Doctors May Be Overlooking the Real Cause of Persistent Arthritis Pain

From scitechdaily.com

A new study suggests that lingering rheumatoid arthritis symptoms are not always caused by ongoing inflammation.

For people with rheumatoid arthritis, lingering pain and fatigue are often assumed to be signs that inflammation remains active. But new research suggests the real culprit may sometimes lie elsewhere. Researchers at Semmelweis University report that sleep disorders, depression, obesity, and smoking can help sustain symptoms even when inflammation is under control, potentially trapping patients in self-reinforcing cycles that are difficult to break.

In studies published in Nature Reviews Rheumatology and The Lancet Rheumatology, the team introduced a model designed to help doctors identify and address the underlying causes of symptoms sooner.

The researchers examined the connections between depression, smoking, obesity, sleep problems, and other health conditions in people with difficult-to-treat rheumatoid arthritis.

Dr. György Nagy and Lilla Gunkl-Tóth, authors of the study, with a patient. Credit: Semmelweis University

Rheumatoid arthritis is a chronic autoimmune condition in which the immune system mistakenly attacks the joints, leading to pain, swelling, and stiffness. The disease affects tens of thousands of people in Hungary. While most patients respond to treatment, an estimated 6 to 28 percent fall into the “difficult-to-treat” category because they do not achieve sustained remission despite therapy.

The findings suggest that conditions such as depression, obesity, smoking, and sleep disorders do more than simply occur alongside rheumatoid arthritis. They may also contribute to the persistence of the disease and its symptoms.

The Vicious Cycle of Pain, Depression, and Poor Sleep

For example, pain and depression can reduce physical activity, contribute to weight gain, and worsen both sleep quality and mood. These effects can then intensify pain and interfere with daily functioning, creating a self-reinforcing cycle that is difficult to break.

In addition to identifying these patterns, the researchers developed a model aimed at improving care for patients with difficult-to-treat rheumatoid arthritis. Under the widely used “treat-to-target” strategy, doctors regularly track measurable indicators of disease activity and adjust treatment if inflammation remains uncontrolled. This may involve increasing medication doses or switching to a different therapy.

The researchers argue that this approach can serve another purpose as well. It may act as an “early warning system” that helps identify cases in which symptoms are not primarily caused by inflammation.

“When target values improve, but the patient still suffers from pain and fatigue, it is worth taking a step back. In such cases, instead of automatically prescribing more medication, doctors should look for what is maintaining the symptoms – whether it is chronic pain syndrome, depression, sleep disorders, or obesity,” said Dr. György Nagy, head of the Department of Rheumatology and Immunology at Semmelweis University.

Dr. György Nagy and Lilla Gunkl-Tóth discussing their findings. Credit: Semmelweis University

A New Early Warning System for Persistent Symptoms

The team has observed that this approach can improve outcomes for patients with difficult-to-treat disease. In many cases, it may also strengthen the relationship between doctors and patients.

Their model has gained significant international attention. The publications that introduced the concept of difficult-to-treat disease and the associated treatment strategy have been cited more than 1,000 times by other researchers. The definition is now used worldwide not only for rheumatoid arthritis but also for other medical conditions.

The researchers are now focused on the next phase of their work. Alongside their ongoing studies, they plan to participate in projects that use artificial intelligence to develop more effective treatments for people with rheumatoid arthritis.

“With AI-based pattern recognition, we could identify subgroups among patients, and with the help of these data, we could create more effective, almost personalized treatment strategies for them,” explained Dr. Lilla Gunkl-Tóth, PhD student at Semmelweis University and first author of the publications.

https://scitechdaily.com/doctors-may-be-overlooking-the-real-cause-of-persistent-arthritis-pain/

Expert shares the steps you can take to reduce risk of arthritis

From kvia.com

EL PASO, Texas (KVIA) - According to Dr. Karim A. Elsharkawy, Associate Professor of Orthopedic Surgery and Director of Joint Replacement Services at Texas Tech Health Sciences Center, while there is no cure for arthritis taking steps like leading an active lifestyle can help reduce the risk of developing the disease.

Dr. Elsharkawy said that viewing arthritis as an age related disease is a misconception, genetics and family history or even blood pressure or cholesterol issues are more likely to lead to the development of Arthritis.

"I have patients coming in saying my mom had a knee replacement, my dad had a hip replacement, somebody in the family had history of a joint problem or arthritis. That is the most common cause," Dr.Elsharkawy said. "We see this more commonly in younger, more active patients, especially if they sustained injuries growing up like cruciate ligament injuries or an injury to the knee or hip that involved cartilage."

Dr. Elsharkawy says exercise can help reduce people's risk in addition to maintaining a healthy weight to put less stress on the joints, but he advised to do any physical activities with the proper equipment.

Also, when it comes to exercise, Dr. Elsharkawy recommended stretching before and after, wearing proper form fitting shoes, and gradually escalating intensity to prevent injury.

In addition to these recommendations, Dr. Elsharkawy said even though some soreness is normal after exercise people should not hesitate to ask for medical help if the pain lingers without getting any better.

He said there is no cure for Arthritis, there is also no treatment to prevent it but early detection is ideal so the consultation and tests can be 'quick and easy.'

https://kvia.com/news/top-stories/2026/06/07/expert-shares-the-steps-you-can-take-to-reduce-risk-of-arthritis/ 

10 foods that can help or harm arthritis

From msn.com/en-us

Certain foods can reduce inflammation and support joint health, while others may worsen arthritis symptoms. Anti-inflammatory options such as fatty fish, berries, green tea, turmeric, and nuts may help ease pain and protect cartilage. In contrast, added sugars, processed meats, omega-6-rich oils, refined carbohydrates, and excessive alcohol can increase inflammation and aggravate discomfort.

Fatty Fish Help Reduce Arthritis Inflammation

©Photo by Tammy Ljungblad/Kansas City Star/Tribune News Service via Getty Images. 

Fatty fish like salmon, mackerel, sardines, and trout are high in omega-3 fatty acids and vitamin D, both linked to reducing inflammation and easing arthritis symptoms. Studies show that eating these fish at least twice a week is associated with lower disease activity in rheumatoid arthritis. Health organizations recommend regular servings to help manage joint pain and support overall health. 

Berries' Antioxidants May Ease Arthritis Inflammation

©Photo by Sebastian Kahnert/picture alliance via Getty Images

Berries, including blueberries, strawberries, and raspberries, are rich in antioxidants such as anthocyanins. These compounds have anti-inflammatory properties that may help reduce joint pain and swelling associated with arthritis. Consuming them fresh, frozen, or dehydrated without added sugar can provide these benefits while supporting overall health.

EGCG in Green Tea Supports Joint Health

©Photo by Chantal CASANOVA/Gamma-Rapho via Getty Images. GREEN TEA. 

Green tea contains the antioxidant epigallocatechin-3-gallate (EGCG), which research suggests can reduce inflammation and slow cartilage damage in arthritis. Regular consumption, such as two servings daily without added sugar, may help protect joints and support overall joint health.

Turmeric's Curcumin May Ease Arthritis Pain

©Photo by Soumyabrata Roy/NurPhoto via Getty Images

Turmeric contains curcumin, a natural compound with notable anti-inflammatory effects. Research suggests it may help reduce arthritis-related joint pain and swelling, especially when combined with black pepper to improve absorption. Incorporating turmeric into meals is a safe and flavourful way to potentially support joint health.

Numerous high-quality studies and research indicate that turmeric contains compounds with medicinal properties. These have significant benefits for the body and brain, and are beneficial for conditions like osteoarthritis, obesity, cancer, heart disease, and diabetes. Turmeric is also good for the liver and acts as an antifungal and antibacterial agent. Many of these benefits are attributed to its main active ingredient, curcumin. Turmeric is also the spice that gives curry its yellow colour and has been used in India for thousands of years as both a spice and a medicinal herb.

Nuts Provide Anti-Inflammatory Benefits for Joint Health

©Photo by Sebastian Gollnow/picture alliance via Getty Images

Nuts like walnuts and almonds are high in healthy fats, fibre, and antioxidants that can help lower inflammation and support joint function. Research links regular nut consumption to reduced risk of inflammatory diseases, including arthritis. They are an easy, nutrient-dense snack that may contribute to better joint health over time.

Added Sugars May Aggravate Arthritis Symptoms

Photo by Peter Byrne/PA Images via Getty Images. 

Research indicates that consuming added sugars, such as those in soda, desserts, and processed foods, can increase inflammation in the body. In people with rheumatoid arthritis, sugar-sweetened beverages are often reported as major triggers for worsening pain and discomfort. Limiting these sugars may help manage symptoms and improve overall joint health.

Processed and Red Meats May Worsen Arthritis Symptoms

©Photo by CHARLY TRIBALLEAU / AFP via Getty Images

Research suggests that consuming processed meats such as bacon and sausages, as well as red meats, is linked to higher levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6). These markers are associated with increased inflammation, which can aggravate arthritis symptoms. Diets that limit or exclude these meats in favour of plant-based options may help reduce inflammation and improve symptom management.

Omega-6-Rich Oils and Inflammation Risk

©Photo by Derek Davis/Portland Portland Press Herald via Getty Images. 

Corn, sunflower, and soybean oils are high in omega-6 fatty acids, which can contribute to inflammation if consumed in excess without adequate omega-3 intake. These oils are frequently found in processed and fast foods, making them easy to overconsume. Choosing alternatives like olive or avocado oil and incorporating omega-3-rich foods may help balance dietary fats and reduce inflammation.

Refined Carbohydrates May Worsen Joint Pain

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Refined carbohydrates such as white bread, white rice, and pasta can cause rapid increases in blood sugar, which may trigger inflammation. Over time, this inflammation can contribute to chronic joint pain in people with arthritis. Choosing whole grains instead can help reduce these effects and support joint health.

Excessive Alcohol Can Aggravate Arthritis Symptoms

©Photo by ASIF HASSAN/AFP via Getty Images

Regular heavy alcohol use can inflame the gut lining and contribute to a condition known as leaky gut, which may worsen the body's inflammatory response. It can also interfere with the effectiveness of arthritis medications, making symptom control more difficult. Reducing or eliminating alcohol intake may help lower inflammation and ease joint discomfort.

https://www.msn.com/en-us/health/other/10-foods-that-can-help-or-harm-arthritis/ss-AA24AJZU

Depression and Sleep Problems May Sustain Rheumatoid Arthritis Symptoms

From technologynetworks.com

Depression, sleep problems, obesity and smoking may sustain difficult-to-treat rheumatoid arthritis symptoms

According to researchers at Semmelweis University, not only inflammation, but also sleep disorders, depression, obesity, and smoking may sustain persistent rheumatic symptoms. In their publications in the journals Nature Reviews Rheumatology and The Lancet Rheumatology, they also proposed a model that can help identify and treat the true causes of symptoms in time.

Researchers at Semmelweis University analysed how depression, smoking, obesity, sleep disorders, and other health problems are linked to difficult-to-treat rheumatoid arthritis.

Rheumatoid arthritis is a chronic autoimmune disease in which the immune system attacks the joints, causing pain, swelling, and stiffness. It affects tens of thousands of people in Hungary only. Most patients respond well to treatment, but 6–28 percent belong to the so-called “difficult-to-treat” group because they do not achieve lasting remission despite therapy.

According to the publications in Nature Reviews Rheumatology and The Lancet Rheumatology, these factors may not only coexist with the disease but may also help maintain it.

For example, pain and depression may reduce physical activity, increase body weight, worsen sleep and mood – all of which can feed back into pain and everyday functioning, creating a difficult-to-break “vicious cycle.”

The researchers not only identified these patterns but also developed a new model that could improve the treatment of such difficult-to-treat patients. Under the currently used “treat-to-target” therapeutic approach, patients’ conditions are regularly monitored using measurable indicators, and if treatment does not sufficiently reduce inflammation, therapy is adjusted – for example by increasing the medication dose or switching to another drug. However, according to the researchers, this approach can function not only as a therapy but also as a kind of “early warning system”: it can quickly indicate when symptoms may not be caused solely – or at all – by inflammation.

“When target values improve but the patient still suffers from pain and fatigue, it is worth taking a step back. In such cases, instead of automatically prescribing more medication, doctors should look for what is maintaining the symptoms – whether it is chronic pain syndrome, depression, sleep disorders, or obesity,” said Dr. György Nagy, head of the Department of Rheumatology and Immunology at Semmelweis University. The researchers themselves have observed that this approach can improve outcomes for difficult-to-treat patients, and in many cases it can also positively affect the doctor–patient relationship.

The researchers’ model has achieved major international recognition: the publications introducing the concept of “difficult-to-treat” disease and the related treatment strategy have already been cited more than a thousand times by other researchers. Moreover, the definition is now used worldwide not only in the context of rheumatoid arthritis but also in connection with other diseases.

Meanwhile, the team is already working on the next steps: alongside their own research, they are planning to join projects that would use artificial intelligence to develop even more effective therapies for people with rheumatoid arthritis.

“With AI-based pattern recognition, we could identify subgroups among patients, and with the help of these data we could create more effective, almost personalized treatment strategies for them,” explained Dr. Lilla Gunkl-Tóth, PhD student at Semmelweis University and first author of the publications.

https://www.technologynetworks.com/tn/news/depression-and-sleep-problems-may-sustain-rheumatoid-arthritis-symptoms-412951 

Arthritis cases on the rise as doctors warn of early signs often ignored

From standardmedia.co.ke

Arthritis often begins subtly, with morning stiffness or joint aches that are easily mistaken for fatigue or ageing. Over time, it can worsen, limiting movement, disrupting sleep and reducing quality of life. The condition covers more than 100 disorders affecting joints, muscles and connective tissues, and can occur at any age.

Doctors warn that many people dismiss early symptoms until significant damage has already occurred. The most common form, osteoarthritis, is a “wear-and-tear” condition caused by the gradual breakdown of cartilage, leading to pain, swelling and stiffness, particularly in the knees, hips, fingers and lower back.

It is more prevalent among older adults, people with excess weight, and those in physically demanding jobs involving prolonged standing, lifting or kneeling.

                                                                                                                            [Courtesy/iStock]

Grace Achando Opwoche, 63, is living with osteoarthritis, which she believes developed after years of strenuous work and weight gain. Persistent pain has made walking and daily tasks increasingly difficult.

“From my doctor’s explanation, I came to believe that the nature of my job contributed a lot to the persistent joint pains,” she says. “My work required a lot of standing and moving around for long hours. I have also added extra weight over the years, which is weakening my joints.”

Dr Boniface Adhiambo explains that cartilage acts as a shock absorber between bones. When it wears down, movement becomes painful and even basic activities such as climbing stairs can become difficult.

Another major form is rheumatoid arthritis, an autoimmune disease in which the immune system mistakenly attacks healthy joint tissue. Unlike osteoarthritis, it often affects both sides of the body simultaneously, such as both wrists or both knees.

Doctors warn that if left untreated, rheumatoid arthritis can also damage other organs, including the lungs, eyes and heart.

“Rheumatoid arthritis is not simply joint pain,” says Dr Adhiambo. “It is a systemic disease that may cause fatigue, fever, weight loss and prolonged morning stiffness lasting more than an hour.”

Gout is another increasingly common form, caused by a buildup of uric acid crystals in the joints. It typically strikes suddenly, causing intense pain, redness and swelling, often in the big toe, ankle or foot.

It is associated with diets high in red meat, sugary drinks, processed foods and alcohol, and is more common among people with obesity, diabetes and hypertension.

Psoriatic arthritis and juvenile arthritis can affect both adults and children, causing joint pain, swelling and fatigue. In children, juvenile arthritis may also affect growth and daily functioning. Doctors caution that persistent joint pain, stiffness, swelling and fatigue should not be ignored.

Joint pain may also result from other conditions such as viral infections, fibromyalgia and lupus. Rising obesity levels, sedentary lifestyles and nutrient deficiencies are increasing risk among younger people, while injuries can lead to post-traumatic arthritis if joints fail to heal properly.

There is no cure for most forms of arthritis, but early diagnosis and treatment, alongside physiotherapy, exercise and weight management, can help preserve mobility. With cases rising globally, arthritis is becoming an increasingly significant public health concern, affecting movement, independence and overall quality of life.

https://www.standardmedia.co.ke/health/amp/features/article/2001548590/arthritis-cases-on-the-rise-as-doctors-warn-of-early-signs-often-ignored 

No pills, no surgery: Scientists uncover simple arthritis pain relief method

From thehealthsite.com

Researchers found a simple walking adjustment which may significantly reduce arthritis pain, improve joint function and potentially slow knee damage without needing medication, injections or surgery

Almost 25 per cent of older adults typically aged 40 and above suffer from painful osteoarthritis which is a condition that can make simple tasks such as walking, climbing stairs or standing for extended periods hard. Over time, the disease deteriorates the cartilage that provides cushioning for the joints and once the damage occurs there is no way to reverse.

While the standard approach for treatment often focuses on pain relief or replacement surgery for the joint, a new study claims that as simple as changing the way people walk can help reduce pain and slow joint damage. The team of researchers from the University of Utah, New York University and Stanford University found that personalized gait retraining was quite effective when it comes to easing symptoms for individuals with knee osteoarthritis.

                                                                                                                (Image: AI Generated)

The study published in The Lancet Rheumatology was based on modifying walking style examining how the angle of the foot changes during gait. Participants were instructed to turn their toes slightly inwards or outwards depending on what caused the least pressure on their knee joint. Explaining the concept Scott Uhlrich, study co-lead said, "We've known that for people with osteoarthritis, higher loads in their knee accelerate progression and that changing the foot angle can reduce knee load. So the idea of a biomechanical intervention is not new, but there have not been randomized, placebo-controlled studies to show that they're effective."

Why personalisation matters

Osteoarthritis often occurs on the inside of the knee as it is subjected to more body weight. Although the adjustments for walking do not work for all patients some participants found that setting their toes slightly inwards helped while others found it helpful when turned outwards.

According to Uhlrich, past studies have been unsuccessful because the same walking protocol was used for all participants. He explained, "Each person's new walking pattern was customized to him or her and helped increase the amount of weight individuals could offload from their knee, which was likely a factor in the positive knee cartilage and pain results we observed."

How the trial was conducted

The trial included 68 people with mild to moderate knee osteoarthritis. Participants' walking patterns were initially evaluated on the basis of MRI, pressure-sensitive treadmills and motion capture cameras. Afterwards they received six weeks of gait training sessions during which they were instructed to keep their designated foot angle with vibration feedback devices placed on their shin.

The participants were instructed to walk for at least 20 minutes a day after the training period to make the movement automatic. The results showed that after a year the participants in the real gait retraining group experienced similar pain relief as with common medications. MRI scans also revealed lower deterioration of cartilage health markers in the group compared to the placebo group.

Even though results were promising, researchers emphasized that patients shouldn't try to alter their gait on their own without professional help. The incorrect foot angle may cause more stress to the knee rather than less.

Disclaimer: This content is for informational purposes only and is not medical advice. Consult a qualified healthcare professional before making changes to arthritis treatment or exercise routines.

https://www.thehealthsite.com/diseases-conditions/no-pills-no-surgery-scientists-uncover-simple-arthritis-pain-relief-method-1325959/ 

Psoriatic Arthritis: Are You Settling for Less-Than-Optimal Control?

From everydayhealth.com

For most people with psoriatic arthritis, the availability of highly effective therapies means that the goal of treatment is a score-based outcome known as minimal disease activity (MDA).

But many people with psoriatic arthritis don’t have minimal disease activity — and experience significant joint swelling, pain, and fatigue. In some cases, this may be because you aren’t getting the right treatment.

Here’s what you should know about optimizing your control of psoriatic arthritis, and recognizing when you may need to advocate for more effective treatment.

What Is ‘Optimal Control’ in Psoriatic Arthritis?

Usually, doctors aim to treat psoriatic arthritis using what’s known as a treat-to-target approach — meaning they set a specific goal that makes sense for a patient, then adjust treatment as needed to achieve that goal.

For most people with psoriatic arthritis, the goal of treatment will be minimal disease activity, which is defined as meeting 5 out of 7 criteria that are based on clinical assessments and patient-reported outcomes. “It fits well with the treat-to-target principle — assess regularly, define the goal, and adjust therapy when the goal is not met,” says M. Elaine Husni, MD, MPH, a rheumatologist and the director of the Arthritis and Musculoskeletal Center at Cleveland Clinic in Ohio.

While many doctors use minimal disease activity as the main measure of psoriatic arthritis control, “Others may use informal targets and rely on a physical exam and patient reported satisfaction,” says Rebecca Gordon, MD, a rheumatologist at UCHealth Cherry Creek Medical Center in Denver. Tolerating medications well is another important measure that isn’t a component of minimal disease activity, Dr. Gordon says.

Some practical outcomes indicating minimal disease activity, or good control of psoriatic arthritis, include:

• Minimal or no joint swelling or pain
• Small area, or no area, of skin with active psoriasis
• Minimal or no pain in areas where tendons join bones (enthesitis)
• Minimal or no swollen “sausage fingers” or toes (dactylitis)
• Minimal or no systemic symptoms, like fatigue or brain fog

Above all, your psoriatic arthritis shouldn’t get in the way of daily activities, says Eric Ruderman, MD, a rheumatologist at Northwestern Medicine in Chicago. “I think function is a really important target,” he says. “We want to get the disease controlled enough that it doesn’t limit the things they do.”

Signs You’re Settling for ‘Good Enough’

                                                                                                                                                     iStock

Psoriatic arthritis symptoms that persist in a significant way may be a sign your disease isn’t adequately controlled.

The following “red flags” may indicate less-than-optimal disease control, according to Dr. Husni:

• Ongoing swollen joints
• Ongoing enthesitis or dactylitis
• Morning stiffness that doesn’t improve soon
• Recurrent disease flares that require steroid treatment
• Worsening skin or nail symptoms
• Pain that interferes with work, sleep, exercise, or family activities

But it’s important to distinguish symptoms of psoriatic arthritis from any other health conditions you may have. “Ongoing pain does not always mean that psoriatic arthritis is not under control,” says Gordon. “In cases where it is not certain what is causing ongoing pain, imaging with ultrasound or MRI can help evaluate ongoing inflammation or other causes of pain.”

You may also be settling for inadequate treatment if your overall disease control is good, but an aspect of your psoriatic arthritis that especially bothers you persists, says Dr. Ruderman. “If you go after a global outcome measure and yet the thing that bothers [the patient] isn’t truly better, then you haven’t achieved your target,” he says. “I look to them to say, what are the elements of the disease that bother you the most? Is it your joints, your skin disease, your Achilles tendinitis?”

The Risks of Settling

Settling for less-than-adequate treatment of your psoriatic arthritis doesn’t just mean a worse quality of life in the present. It could also endanger your health in the future.

Gordon says that suboptimal disease control is linked to both accelerated joint damage and a higher risk for cardiovascular disease. “Patients should be working closely with their primary care providers to ensure optimal control of things like lipids, blood pressure, and diabetes,” she says, particularly if you’ve had periods of ongoing psoriatic arthritis activity.

Ongoing symptoms that seem fairly tolerable can still mean trouble in the future. “If you settle, sometimes disease with low-grade symptoms can continue and lead to disability over time,” says Husni.

Ruderman notes that some therapies for psoriatic arthritis, particularly biologic drugs, may help prevent joint damage even if they don’t fully control your symptoms. “You risk the possibility that you might do less well on something that we switch you to,” he says. “So it becomes a bit of a judgment call.”

A key question, Ruderman says, is whether you’re fully living your life instead of being limited by your psoriatic arthritis. “If the answer is no, we can maybe get there,” he says. “And why shouldn’t we, when we have the medications and tools to do so.”

How to Advocate for Improved Treatment

If you feel that your psoriatic arthritis treatment leaves something to be desired, it’s important to let your doctor know about your concerns so they can take action. If your disease has improved but you have some ongoing symptoms or episodes of feeling worse, “There may still be some lingering disease activity, and more imaging or frequent exams could help,” says Husni.

Husni suggests keeping a diary with weekly entries listing any symptoms or concerns and sharing this with your doctor at your next appointment. “This will help the physician understand what is bothering you the most and better understand what is related to psoriatic arthritis and what may not be,” she says.

Since appointments with a rheumatologist can be difficult to schedule and may feel short or rushed, Gordon suggests asking your doctor about the best way to communicate between appointments to share your concerns as needed.

During appointments, “patients should not be afraid to ask directly, ‘Am I at my treatment target?'” says Gordon. “Patients should also express their priorities — i.e. reduced pain, minimizing side effects — to help tailor treatment selection.”

Don’t be afraid to let your doctor know if you’re not satisfied with your disease control, says Ruderman. “You have to say, ‘These are the elements of my disease that I’m not happy with. What are we going to do to fix that?’”

The Takeaway

• For most people with psoriatic arthritis, optimal control means achieving minimal disease activity (MDA), with few if any ongoing symptoms.
• Even relatively minor disease activity can worsen joint damage over time, and may increase the risk of developing cardiovascular disease.
• Let your doctor know if you have any symptoms that bother you, keeping track of how often they occur. Ask how your treatment can be changed to address your concerns.

https://www.everydayhealth.com/psoriatic-arthritis/are-you-settling-for-less-than-optimal-control/