What Happens If Psoriatic Arthritis Goes Untreated?

If you don’t reign in inflammation, problems can arise.

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The joint pain caused by psoriatic arthritis (PsA) can be brutal on its own. Some people find that it inhibits them from fully participating in life. It may be painful to engage in your usual activities, to exercise, or even to go to work or get out of bed.

However, without treatment, PsA can cause even more problems. Treatment for PsA aims not only to reduce PsA symptoms, but also to reduce the risk of complications caused by unbridled inflammation in the body.  

“The body’s not meant to live in a state of continued inflammation,” says Bobby Buka, MD, dermatologist and associate clinical professor at The Mount Sinai Hospital. “It wears the body down in the joints, [and] the skin, and also some unknown areas that we may not think about.”

For example, people with psoriasis and PsA have an increased risk of depression. In general, depression is more common among people with chronic illnesses, potentially due to the stress of dealing with the illness itself. However, there’s also some evidence to suggest that depression could be linked to inflammation as well. 

People with PsA are also 43 percent more likely to develop coronary artery disease than those without PsA, according to the Arthritis Foundation. That’s partially because inflammation in the body creates damage to the blood vessels.

How Treatment Can Help

Today’s treatments for PsA work to not only reduce pain, but to control inflammation. One of the most effective treatments for moderate to severe PsA is biologics, a type of disease-modifying antirheumatic drug (DMARD) that targets parts of the immune system that fuel inflammation. 

PsA is an autoimmune disease, meaning the immune system—which is supposed to protect the body against external threats—is mistakenly attacking your own body. In the case of PsA, the immune system is attacking the joint space. 

When the immune system is in attack mode, it releases inflammatory proteins. These inflammatory substances are what causes pain, swelling, and redness. Although researchers haven’t yet figured out how to stop the immune system from attacking the joints altogether, biologics work by eliminating those inflammatory proteins that cause damage to otherwise healthy tissue.

Biologics have two major perks: They reduce inflammation in the joints (thus reducing pain, swelling, and long-term joint damage), and they prevent complications caused by chronic inflammation in the body.

When to Talk to Your Doctor

Many people with psoriasis might ignore mild joint pain, thinking it’s tolerable or not a big deal. Even if you can “deal with” your joint pain, your body may still be suffering from the effects of untreated inflammation.

“If you have psoriatic skin disease, and you have some joints that don’t feel right, that’s psoriatic arthritis,” says Dr. Buka. “If you have marginal symptoms that you may not think are related to your psoriatic skin disease, ask your doctor about it.”