Are you experiencing frequent psoriatic arthritis flare-ups? If not treated early, the condition can cause severe damage to joints and impair movement.
Being a chronic condition, psoriatic arthritis requires an ongoing management plan to avoid progress of the disease. This is why the ancient Ayurvedic scriptures have laid down strict guidelines that keep your doshas balanced and your immune and body systems functioning.
Following the Ayurvedic method of treatment can help you naturally control psoriatic arthritis symptoms and make a holistic approach to better health. Read on to better understand the causes and best available treatments for this condition.
Our Ayurvedic Doctor Speaks
“Psoriatic arthritis is Yapya (controllable) not Sadhya (curable). Hence, the condition requires long-term management plans.”
Dr. Zeel Gandhi (Bachelor of Ayurveda, Medicine and Surgery), Chief Ayurvedic Doctor, Vedix
- What Is Meant By Psoriatic Arthritis?
- What Does Psoriatic Arthritis Look Like?
- Types Of Psoriatic Arthritis
- Signs And Symptoms Of Psoriatic Arthritis
- Causes Of Psoriatic Arthritis
- Treatment Options For Psoriatic Arthritis
- How To Prevent Psoriatic Arthritis?
- Risk Factors And Complications Of Psoriatic Arthritis
- When To See A Rheumatologist/ Dermatologist About Psoriatic Arthritis?
- Frequently Asked Questions On Psoriatic Arthritis
What Is Meant By Psoriatic Arthritis?
Psoriasis is an auto-immune condition that causes hyper-proliferation of skin cells. Due to this increase in cell turnover rate, dead cells accumulate to form hard scaly lesions in affected parts of the body. Psoriatic arthritis  usually affects people who are diagnosed with psoriasis or have a family member suffering from the disease.
This is a type of chronic inflammatory arthritis that affects the joints and enthesis (connective tissue that joins bone to ligament or bone to tendon) of your body. Due to inflammation within the joints, the condition hinders movement and causes stiffness and pain.
“Psoriatic arthritis, although a complication of psoriasis (Eka Kushtha), is classified under Vatarakta. Psoriatic arthritis is Yapya (controllable) not Sadhya (curable). Hence, the condition requires long-term management plans. Internal medicine along with Panchakarma techniques are very effective in managing Psoriatic arthritis,” says Dr. Zeel.
The commonly affected areas by psoriatic arthritis are:
- Distal joints of fingers and toes
- Neck and shoulders
- Sacroiliac joints in the pelvic region
What Does Psoriatic Arthritis Look Like?
Psoriatic arthritis may be accompanied by a psoriasis flare up. In such cases, one is likely to observe swollen finger joints, joint pain in other parts along with thick reddish plaques on the skin. Dented nails are also a sign of psoriatic arthritis.
Types Of Psoriatic Arthritis
Psoriatic arthritis is classified in two ways. One is based on the type of joints affected, while the other is based on the areas or ‘domains’ the condition manifests itself. Modern medicine gives more importance to the domains for understanding and treatment of the condition.
A. 5 Types Of Psoriatic Arthritis Based On Joints Affected
1. Asymmetric Oligoarthritis
This affects different joints on each side of the body. A maximum of 4 or 5 small or large joints are affected in this condition. However, its peculiarity is that pain due to inflammation is usually felt in one side of the body despite both sides being affected.
2. Symmetric Polyarthritis
Symmetric psoriatic arthritis manifests itself in both sides of the body and affects the same joints (eg: both wrists). It may affect more joints when compared to asymmetric psoriatic arthritis.
3. Distal Arthritis
This type affects the joints at the tip of your hands and feet, also known as the distal interphalangeal joints. This can cause pain and swelling at the ends of your fingers and toes. People suffering from distal arthritis may also exhibit symptoms like dented nails.
4. Arthritis Mutilans
This is a rare and severe type of psoriatic arthritis that attacks the joints in your hands and feet. The condition hinders the development of bone cells, leading to joint deformation, bone loss and infusion of bones. The term ‘opera glass hand’ and ‘telescoping of fingers’ are related to arthritis mutilans. Other symptoms include pain in the back and neck areas.
Patients with psoriatic arthritis may experience inflammation of the facet joints present between the vertebrae of the spine. This makes it fall under the wider category of spondyloarthritis.
B. 6 Domains Affected By Psoriatic Arthritis
1. Peripheral Arthritis
This affects the outer large joints of the body such as your knees, ankles, wrists and elbows. The pain and inflammation may gradually spread from one joint to the other.
2. Axial Arthritis
Axial arthritis impacts the joints in your backbone and lower back and is also referred to as spondylitis.
As per the name, this type of psoriatic arthritis causes inflammation of the entheses (tissue connecting bones to ligaments and tendons) of the body. The most commonly affected areas include the heel, bottom of the feet and elbow.
Dactylitis  causes diffuse inflammation of the entire digit (finger or toe). The symptoms may differ in severity ranging from mild swelling and pain to acute inflammation, leading to a sausage-like appearance of the digit and movement disability.
5. Skin Psoriasis
According to a study by NCBI, people with skin psoriasis have a higher chance of developing psoriatic arthritis. This is more so in people who have scalp and nail involvement. In others, symptoms of psoriatic arthritis may appear first and later lead to the occurrence of skin lesions.
6. Nail Lesions
It is common for people with psoriatic arthritis to develop nail lesions . This includes dented nails, separation of the nail from the nail bed, blood clotting under the nail or nail plate crumbling.
Signs And Symptoms Of Psoriatic Arthritis
- Inflammation  and pain in the joints and entheses.
- Stiffness and difficulty in movement.
- Acute swelling of digits leading to ‘sausage fingers’.
- Telescoping of fingers.
- Dry, hard, pink, reddish or silvery scale like skin lesions.
- Pitted nails, red spots on the nails and hyperkeratosis under the nail bed.
Causes Of Psoriatic Arthritis
Various studies have shown gene involvement in the pathogenesis of psoriatic arthritis. One is at a higher risk of developing the condition if it runs in the family. There is around a 50% chance of getting it, if both parents are diagnosed with it.
With psoriatic arthritis being an immune driven inflammatory condition, ailments like an infection  that involve immune activity may trigger it. Though there is ongoing research on the subject, there are claims that indicate viruses like the streptococci may increase chances of a psoriatic arthritis flare-up.
Obesity  can make one prone to developing psoriatic arthritis as adipose tissue triggers certain inflammatory factors that lead to a continuous state of inflammation in the body. Studies show almost 30% patients with the condition being obese. Obesity also hinders the treatment of psoriatic arthritis. Reduction of body fat has shown to improve psoriatic arthritis conditions in patients.
As per Ayurvedic review, a Vata-Kapha vitiation along with contamination of the Rakta (blood component) leads to the development of psoriatic arthritis. It is classified as a Vatarakta Kushta. Vatarakta line of treatment, as per Ayurvedic medicine, is prescribed for joint and vascular disorders. It is also recommended for immune dysfunctions that affect the twak (skin), rakta (blood vessels), mamsa (muscles) and ambu (lymph) as in the case of psoriatic arthritis.
New studies claim that aggressive treatment of psoriatic arthritis at the early stages prevent the disease from progressing further. It is also proved that patients receiving such treatment experienced fewer flare-ups.
Treatment Options For Psoriatic Arthritis
A. Ayurvedic Treatments
To treat psoriatic arthritis, Ayurveda first addresses the vitiated doshas of vata and kapha followed by a treatment of the affected rakta, ashti and majja channels. The treatment is completed with a Panchakarma therapy that purifies the body and helps prevent the recurrence of the symptoms.
1. Ayurvedic Chikitsa
A. Vata Kaphar  and Kushtahara Chikitsa
This cure aims to balance the vitiated vata and kapha doshas as the first step of treatment for psoriatic arthritis.
Method Of Treatment
The treatment involves lepas (external application of herbal medicines), abhyanga (herbal massages), dhara (pouring of medicated oils and liquids), avagahana (immersing disease affected parts of the body in medicated liquids) and poultice.
B. Raktavaha Sroto Dushti Chikitsa
According to Ayurvedic medicine, psoriatic arthritis causes the contamination of the ‘Rakta’ and the ‘Raktavaha Srotas’ (blood and its channels). Treatment aiming to purify these channels can improve the condition.
Method Of Treatment
The treatment includes various procedures such as bloodletting, purgation through lower channels of the body, treatment of hemophilia and starving the body.
C. Ashtivaha Sroto Dushti Chikitsa
With psoriatic arthritis mainly affecting the joints, the ashtivaha sroto (channels that supply nutrition to the bone tissue) treatment focuses on removing contamination from these channels.
Method Of Treatment
The treatment method includes the 5 purgatory procedures of emesis, purgation through the consumption of Ayurvedic oils and herbs, decoction enema, oil enema and purgation through administration of medicated oils through the nasal channel.
D. Majjavaha Sroto Dushti Chikitsa
With the bones and joints being mainly affected in psoriatic arthritis, this treatment seeks to purge the channels of the body that bring nutrition to the bone marrow.
Method Of Treatment
A diet consisting of sweet and bitter foods is administered to the patient. Exercises and purgatory methods such as emesis and therapeutic vomiting are also prescribed.
E. Panchakarma Treatment
The panchakarma is a complete body cleansing method that includes the 5 procedures of Snehan (oleation), vashpa swedana (body steaming), vaman (medicated vomiting), virechana (purgation), vasti (oil or decoction enemas).
The panchakarma treatment for psoriatic arthritis ensures the removal of harmful ama toxins from the body and balances your vitiated doshas. It is believed that an ongoing panchakarma treatment can curb further progress of psoriatic arthritis.
2. Ayurvedic Medicines For Internal Consumption
Ayurvedic medications made from powerful anti-inflammatory and immuno-modulating herbs are prescribed for the treatment of psoriatic arthritis. A few of the best Ayurvedic medicines are listed below:
- Rasnaerandadi kashayam
- Guggulutiktakam kashayam
- Triphala churna
- Vaishvanara churna
- Amavatari ras
- Triphala guggulu
- Tiktaka ghrita
- Khadira rasa
- Panchagavya ghrita
- Nimbadi kalka
3. Ayurvedic Medication For External Application
Lepas that reduce psoriatic arthritis symptoms are prescribed for external application on the affected joints and skin lesions. These include:
- Simhasyapallava lepa
- Pathyadi lepa
- Vidangadi lepa
4. Ayurvedic External Treatments
Abhyanga or herbal massages promote blood circulation, remove ama toxins and improve nutrition supply to the areas affected by psoriatic arthritis. Herbal oils listed below are used for the procedure along with coarsely powdered herbs:
- Kottamchukkadi taila
- Eladi taila
- Vajra taila
In this procedure, medicated oils are poured on the psoriatic arthritis affected areas. The selection of herbal oils depends on the symptoms and vitiated doshas of the patient in concern. Dhara follows the sudation method of treatment to heal skin lesions, muscle and joint pains that occur as symptoms of psoriatic arthritis.
5. Ayurvedic Herbs
It has immunomodulatory effects and balances all three doshas.
It has anti-inflammatory properties, controls obesity and balances vata and kapha doshas.
It is anti- inflammatory and balances the vata dosha.
This tridoshic herb has powerful anti-inflammatory abilities.
E. Haridra :
It controls inflammation and balances all three doshas.
It has immunoprotective and anti-inflammatory properties. It balances the vata dosha.
It reduces swelling and balances the vata and kapha doshas.
It balances pitta and vata doshas, and has immunomodulating and anti-inflammatory properties.
It has anti-inflammatory properties and balances the kapha and vata doshas.
It relieves arthritis and is useful in treating skin diseases. It balances all three doshas.
B. Natural Treatment Options
1. Moist Heat Compress / Hot bags
Soak a tea bag or cotton pad in hot water, squeeze out excess water and apply to your heels and joints affected by psoriatic arthritis. The moist heat helps to relieve immediate pain and stiffness.
Though not backed by enough evidence, acupressure is known to be beneficial for those suffering from various forms of arthritis. The procedure involves applying manual pressure on various acupoints in the body to ease your muscles and treat joint aches caused by psoriatic arthritis.
3. Salt Baths And Soaks
Salt baths are known to benefit fatigued muscles and joint pains. Add epsom salt to your bath or foot soak for relief from psoriatic arthritis symptoms.
C. Other Medications
1. Non-Steroidal Anti-Inflammatory Medication
These drugs are considered comparatively safe for treating psoriatic arthritis. NSAIDs  such as Ibuprofen, reduce pain, swelling and stiffness of joints. However, these drugs are said to lose their effect over a period of time and your doctor may need to increase the strength of the medicine prescribed.
2. Corticosteroids Injections
These are injected into the inflamed joints to relieve pain and treat psoriatic arthritis. However, corticosteroid injections are not meant for long term use due to their side effects such as bruising and pale skin around the site of injection, insomnia, rise in blood sugar etc.
3. Disease Modifying Antirheumatic Drugs (DMARD)
DMARDs are a group of drugs usually prescribed to patients with rheumatoid arthritis. These work by suppressing the immune functions of T and B cells, and as a result control the inflammatory responses of the immune system that is responsible for causing psoriatic arthritis.
D. Diet, Exercise & Lifestyle Changes
1. Foods To Eat
Diet for psoriatic arthritis must include anti-inflammatory, low calorie foods. Also make sure to consume foods that have a high content of calcium and vitamin D to prevent bone degeneration. Such foods include:
- Barley, wheat, brown rice
- Toor dal, green gram
- Milk, butter, raw ghee
- White meat, bone broth
- Pointed gourd, bitter gourd, ash gourd
- Grapes, blueberries,
- Tuna, salmon, mackerel
- Spinach and other green leafy vegetables
- Turmeric, ginger
2. Foods To Avoid
Foods that cause inflammation in the body must be totally avoided. Also refrain from consuming processed foods, trans fats and foods that have a high glycemic index, as obesity hinders the treatment of psoriatic arthritis. These include,
- Sugar, carbonated drinks, oil
- Brinjal, tomato, radish, potatoes
- Red meat
- Fermented drinks
- Salty food
- Spicy food
3. Yoga And Exercise For Psoriatic Arthritis
The benefits of yoga and exercise  in maintaining the functionality of joints and muscles in people diagnosed with psoriatic arthritis has been clinically proven. Practising the below asanas can not only keep the condition from progressing but also improve one’s mental health and confidence.
Also known as the warrior pose, this asana is a compilation of various stretches and lunges. The virabhadrasana benefits muscles and joints by keeping them flexible and functional. It is also effective in relieving stress. According to belief, this asana depicts the bravery of Shiva or a warrior in battle.
B. Adho Mukha Svanasana
The downward dog pose supports the healthy development of your bones. It flexes your back and ensures better circulation of blood. Due to its ability to reduce joint pains, adho mukha svanasana is often recommended as part of psoriatic arthritis treatment.
C. Baddha Konasana
The bound angle pose is known to help psoriatic arthritis joint pains. It strengthens the muscles in the lower back, hips, ankles, knees and the pelvic region which are most affected by psoriatic arthritis.
D. Ardha Bhujangasana
The half cobra pose that imitates the pose of a cobra ready to strike its prey, stretches your back muscles and prevents body stiffness caused by psoriatic arthritis.
The tree pose is a simple asana recommended to people suffering from knee and back pain. Despite its benefits, vrikshasana must be avoided by people with high blood pressure.
F. Setu Bandha Sarvangasana
The bridge pose is another stretching exercise that focuses on the neck, spine, back and chest. It is known to provide immediate relief from back pain and is helpful in treating psoriatic arthritis symptoms.
Psoriatic arthritis is a chronic condition that can be kept in check with a disciplined Ayurveda recommended lifestyle. Avoiding practises that trigger the fine balance of your doshas can keep the condition from flaring up. Below mentioned are some lifestyle tips that can aid an ongoing psoriatic arthritis treatment.
- Avoid excessive sun exposure.
- Refrain from smoking and consumption of alcohol.
- Avoid sleeping during the day.
- Lead a stress free life.
- Avoid over eating.
- Refrain from indulging in excessive exercise in hot climates.
- Avoid excessive sexual activities.
Vedix Tip: As per research, regular consumption of green tea can reduce inflammation in the body and aid the treatment of autoimmune diseases.
How To Prevent Psoriatic Arthritis?
Though there is no way to completely prevent psoriatic arthritis, one can prevent the condition from flaring up or progressing.
1. Consult your doctor to identify your trigger factors. This helps to prevent psoriatic arthritis flare-ups.
2. Take precautionary measures to reduce the chances of infection. In case of infection, resort to immediate treatment.
3. Continue your prescribed treatment. Do not halt the treatment abruptly.
4. Avoid stress, as it is a well known trigger for psoriatic arthritis.
Risk Factors And Complications Of Psoriatic Arthritis
The following risk factors can make one more prone to developing psoriatic arthritis:
- Infection or injury
Psoriatic arthritis symptoms can range from mild to severe. Progress of the condition to more than 5 joints (polyarticular psoriatic arthritis) is a risk and may cause permanent erosion of joints. Certain comorbidities that patients diagnosed with psoriatic arthritis suffer from are obesity, diabetes, cardiovascular conditions, fatty liver disease and depression. Fatigue, anemia and high blood pressure are also observed.
When To See A Rheumatologist/ Dermatologist About Psoriatic Arthritis?
It is advisable to consult your rheumatologist when you begin to notice the first symptoms of psoriatic arthritis. Progress of the disease can be halted or trigger factors prevented if diagnosed early. For nail and skin lesions, consult a dermatologist.
Frequently Asked Questions On Psoriatic Arthritis
1. How Serious Is Psoriatic Arthritis?
Psoriatic arthritis is a serious inflammatory arthritis that causes severe pain and inflammation of joints. The condition can quickly spread to more areas of the body without medical attention. Unchecked psoriatic arthritis can erode your joints resulting in difficulty in movement and disability.
2. Can Psoriasis Become Psoriatic Arthritis?
Psoriasis is a risk factor for psoriatic arthritis. About 30 percent of people who have the condition develop psoriatic arthritis.
3. How Long Does Psoriatic Arthritis Last?
A permanent cure for psoriatic arthritis is yet to be discovered. Being a chronic condition, a flare up can last from a few days to weeks. A strict lifestyle and medication can prolong your dormant phase with more time in between flare-ups.
The Last Word
Apart from classifying the condition as a Vatarakta Kushta, Ayurveda also states that psoriasis and psoriatic arthritis are psychosomatic disorders. Therefore, controlling your level of stress can help improve the condition. Maintaining a healthy weight, controlling your blood pressure and following a lifestyle that increases your immunity can make living with psoriatic arthritis less difficult and prevent its recurrence.Know Your Dosha Now
1. Psoriatic Arthritis (2019)
2. Classification Of Psoriatic Arthritis
3. The Different ‘Types’ Of Psoriatic Arthritis- And Why Knowing Your Type Matters (2019 November)
4. Psoriatic Arthritis
5. Infections And The Risk Of Psoriatic Arthritis Among Patients: A Systematic Review (2017 November)
6. Obesity And Psoriatic Arthritis: A Narrative Review (2020 June)
7. Psoriatic Arthritis- Ayurvedic Review (2018 January)
8. Natural Products For The Treatment Of Autoimmune Arthritis: Their Mechanisms Of Action, Targeted Delivery, And Interplay With The Host Microbiome (2018 September)
9. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
10. Exercise And Arthritis (2020 December)
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