The couples who cope together, stay together

From eurekalert.org

An Australian-first study has lifted the lid on how couples living with rheumatoid arthritis cope with the debilitating disease finding that those who cope with problems together had less psychological distress and better relationships.

The study, published in The Journal of Rheumatology examined dyadic coping - when a couple engages in joint problem solving, joint information gathering, or the sharing of feelings and mutual commitment - from both partners' perspectives using a sample of 163 couples.

“Dyadic coping, the process of coping that transpires between couples challenged by one partner’s illness, is an important predictor of disease adjustment and patient well-being,” says lead author Dr Manasi Murthy Mittinty from the College of Medicine and Public Health.

“Dyadic coping contributes to a sense of togetherness, encouraging couples to develop strategies as a unit to respond to stressful events, and it represents a protective factor for minimising the risk of divorce.

“Working together as a couple is crucial for managing the challenges they face when one partner has an illness, particularly in rheumatoid arthritis.”

Rheumatoid arthritis (RA) is an autoimmune condition that can cause irreversible tissue damage, progressive deformity and pain. Approximately 18 million people worldwide are living with RA, including nearly 456,000 Australians.

Although management of RA has improved dramatically due to biologics, some patients are still confronted by severe physical pain and stiffness and about 35% of people report experiencing mental and behavioural conditions, such as bipolar disorder, mania and anxiety disorder.

“We found that supportive dyadic coping leads to lower depression, anxiety, and stress for patients, as well as improved relationship quality. In contrast, negative dyadic coping increases psychological distress and reduces relationship quality for both partners,” says Dr Mittinty.

“By examining the interpersonal dynamics of couples grappling with chronic disease, we hope to significantly improve the quality of life for patients living with rheumatoid arthritis and their spouse.”

The study is the first in Australia to report dyadic coping from the perspective of both participants with RA and their spouses.

RA patients and their spouses were invited to participate in an online survey study if they were more than 18 years old and had lived together for more than a year. The survey included the Chronic Pain Grade Scale, Dyadic Coping Inventory, Depression Anxiety Stress Scale, and Dyadic Adjustment Scale.

“The results underscore the interconnected nature of dyadic coping, highlighting the need to consider both viewpoints in understanding its impact on couples.

“For decades, the focus has been limited to reducing patients’ illness-related distress and improving patient outcomes. More recently, scientists have adopted a new approach into understanding how illness in a spouse can affect the couple’s relationship and the other spouse’s well-being.

“Our findings demonstrate the reciprocal nature of dyadic coping that transpires between patients with RA and their spouses and showcases that integrating dyadic coping training in disease management may be a valuable resource for enhanced mental health outcomes and relationship quality of couples,” she adds.

The article, ‘Interpersonal Process of Dyadic Coping in Rheumatoid Arthritis: A Perspective From the Australian Rheumatology Association Database’, by Manasi M. Mittinty, Murthy N. Mittinty, Rachelle Buchbinder, Marissa Lassere, Vibhasha Chand, Samuel Whittle, Lyn March and Catherine Hill was published in The Journal of Rheumatology. DOI: 10.3899/jrheum.2023-0664

https://www.eurekalert.org/news-releases/1062990

A proactive approach to hip pain in younger adults: What is hip arthroscopy?

From uchealth.org

Hip pain in younger adults can be hard to diagnose. If non-surgical options fail, hip arthroscopy may help people return to pain-free activities

Younger adults suffering from certain types of hip pain can get relief, as well as potentially prevent future problems such as hip arthritis, with an outpatient arthroscopy procedure.

Arthroscopy for the hip is the relative new kid on the block compared to similar procedures done on the knee and shoulder. It can relieve pain in adults with certain hip problems who are not responding to nonsurgical procedures.

“The goal of hip arthroscopy is to get you back pain free to the activities you love, and it may postpone having hip arthritis for years or even decades,” said Dr. Jay Thompson, an orthopaedic surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center.

Hip pain in younger adults can be hard to diagnose. If non-surgical options fail, hip arthroscopy may help people return to pain-free activities. Photo: Getty Images

What is causing your hip pain?

The hip joint is like a basic ball and socket and is one of the largest joints in the human body – it is vital to movement. Pain there can happen for many reasons, such as wear and tear from age, traumatic accidents, genetic conditions and certain repetitive motions or exercises.

The origin of hip pain can be difficult to diagnosis, Thompson said. Patients usually have specific symptoms such as deep hip or groin pain, or pain that comes with squatting, skating or deep inflection motions.

Doctors may diagnose some patients with femoroacetabular impingement, or FAI, which is more commonly known as hip impingement. This occurs when excess bone causes the ball and socket of the hip joint to not fit together properly. Other patients may have a symptomatic hip labral tear, which is when the cartilage that lines and protects the hip socket is damaged.

“Many of us experience hip pain at some time or another, and these more specific conditions can be commonly missed,” said Thompson. “It’s best to see a specialist for evaluation and treatment.”

When is arthroscopy for hip pain in younger adults recommended?

Patients suffering from hip pain are usually referred to physical or occupational therapy for pain management, as well as told to rest and modify the sports or physical activity that they suspect is the source of the pain.

If the condition does not improve, medication or pain injections to relieve inflammation are typically prescribed. Doctors commonly use Injections not only to treat the pain but also to confirm the diagnosis, as hip pain can be originate from various sources.

If those non-surgical options don’t provide relief, hip arthroscopy may be recommended.

“Hip arthroscopy is a good choice for a patient who is in pain from hip impingement or a labral tear,” said Thompson. “Once treated, it can help prevent arthritis in the future.”

What happens during the procedure?

During hip arthroscopy, a patient is placed under anaesthesia. A surgeon makes a small incision in the hip and uses a special device with a small camera to see the joint. Loose or damaged tissue such as the labrum can be removed, repaired or reconstructed, and the bone can be reshaped to within normal tolerances.

The minimally invasive approach means that patients can go home the same day and typically have a quicker recovery time.

“Hip arthroscopy can improve hip pain and can even prevent or postpone a person from getting early onset hip arthritis,” said Thompson. “We can repair the labrum and reshape the bone. It’s not a 100% guarantee, but for patients in their 30s and 40s, it can give them another 10 to 20 years of good hip life.”

https://www.uchealth.org/today/proactive-approach-to-hip-pain-in-younger-adults-what-is-hip-arthroscopy/ 

Some rheumatoid arthritis patients are more vulnerable to pulmonary fibrosis than others

From koreabiomed.com

Some pulmonary fibrosis, the progressive hardening of the lungs that causes breathing difficulties, occurs in relation to rheumatoid arthritis (RA). Specific patient groups are at a higher risk of RA-related pulmonary fibrosis, which affects 3-15 percent of all RA patients.

“Rheumatoid arthritis mostly affects middle-aged women. However, suppose RA occurs in men or older adults. In that case, there are problems (due to higher chances of rheumatoid arthritis-related pulmonary fibrosis,” said Professor Kim Hyun-sook of the Department of Rheumatology at Soon Chun Hyang University Hospital Seoul on the Korean Blood Disease and Cancer Association's YouTube channel, “KBDCA.”

                                                                                                                            (Credit: Getty Images)

It's unclear why pulmonary fibrosis occurs in around 10 percent of patients with RA, an autoimmune disease. However, it is believed that some autoantibodies that attack the joints also attack the bronchi and alveoli of the lungs, causing inflammation and fibrosis.

In addition to being male and older, there are other characteristics of patients at high risk for RA-related pulmonary fibrosis.

“We test patients with rheumatoid arthritis for rheumatoid factor or anti-CCP (anti-cyclic citrullinated peptide) antibodies, and those with exceptionally high levels of the factor have a high risk of RA-related pulmonary fibrosis,” Professor Kim said. “Anti-CCP antibodies are normal at 5 to 15, but many patients with high levels are more likely to be hit at their lungs.”

Specific gene variants are also associated with the development of RA-related pulmonary fibrosis.

“We've looked at some genetic variants and found that certain genetic variants are associated with an increased risk of pulmonary fibrosis, so it may be important to get screened if you have a family history of the disease,” said Professor Yoon Hee-young of the Department of Respiratory and Allergy Medicine at the same hospital.

People with poorly controlled rheumatoid arthritis are also at higher risk for RA-related pulmonary fibrosis. Besides, there are other cases where the risk of pulmonary fibrosis is increased in people with rheumatoid arthritis regardless of the disease.

“Some patients may develop or worsen pulmonary fibrosis, not necessarily because of RA, but because they are taking medications that can affect the lungs (respiratory toxicants),” Professor Kim said. “Screening, diagnosis, and treatment should be tailored to each individual's risk.”

If diagnosed with RA-related pulmonary fibrosis, there is one thing that all patients should do -- stop smoking.

“Another important risk factor (for RA-related pulmonary fibrosis) is smoking,” Professor Yoon said. “Certainly, it has been reported that patients who smoke have a higher incidence of pulmonary fibrosis. We explain to patients that they should quit smoking if they are diagnosed with pulmonary fibrosis.”

https://www.koreabiomed.com/news/articleView.html?idxno=25487

Early rheumatoid arthritis tied to hypertension

From medicalxpress.com/news 

Patients with early rheumatoid arthritis (RA) have a high incidence of prevalent and incident hypertension, according to a study published online in the August issue of Rheumatology: Advances in Practice.

Brook Hadwen, from the University of Western Ontario in London, Canada, and colleagues used data from the Canadian Early Arthritis Cohort to explore the prevalence and incidence of hypertension and baseline factors associated with incident hypertension in early RA (2,052 patients).

The researchers found that the prevalence of hypertension at study enrolment was 26% (23% in women and 34% in men). Prevalent hypertension was associated with older age, diabetes, and hyperlipidemia in both sexes. In women, hypertension was associated with being overweight or with high alcohol consumption.

One quarter (24%) of the RA patients did not have hypertension at enrolment but developed hypertension during the median follow-up period of five years. Incident hypertension was significantly associated with the baseline factors of older age, being overweight, excess alcohol consumption, and having hyperlipidemia. There were no significant associations between RA-associated disease factors and treatments with prevalent or incident hypertension.

"Weight loss and lifestyle modifications such as changes in diet, exercise, and limiting alcohol intake may reduce the risk of high blood pressure and prevent heart disease," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

More information: Brook Hadwen et al, Risk factors for prevalent and incident hypertension in rheumatoid arthritis: data from the Canadian Early Arthritis Cohort, Rheumatology Advances in Practice (2024). DOI: 10.1093/rap/rkae066

https://medicalxpress.com/news/2024-10-early-rheumatoid-arthritis-hypertension.html

Does your body feel tight when you wake up? Learn how to manage morning stiffness with doctor-approved tips

From hindustantimes.com

Do you know morning stiffness can be the first symptom of early arthritis? Here's all you need to know about morning stiffness, its treatment and more

Morning stiffness is common among people with joint conditions. It manifests as difficulty in moving joints upon waking and often lasts for 30 minutes or more, says Dr Abhisar Katiyar, senior consultant and robotic surgeon-orthopaedics and joint replacement, Yatharth Hospitals Greater Noida. This stiffness is typically more pronounced in inflammatory conditions such as rheumatoid arthritis, he adds.

More about morning stiffness

Waking up with stiff joints can make simple tasks like getting out of bed or walking a challenge. According to Dr Yash Gulati, senior consultant, orthopaedics, joint replacement and spine, Indraprastha Apollo Hospitals, morning stiffness can be the first symptom of early arthritis. 

"If stiffness wears away rapidly, it could be due to age-related osteoarthritis, and if stiffness continues for a prolonged period throughout the day, it can be a symptom of an inflammatory type of arthritis," he says. Arthritis is a condition characterised by inflammation of the joints, leading to pain, stiffness, and reduced mobility.

                                          Even some light stretching will help keep your body healthy and fit. (Freepik)

Managing morning stiffness

According to Dr Abhisar Katiyar, management strategies include taking prescribed medications before bedtime, gentle stretching exercises before getting out of bed, and using warm compresses. Patients experiencing persistent morning stiffness should consult expert professionals for further evaluation, he adds.

Dr Yash Gulati suggests keeping the body moving to battle morning stiffness. "Gentle stretching before getting out of bed can help loosen tight muscles and improve joint mobility. Activities like yoga or a short morning walk can also boost circulation, easing stiffness. Applying warmth, such as taking a hot shower or using a heating pad, can soothe sore joints and relax muscles, making movement easier," he says.

"Additionally, staying hydrated throughout the day and eating a balanced diet rich in anti-inflammatory foods like omega-3 fatty acids can help maintain joint health. For those with arthritis, it may be necessary to consult a doctor to explore treatment options, such as medication or physical therapy. Taking steps to address morning stiffness not only helps with mobility but also sets a positive tone for the day, making it easier to engage in daily activities with less pain and discomfort," Dr Yash Gulati adds.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

https://www.hindustantimes.com/lifestyle/health/does-your-body-feel-tight-when-you-wake-up-learn-how-to-manage-morning-stiffness-with-doctor-approved-tips-101729418930826.html

Is it time for a knee replacement?

From health.harvard.edu

By Maureen Salamon

Find out why women undergo this common surgery more often than men — and how to preserve your knee health

Back in the day, going weak in the knees meant something good. Decades later, though, it's merely a glaring sign you may need to replace your natural knee joint — the largest in the body — with a metal and plastic version.

It's a growing phenomenon as the population ages and more people want to stay active as they grow older. Total knee replacement is one of the most common surgeries in the United States, performed in about 790,000 Americans each year — about 60% of whom are women.

What accounts for the sex gap? We're about 30% likelier than men to cope with arthritis in our knees — a propensity driven by factors such as hormones, joint laxity, and anatomical differences between the sexes. And arthritis pain happens to be the culprit that leads to most knee replacements, whether from wear-and-tear osteoarthritis, inflammation-driven rheumatoid arthritis, or post-traumatic arthritis stemming from an injury to the knee joint. 

Ligaments in the knee can also loosen, causing the joint to bend inward or outward. Women also experience this complication more often than men, says Dr. Scott D. Martin, director of the Joint Preservation Service at Harvard-affiliated Massachusetts General Hospital.

But while women are more vulnerable to these knee-wrecking issues, we're also more apt to jump on the problem and be evaluated for joint replacement.

"Men are more reluctant than women to come and get treated," Dr. Martin says. "Women come in sooner, and they tend to be better at sticking with the treatment plan."

Taking the leap

You might have already coped with years of limitations — difficulty walking distances, climbing stairs, or getting in and out of chairs — related to your knee problems. Before knee replacement becomes an option, your doctor will likely require you to have tried every available non-invasive treatment. These include pain relievers; injections of medications such as cortisone and hyaluronic acid, which can dampen inflammation or lubricate the joint; and physical therapy.

Any of the following situations might suggest it's time to consider surgery:

Pain slows you down no matter what you've tried. You're hobbled by pain that hinders you from doing the most basic things. The effects aren't just physical. "If you've tried everything else, it starts to physically, mentally, and emotionally affect you on a daily basis," Dr. Martin says.

Your walking is unstable. As the day goes on, your legs may feel stiffer and weaker. Your knee may even buckle. "After you've been up for eight to 10 hours, your muscles get angry, so you're feeling every step," Dr. Martin explains. "It's not that the arthritis progressed in six hours, it's that the muscles are fatigued." Moreover, this raises your risk of falling.

You need multiple medications to function. Getting through the day may require taking several forms of nonsteroidal anti-inflammatory drugs (NSAIDs) or even prescription pain relievers. But age factors into your ability to continue this regimen indefinitely, Dr. Martin says. Someone in her 40s will likely draw this strategy out for many years, while others in their 60s or 70s may be spurred by their dependence on pain relievers to go ahead with the operation.

Knee-sparing strategies

Even if you have knee problems, you might be able to delay replacement surgery while you protect your knees from further damage. Here are some ways to buy time:

Consider a less-extensive operation. Same-day arthroscopic procedures enable surgeons to use a tiny camera to visualize problems inside the joint and trim away damaged tissues.

Wear a knee brace. This can stabilize the knee, but the approach has drawbacks. "Some people swear by them, but they don't treat the root cause of the problem," Dr. Martin says.

Use topical creams or pain patches. These products can offer targeted relief without side effects common to systemic medications. But pain patches are more effective for muscular pain around the knee than pain deeper within the joint, Dr. Martin notes.

Stay active. Regular exercise — especially low-impact activities like swimming, biking, and walking — keeps leg muscles strong, alleviating knee strain.

Lose weight. If you already have arthritis or a knee injury, carrying extra weight "can greatly accelerate the wear on that knee," he says. "Losing weight can take pressure off the joint."

If you're interested in learning more about knee replacement, consult Harvard's online guide Total Knee Replacement. This in-depth look will help you decide if knee replacement is right for you.

https://www.health.harvard.edu/staying-healthy/is-it-time-for-a-knee-replacement

Ease arthritis symptoms this winter with these four breakfasts, nutritionist says

From getsurrey.co.uk

A nutritionist also revealed some popular foods that could make arthritis symptoms worse 

Arthritis and other joint problems are common in the UK, thought to affect more than 10 million people. While symptoms will vary depending on your specific condition, it can cause issues such as pain, inflammation, joint stiffness and even difficulty moving.

In the winter these symptoms can worsen as cold temperatures can heighten pain sensitivity, slow blood circulation and even cause muscle spasms. Although there is no cure for arthritis, there are ways to reduce pain and ease other symptoms.

As is the case with many medical conditions, focusing on what you eat is one such way to minimise the impact of arthritis. With this in mind, nutritionist Trevor Roberts, from Nutra Ingredients, recommended incorporating four anti-inflammatory breakfasts that could help reduce joint pain and improve overall health.

Smoothie bowls that contain yoghurt and fruit are one breakfast that could help ease arthritis symptoms (Image: Getty)

Oatmeal

According to Trevor, oatmeal topped with almonds and nut butter is a “smart choice” for breakfast. He said: “Oats are rich in magnesium, which is vital for activating vitamin D to assist with calcium absorption. Oats are an excellent choice for breakfast as their high fibre content helps regulate blood sugar levels, which can prevent spikes in inflammation and reduce arthritis pain."

Smoothie bowl

Made correctly, smoothie bowls can be both versatile and nutrient-dense. He continued: “Including dairy products provides calcium, a critical component for bone health, while berries, nuts and seeds are rich in antioxidants that can help lower inflammation and oxidative stress in the joints.

"Berries, such as blueberries, strawberries, and raspberries, are packed with antioxidants and anti-inflammatory compounds. Regularly consuming these fruits can combat chronic inflammation, a major contributor to arthritis symptoms.

"Greek yoghurt is beneficial for breakfast due to its rich protein and probiotic content. A healthy gut microbiome can positively influence inflammation levels, potentially easing the pain associated with arthritis.

"Nuts and seeds, including almonds and flaxseeds, offer powerful antioxidants and anti-inflammatory properties. Including them in your morning breakfast can help neutralise free radicals, protecting your joints from damage."

Egg and spinach

Trevor advised combining egg and spinach for a tasty breakfast wrap that can minimise arthritis symptoms. “Eggs are a natural source of vitamin D, which is crucial for calcium absorption, while spinach provides vitamin K, calcium, and magnesium—all essential for bone strength and joint function,” he said.

"Leafy greens like spinach and kale are often overlooked at breakfast, yet they are rich in vitamins and minerals essential for joint health. Their high fibre content also supports stable blood sugar levels, helping to minimise inflammation."

Salmon and avocado toast

Salmon and avocado on whole-grain toast is not only delicious but also packed with health benefits. He added: “The omega-3 fatty acids in salmon have powerful anti-inflammatory properties that can help alleviate joint pain, while whole-grain bread contributes to reducing inflammation overall.

Trevor also warned of foods and drinks to avoid this winter if you have arthritis or joint issues:

• Processed foods - they often contain unhealthy fats and additives that can trigger inflammation in your body, worsening arthritis symptoms
• Foods made with refined carbs - white bread and pastries can cause spikes in blood sugar levels, which may increase inflammation and lead to more joint pain
• Red meat - this is high in saturated fats, which can worsen inflammation and increase the risk of chronic diseases that affect your joints
• Processed meats - processed meats like sausages often contain preservatives and additives that can trigger inflammatory responses, leading to increased joint pain
• Foods high in sodium - these can cause fluid retention and increased blood pressure, which may worsen joint pain and discomfort.
• Coffee - drinking too much coffee might exacerbate symptoms for some people by triggering inflammation.
• Sugary drinks - drinks like soda and sweetened juices contain high levels of sugar, which can promote inflammation and contribute to weight gain, putting extra stress on your joints.

According to the NHS, common symptoms of arthritis include:

• Joint pain, tenderness and stiffness
• Inflammation in and around the joints
• Restricted movement of the joints
• Warm red skin over the affected joint
• Weakness and muscle wasting.

If you experience any symptoms of arthritis you should speak to your GP.

https://www.getsurrey.co.uk/news/health/nutritionist-breakfast-arthritis-symptoms-30178598

Delaying knee arthritis treatment can damage spine, warn health experts

From bilkulonline.com

New Delhi, Oct 12 : Delay in proper knee treatment, timely detection and ignoring knee arthritis symptoms can worsen the condition of knees and additionally damage the spine affecting the quality of life, health experts said on Saturday on the occasion of the World Arthritis Day. Knee arthritis, particularly osteoarthritis, is a degenerative joint condition that primarily affects adults. It causes pain, stiffness, and reduced mobility in the knees, often making everyday activities difficult.

However, according to experts, the repercussions of untreated or poorly managed knee arthritis extend far beyond the knee join. Dr L Tomar from Max Hospital said that in more than 70 per cent cases, osteoarthritis is the commonest reason for knee arthritis. Osteoarthritis causes more progressive damage to the medial (inner) joint compartment cartilage leading to reduction in the gap between the two bones. Patients with advanced knee arthritis are often seen to have spinal deformity because when patients continue to walk with a bow leg deformity it put more pressure on lumber spine leading to its damage, such cases can be corrected with minimally invasive total knee replacement surgery, said Dr Tomar.

In osteoarthritis, multiple osteophytes form around the joint causing progressive limitation in knee movements. Patient with late-stage knee arthritis often report with fixed deformity with very little movement. According to Dr Praveen Gupta from Fortis Hospital, several neurological symptoms can be a consequence of rheumatological diseases. For instance, inflammatory arthritis can lead to nerve compression syndromes, resulting in pain and numbness.

Yet, these interconnections are frequently overlooked in clinical practice, primarily due to a lack of knowledge and training in the field. Experts urged patients not to ignore early signs of arthritis, advising them to consult specialists for proper diagnosis and treatment. Timely action, they stressed, can prevent long-term complications and improve overall quality of life. 

https://bilkulonline.com/2024/10/12/delaying-knee-arthritis-treatment-can-damage-spine-warn-health-experts/ 

Living With Arthritis: Tips For Managing Pain And Improving Quality Of Life

From news18.com 

You can effectively manage arthritis pain, improve mobility, and enhance overall well-being by incorporating these tips into your daily life

World Arthritis Day, observed annually on October 12, aims to raise awareness about arthritis and related conditions, which affect millions globally. It highlights the importance of early diagnosis, treatment, and support for those living with arthritis. Arthritis encompasses over 100 diseases, including osteoarthritis and rheumatoid arthritis, leading to joint pain, stiffness, and reduced mobility. The day promotes advocacy, education, and research efforts to improve the quality of life for arthritis patients. By fostering understanding and empathy, World Arthritis Day encourages both individuals and healthcare systems to prioritize arthritis care and patient well-being.

Living with arthritis can be challenging, but there are ways to manage pain and improve your quality of life. Dr Ajay Kumar SP, Consultant- Spine Care, Manipal Hospital Varthur shares some valuable tips:

Pain Management

• Medication adherence: Follow your doctor’s prescription plan.
• Exercise regularly: Gentle exercises like yoga, swimming, or cycling.
• Heat or cold therapy: Apply heat or cold packs to affected joints.
• Mind-body techniques: Practice meditation, deep breathing, or tai chi.
• Rest and relaxation: Balance activity with rest.

Lifestyle Adjustments

• Maintain a healthy weight: Reduce joint stress.
• Balanced diet: Include omega-3 fatty acids, fruits, and vegetables.
• Stay hydrated: Drink plenty of water.
• Quit smoking: Smoking exacerbates arthritis.
• Prioritize sleep: Aim for 7-8 hours of sleep.

Assistive Devices

• Canes or walkers: Support mobility.
• Joint supports: Use splints or orthotics.
• Adaptive tools: Modify daily items (e.g., ergonomic handles).
• Bathing aids: Install grab bars or use non-slip mats.

Staying Active

• Physical therapy: Improve flexibility and strength.
• Gentle exercises: Try tai chi, qigong, or water aerobics.
• Join a support group: Connect with others.

Mental Well-being

• Seek counselling: Address anxiety or depression.
• Stress management: Practice relaxation techniques.
• Connect with loved ones: Build a support network.

Healthcare Team Collaboration

• Regular check-ups: Monitor condition progression.
• Open communication: Share concerns and questions.
• Explore alternative therapies: Discuss options with your doctor.

By incorporating these tips into your daily life, you can effectively manage arthritis pain, improve mobility, and enhance overall well-being.

https://www.news18.com/lifestyle/living-with-arthritis-tips-for-managing-pain-and-improving-quality-of-life-9084085.html

What’s the Prognosis for Psoriatic Arthritis?

From healthcentral.com

Without treatment, symptoms for PsA can get worse. Learn how to manage this disease so you can keep living an active life 

Psoriatic arthritis (PsA) is a chronic inflammatory disease that can impact practically every part of your body. The chronic condition can lead to peripheral arthritis, skin disease, spine disease, enthesitis, dactylitis, nail disease, as well as other comorbidities such as eye disease and anxiety.

The complications and symptoms of psoriatic arthritis can worsen over time and negatively impact your quality of life. In years past, the prognosis for someone with a psoriatic arthritis diagnosis wasn’t great. But recent treatment advances have improved outcomes for those with this disease and lifestyle modifications are helping people with PsA stay active longer. We asked the experts what you can expect if you’ve been diagnosed with this disease and how you can slow its progression.

Typical Progression of Psoriatic Arthritis

Psoriatic arthritis often begins as the skin disorder psoriasis. Psoriasis causes rashes with itchy, scaly patches, and can be found anywhere on the body. About a third of people who have psoriasis will also develop psoriatic arthritis, according to the National Psoriasis Foundation.

Early in the disease course, it may be hard to determine if you have psoriatic arthritis. This stage of the condition is referred to as subclinical or preclinical, according to a 2022 article in the Journal of Dermatological Treatment. At the subclinical psoriatic arthritis stage, you may have joint inflammation and/ or changes to the joint that are detectable via diagnostic imaging techniques like ultrasonography or magnetic resonance imaging.

Largely, though, the joints are pain-free at this point, making it hard to know you have the condition, unless you go looking for it. In fact, subclinical symptoms indicating early PsA are widespread among patients with psoriasis who do not yet have a diagnosis of psoriatic arthritis, according to the article authors. In one study, 41% of patients with psoriasis in whom psoriatic arthritis was identified by rheumatologists were undiagnosed by their dermatologists.

The early stage of the disease can also be a difficult time for patients, says Hannah Pugh, an occupational therapist and head of clinical experience at Reactiv, a virtual physical therapy company in Brooklyn, NY. “During the early stages of PsA, treating and managing the condition can be challenging as patients have not yet received a diagnosis, which often means they have not started appropriate medication,” says Pugh, who works with patients who have a chronic condition to help them manage their condition and equip them with tools to regain control over their disease.

Beyond the early stages of psoriatic arthritis, how the condition progresses varies greatly from one person to the next. “It is a full-body disease,” acknowledges Laura Coates, Ph.D., an associate professor and researcher of psoriatic arthritis at the University of Oxford in England. “It can affect many different types of tissues—like your joints, tendons, skin, spine—and can affect any joint in the body,” she explains. Even for a single person the disease can look different from month to month or season to season.

Still, there are some issues that most psoriatic arthritis patients share in common that were identified by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). These complications and symptoms can worsen over time. According to a 2023 study in the journal Joint Bone Spine, people with PsA were also like to have:

• Axial disease: Anywhere from 20% to 70% of people with psoriatic arthritis face the sacroiliitis and inflammatory back pain caused by this disease. Back pain typically increases as time goes on.

• Dactylitis: 15% to 48% of patients with psoriatic arthritis also have this symptom, often referred to as “sausage digits.”

• Enthesitis: 7% of psoriatic arthritis patients with a disease duration of five years have this complication.

• Nail psoriasis: Anywhere from 40% to 67% of psoriatic arthritis patients have nail issues.

• Peripheral arthritis: 64% of people living with psoriatic arthritis have this form of arthritis.

• Skin psoriasis: 77% have active psoriasis.

Will Symptoms Get Worse Over Time?

Without treatment, uncontrolled inflammation can cause multiple psoriatic arthritis symptoms to occur at once. For example, in one study, 50% of people with psoriatic arthritis experienced peripheral joint involvement and skin psoriasis at the same time.

And for those with psoriatic arthritis who have skin involvement, progression is often unpredictable, according to Christopher Sayed, M.D., an associate professor of dermatology at the University of North Carolina at Chapel Hill. “Many patients with mild psoriasis may continue to have occasional mild flares that are controlled with topical medications, but it can decide to get worse at seemingly random times,” he says. Severe disease may predict even worse outcomes, says Dr. Sayed. “Patients that have had severe flares with extensive involvement of the skin are more likely to have more frequent and more severe swings in disease activity,” he explains.

Does Psoriatic Arthritis Affect Life Expectancy?

According to a 2022 study in the journal Rheumatology, among psoriatic arthritis patients, mortality rates may be slightly higher than in the general population. Researchers relate those stats to a greater amount of cardiovascular disease in the PsA community.

In another study, researchers set out to discover whether new treatment advances have translated into normalizing life expectancy for those with psoriatic arthritis. Compared to the general population, they found a small but significant increase in all-cause and cardiovascular mortality among women with psoriatic arthritis but not men. What’s more, mortality increased among patients who had used glucocorticoids but not biologic disease modifying anti-rheumatic drugs (bDMARDs).

The three leading causes of death for psoriatic arthritis patients (as well as the general population) were:

• cardiovascular disease

• malignancies

• respiratory diseases

Death from cardiovascular disease was higher among women. The authors of the study hypothesized that risk factors such as obesity, hypertension, smoking, and diabetes may have been more prevalent among women with psoriatic arthritis.

Factors That May Affect PsA Life Expectancy

People with psoriatic arthritis have a higher burden of risk factors like obesity, hypertension, diabetes, smoking and cardiovascular disease compared to the general population. Each of these can play a role in life expectancy.

Obesity

The World Health Organization defines being overweight or obese as abnormal or excessive fat accumulation that may impair health. The prevalence of obesity among U.S. adults is about 42% where the rates of obesity for those with psoriatic arthritis is about 45%. The problem is that fat increases inflammatory proteins which promote more inflammation. Ongoing inflammation contributes to a number of different diseases that can lead to not only worse PsA but also a shorter life expectancy, according to the Arthritis Foundation. The good news? Losing weight can make a big difference. In one study, weight loss of more than 10% of body mass resulted in an increase in the percentage of patients achieving psoriatic arthritis remission from 6% to 63%.

Hypertension

High blood pressure, another name for hypertension, can damage your body over time if it goes untreated. It is measured in millimetres of mercury (mm Hg) and the optimal range is less than 120/80 mm Hg according to the American College of Cardiology. Body-wide inflammation is known to damage blood vessels, according to the Arthritis Foundation, which can put you at additional risk if your psoriatic arthritis is not controlled. Monitoring your blood pressure numbers and keeping your disease under control can be key to staying healthy.

Diabetes

The prevalence of type 2 diabetes in people with psoriatic arthritis ranges from about 6 to 20%, compared to 2 to 15% in the general population, according to a 2020 review. A higher risk of diabetes is reported in women with more severe forms of psoriatic arthritis. According to the authors of the review, the link between diabetes and psoriatic arthritis is not completely understood, but certain cytokines such as tumour necrosis factor alpha are suspected to play a role. The good news is that treating your psoriatic arthritis may help reduce your risk of diabetes.

Cardiovascular Disease

Also known as heart disease, cardiovascular disease refers to a few conditions including heart attack and stroke. According to the Arthritis Foundation, people with psoriatic arthritis actually have a doubled cardiovascular risk—they have traditional risk factors for heart disease such as obesity and diabetes and they experience whole body inflammation, which is known to damage blood vessels. Achieving and maintaining a healthy weight becomes especially important if you have PsA because obesity is associated with many cardiovascular risk factors.

Does Age of Diagnosis Matter? 

According to a 2023 study, age of onset of psoriatic arthritis can make a difference in disease outcome. In the study, participants with PsA were put into two groups, those who were diagnosed after 60 years of age (late onset) and those diagnosed before 60 years of age (early onset).

Interestingly, people with late onset psoriatic arthritis displayed an increased risk of a major cardiovascular event, even with similar smoking habits and body weight as the group with earlier onset. The authors admit that there is a lot of research needed to understand why this relationship exists.

While some may be hesitant to try a biologic as they get older for treatment, there is research available suggesting that older people with psoriatic disease respond just as well as younger people to biologic treatment. In one study looking at psoriasis treatment with a biologic, the efficacy in elderly subjects (65 or older) was comparable to that in younger subjects throughout 52 weeks of treatment. Notably, 75% clear skin was reached by 82% of the elderly subjects and 79% of younger subjects at week 52. The total rate of adverse events was similar between the elderly and younger participants.

How Severely Can Psoriatic Arthritis Affect the Body?

Thanks to better treatment options and greater awareness of the condition, psoriatic arthritis is increasingly treated early on in the disease stages. That’s a good thing, because without treatment, heightened stiffness and pain can lead to a more sedentary lifestyle, which in turn can give rise to various health issues such as cardiovascular problems, high blood pressure, and mental health disorders, says Pugh. “In more severe cases where PsA remains untreated, cumulative damage to the joints can become permanent,” she explains. Such damage can make it difficult to complete daily tasks resulting in a loss of independence and reduced sense of overall well-being, she adds.

Frailty can be another outcome of untreated psoriatic arthritis, per an American College of Rheumatology study. Frailty is defined clinically as the state of increased vulnerability due to physical and functional decline. “The prevalence of frailty in older adults with psoriatic arthritis was higher than the prevalence found in older adults in the general population in prior studies,” says Sarah Lieber, M.D., a rheumatologist at Hospital for Special Surgery in New York City and co-author of the study.

The frailty in people with PsA was compounded by issues such as comorbid conditions and falls, says Dr. Lieber, who also found that other PsA-related symptoms seemed to multiply when frailty was not addressed. For instance, “we found that anxiety was more common among adults with psoriatic arthritis who were frail than those who were not frail,” she says.

How Does Psoriatic Arthritis Impact Quality of Life?

The presence of enthesitis, dactylitis, inflammatory back pain, and peripheral joint involvement when you have PsA is significantly associated with a worse general quality of life, according to a 2023 study in the journal Joint Bone Spine.

In addition, if left untreated, the functional limitations and chronic pain of psoriatic arthritis can have a profound impact on a person’s mental health, says Pugh. In turn, “a decreased mental state can impact a person’s ability to hold a job, maintain healthy relationships, and affect their physical abilities,” she adds.

Research supports the risk that untreated psoriatic arthritis can have on mental health. In a 2022 study, researchers discovered that depression prevalence was higher in patients with than without PsA. Anxiety prevalence was also higher among psoriatic arthritis patients. According to the same study, depression remains underrecognized and undertreated in over half of moderately-to-severe patients.

Fortunately, a revolution in psoriasis disease treatment over the last 25 years has led to the development of many effective treatments. “Even the worst cases often respond very well to treatments, and because we have more than a dozen drugs that range from very good to great, we can troubleshoot when one doesn’t work well,” says Dr. Sayed.

Many of these drugs lead to substantial improvement within one to two months, and by three to four months, most medications reach their maximum effectiveness, he says. The key: Early diagnosis—timely detection and treatment of psoriatic arthritis is known to result in improved outcomes over time.

Beyond Medication

Researchers now know that psoriatic arthritis outcomes are based on more than medication alone. For instance, both physical and occupational therapy have been shown to improve PsA symptoms over time. “Physical therapy is a very important part of treating psoriatic arthritis,” says Laura Coates, Ph.D., an associate professor and researcher of psoriatic arthritis at the University of Oxford in England. PT along with medication is an effective way to treat inflammation, control pain and maximize function with psoriatic arthritis, she adds.

Other lifestyle factors that may help with your psoriatic arthritis prognosis include:

• Diet

• Exercise

• Maintaining a healthy weight

• Smoking cessation

• Stress reduction

How to Increase Life Expectancy With PsA

Having psoriatic arthritis doesn’t mean that you are destined to live with comorbidities or enjoy less of your life compared to others without the condition. However, it does mean that there is an increase in risk factors and complications, especially with untreated disease. The good news is that you can control your destiny by taking charge of your lifestyle and medical care.

According to the Arthritis Foundation, the first order of business in increasing your life expectancy with psoriatic arthritis is to quit smoking since tobacco increases inflammation and decreases treatment effectiveness. Eating a heart healthy diet and moving with intention can also make a difference—cutting the risk of heart disease nearly in half. The importance of staying on top of your treatment is also critical, since under treatment of PsA leads to uncontrolled inflammation which is the driver of many serious conditions.

Takeaways

Psoriatic arthritis impacts different people in different ways. Skin, joints, tendons, and bones including the spine are commonly impacted. If psoriatic arthritis isn’t diagnosed and treated early, over time the symptoms can worsen, multiply, and lead to permanent joint damage. A reduced quality of life, including a negative impact on mental health, often accompanies more severe disease. Fortunately, new and more targeted treatments today make it possible to slow disease progression and prevent future damage in a matter of months. Physical and occupational therapy along with lifestyle changes such as smoking cessation and weight loss can also help you to live your best life.

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