Step 1: Check in with your rheumatologist.
“Patients with psoriatic arthritis will usually have disease flares,” says Nicola Kim Berman, MD, rheumatologist based in New York. “They might feel fine for a few weeks … and then develop what’s called a flare, [which means] your disease is acting up again and you’ll get swelling in your joints.”
During a flare, it’s important to take steps that will reduce not only your pain and stiffness, but also the inflammation to prevent complications of PsA, such as joint deformities. Thus, when a flare occurs, contact your doctor.
Your doctor will first make sure that what you are experiencing is actually a flare. Some flares can mimic other problems, including viral or bacterial infections that need treatment, especially if you’re taking immunosuppressive medications.
Additionally, doctors may prescribe different medication during a flare than what you would normally take for your day-to-day treatment plan for PsA. “They can prescribe you something to calm down the flare, particularly if you are uncomfortable, can’t go to work, or can’t carry out your activities of daily living,” says Dr. Berman.
These medications—which include steroids and nonsteroidals—are effective at treating a PsA flare, but they’re not ideal for long-term, everyday use. One reason for that is they can worsen psoriasis symptoms, such as red, flaky, scaly plaques on the skin.
But not all flares are created equal. Some mild flares can simply be treated with over-the-counter anti-inflammatory medicines, such as ibuprofen, according to Dr. Berman. However, severe flares that affect multiple joints to a great extent usually require medical intervention, like steroid injections.
Along with medications, you may need to pay attention to your daily habits to prevent and manage flares. “Living a healthy lifestyle to reduce in the inflammation in your body is important,” says Dr. Berman. The following habits may trigger or worsen PsA flares, according to Dr. Berman:
High, unmanaged stress
Lack of sleep
Lack of exercise
To lessen the impact of a flare, learn more about daily habits to manage PsA inflammation here.
Managing psoriatic arthritis flares. Atlanta, GA: Arthritis Foundation. (Accessed on May 15, 2019 at https://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/articles/managing-psa-flares.php.)
To treat or not to treat? Managing PsA flares. Portland, OR: National Psoriasis Foundation, 2016. (Accessed on May 15, 2019 at https://www.psoriasis.org/advance/treat-or-not-treat-how-manage-psoriatic-arthritis-flares.)