Easing psoriatic arthritis pain usually involves finding the right mix of medicines and lifestyle choices. Treatment depends on symptoms and how bad they are. Finding relief might mean trying different medicines or using more than one.

Pain-relieving treatments

Psoriatic arthritis makes joints painful, tender and stiff. Treatments that control the cause of these symptoms, known as inflammation, can help ease them. Psoriatic arthritis treatments include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines ease mild pain and swelling. You take them by mouth. Ones you can get without a prescription include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve).

  Diclofenac (Voltaren Arthritis Pain) is an NSAID that can be rubbed on the skin over the joint. NSAIDs also come in prescription strengths.

• Disease-modifying antirheumatic drugs (DMARDs). These slow the progress of psoriatic arthritis and save the joints and other tissues from damage. Common DMARDs include methotrexate (Trexall), leflunomide (Arava) and sulfasalazine (Azulfidine). These medicines, taken by mouth, might be used with other medicines.
• Targeted synthetic DMARDs. This type of DMARD is taken by mouth. An example is apremilast (Otezla). Some people who can't take other psoriatic arthritis medicines might try apremilast.

• Biological DMARDs. These target the signals between the cells of the immune system involved in pain and swelling, known as inflammation. Biological DMARDs include tumor necrosis factor-alpha (TNF-alpha) inhibitors, such as etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade), certolizumab (Cimzia) and golimumab (Simponi).

  Other biological DMARDs include ustekinumab (Stelara), guselkumab (Tremfya), secukinumab (Cosentyx), ixekizumab (Taltz) and abatacept (Orencia).

  These medicines are given either as a shot or through an IV, known as an infusion. You can learn how to give yourself the shots. A health care provider usually does the infusions in the office or hospital.

• Small molecules. Janus kinase inhibitors are small molecules that are taken in pill form. They block the function of proteins that are involved in pain and swelling. Examples are tofacitinib (Xeljanz) and upadacitinib (Rinvoq).
• Steroid shots in an affected joint. These work quickly to relieve symptoms.
• Surgery to replace joints. This replaces damaged joints with ones made of metal and plastic.

Lifestyle choices

Lifestyle choices also can help. To reduce pain:

• Get to and stay at a healthy weight. Being at a healthy weight can ease joint strain and improve how some medicines work.
• Eat well. No diet can treat psoriatic arthritis. But some foods might help ease symptoms. These include fatty fish, such as salmon, nuts and olive oil. Add in lots of fruits and veggies, whole grains, and lean protein. Limit or avoid red meats and foods high in trans and saturated fats and sugars.
• Keep moving. This helps joints work better and can help you lose weight or stay at a healthy weight. Occupational therapy and physical therapy might help if exercise is too painful for you. Gentler exercises such as walking, cycling, swimming, yoga and tai chi might be good choices. Rest during flares.
• Don't smoke. Some studies show that smoking makes psoriatic arthritis symptoms worse. If you smoke, work with a health care provider to make a plan to quit.
• Limit or avoid alcohol. Alcohol mixed with some psoriatic arthritis medicines might increase the risk of harm to the liver. Also, drinking too much alcohol has been linked to worse psoriatic arthritis.
• Use tools, known as assistive devices. These tools make activities easier to do. They include jar openers, electric can openers, grabbers and zipper pulls. When lifting something heavy, keep the weight even between both hands.
• Make changes at home. For example, get an electric can opener. Add a raised toilet seat and handrails in the bathroom. These changes can ease joint strain.

Talk with your health care provider about which treatments might work best for you. You might need to try different treatments to relieve your psoriatic arthritis pain.

March 21, 2023

Original article: https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/expert-answers/managing-psoriatic-arthritis-pain/faq-20380755