PsA from worsening?

In many cases, you can lower your risk of psoriatic arthritis progression. To do this, you’ll need to stick to your doctor’s prescribed treatment regimen, including following a healthy lifestyle and taking medications consistently.

Another important tip is to recognize the signs of progressing disease. If it seems like you are having more frequent flares or more severe symptoms, talk to your doctor as soon as possible. This may be a sign that your current treatment is not the right fit. Changing treatment can help get your psoriatic arthritis under control to slow the progression.

Remember, it’s okay and “normal” to not find the perfect treatment on the first try. It may take a couple different tries before you find the right medication to control your PsA, and you may benefit from different treatments as your PsA evolves.