Does psoriatic arthritis (PsA) run in your family? If so, you might worry that this inflammatory joint and skin disease is in your future, too. About 40% of people with psoriatic arthritis have at least one family member with the disease.
Experts don't know what causes PsA. They suspect genes set you up for the disease and then something in your environment triggers it. Because you can't rewire your DNA, there's no way to prevent PsA. But there are a few risk factors that are under your control. By making a few tweaks to your daily routine, you can reduce the inflammation that causes painful joints and scaly skin patches in PsA.
Avoid Tobacco
Tobacco smokers have a 27% higher risk for psoriatic arthritis than nonsmokers. Smoking may contribute to both psoriasis and psoriatic arthritis by boosting levels of cytokines – chemicals that produce inflammation in your body. Cytokines like tumor necrosis factor-alpha (TNF-alpha) and interleukin-23 play a role in causing psoriasis and making it worse. Some of the biologic drugs that treat psoriatic arthritis work by blocking these chemicals.
Smoking not only increases your risk of getting PsA, but it could make your disease worse. People who smoke tend to have more symptoms like joint pain and fatigue compared to nonsmokers. The longer you smoke and the more cigarettes you smoke, the more severe your disease could be.
Stay at a Healthy Weight
Having overweight or obesity, especially in your belly, could increase your risk for PsA. One reason for the connection is that fat cells release inflammatory chemicals. Research has shown that teens with a higher body mass index (BMI) are more likely to develop PsA
than teens who are at a healthy weight. Up to 45% of people with PsA also have obesity.
Extra weight also makes PsA more severe because it puts more strain on the joints. People with obesity and PsA tend to have more severe symptoms, and they don't respond as well to biologic drugs. They're also more likely to have other health conditions like high blood pressure, type 2 diabetes, and heart disease. Weight loss can help to reduce inflammation, improve PsA symptoms, and reduce your risk for other diseases.
Eat to Prevent Inflammation
No specific foods have been proven to treat or prevent PsA. But eating certain foods can reduce the inflammation that fuels this disease. Experts recommend including foods like these in your meals:
- Colorful fruits and vegetables like oranges, blueberries, broccoli, and spinach
- Fish that are rich in anti-inflammatory omega-3 fatty acids, such as salmon, tuna, and sardines
- Nuts and seeds such as walnuts, flaxseeds, and chia seeds
- Plant-based oils such as olive and canola oils
- Whole grains like wheat, oatmeal, brown rice, and quinoa
Although experts don't recommend any one specific diet for PsA, the Mediterranean diet incorporates many of these healthy foods into one plan.
Other foods are notorious for causing inflammation. Try to limit or avoid:
- Processed foods such as chips, frozen pizza, and bacon
- Red meat
- Dairy products like milk and ice cream
- Sweets like cookies and candy
If you're not sure what dietary changes to make, your doctor or a dietitian can help you with meal planning.
Avoid or Limit Alcohol
Regular drinking could affect your immune system in ways that increase inflammation. In one study, women who drank a lot of alcohol were at higher risk for psoriasis and PsA than non-drinkers. Green tea and coffee are healthier beverage choices. These drinks contain compounds that combat inflammation.
Get More Active
Aerobic exercise helps you burn calories and lose weight, especially when you add it to a healthy diet. Weight loss could help lower your risk for PsA. Exercise is also good for people who already have PsA. A combination of low-impact aerobic activities like swimming or walking plus strength training and stretching will lubricate your joints and reduce arthritis pain and stiffness.
Aim for the recommended 150 minutes of moderate aerobic exercise or 75 minutes of intense aerobic exercise weekly. Add in weight training and stretches a couple of days a week to improve your strength and flexibility.
Treat Psoriasis
About 30% of people with the inflammatory skin disease psoriasis develop PsA. Often PsA starts about 10 years after the psoriasis diagnosis. Many treatments, from medicated creams to biologic drugs, can help you manage psoriasis. Biologic drugs also slow the progression to PsA and might reduce the risk of developing it. Work with your doctor to find a treatment plan that works for you and stick with it.
Manage Stress
Stress sets off your body's fight-or-flight response. It triggers the release of chemicals that increase your breathing, send energy to your muscles, and prepare your body to either fight or run. Those chemicals are also part of your immune system's inflammatory response. Inflammation is what triggers PsA symptoms and makes the disease worse.
Use whatever stress management technique works for you. Some people like to meditate or pray. Others find that walking in nature or listening to their favorite music relaxes them. If stress becomes overwhelming, talk to a therapist or other mental health professional.
Get Screened
If you have psoriasis, you're more likely to be diagnosed with PsA. Watch for symptoms like:
- Swollen, stiff, and painful joints
- Pain in your heels or soles of your feet
- Tiredness or low energy
- Painful and swollen fingers and toes that look like sausages
- Dents, lines, or crumbling in your fingernails or toenails
- Eye pain, redness, and blurry vision
Report symptoms like these to your doctor. During your visits, ask about getting screened for PsA. The National Psoriasis Foundation offers a five-question screening tool that you can print out and bring with you to your doctor's office. Your doctor may be able to predict whether you'll get PsA before you have symptoms. The earlier you get a PsA diagnosis and start treatment, the better your outcome will be.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Annals of the Rheumatic Diseases: "The Smoking Paradox in the Development of Psoriatic Arthritis Among Psoriasis Patients – A Population-Based Study."
Arthritis Foundation: "Best Drinks for Arthritis," "How Fat Affects PsA," "How Stress Affects Arthritis."
Canadian Association of Psoriasis Patients: "PsA and Smoking."
Cleveland Clinic: "How What You Eat Affects Your Psoriatic Arthritis," "Psoriasis," "Psoriatic Arthritis."
International Journal of Molecular Sciences: "Inflammatory Cytokines in Psoriatic Arthritis: Understanding Pathogenesis and Implications for Treatment."
Journal of Clinical Medicine: "Psoriatic Arthritis: Development, Detection and Prevention: A Scoping Review."
Mayo Clinic: "Diet and Psoriatic Arthritis: What's Worth Trying?" "Exercise for Weight Loss: Calories Burned in 1 Hour," "Psoriatic Arthritis."
MyPsA: "How Smoking Affects Your Psoriatic Arthritis."
National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Psoriatic Arthritis."
National Psoriasis Foundation: "About PsA," "Psoriatic Arthritis Screening Tool for Providers," "Screening Tool for Psoriatic Arthritis."
NYU Langone Health: "Lifestyle Changes for Psoriatic Arthritis."
Rheumatology: "Obesity and Psoriatic Arthritis: From Pathogenesis to Clinical Outcome and Management."
Rheumatology and Therapy: "Obesity and Psoriatic Arthritis: A Narrative Review."
Journal of Rheumatology: "Alcohol Intake and Risk of Incident Psoriatic Arthritis in Women."
