Have you every googled "What is Psoriatic Arthritis?" I know I did once I got my diagnosis and had a name for the pain I was feeling. But what I realized is that all the definitions come from drug companies... And I didn't care for that at all. Especially since I was VERY anti-medication when I first started out! My main goal was to try and figure out what was wrong with me, and how could I heal myself through food and holistic ways (still a mindset I follow!) Now almost 15 years later we have more people talking about PsA and so there is more information. But here is the information I wish I had when I was newly diagnosed and then I will tell you about what my pain is like because we all experience pain differently!

Psoriatic Arthritis

is a form of arthritis that affects some people who have the skin condition psoriasis also known as PsA. PsA is a type of inflammatory arthritis.

Personally this definition was not helpful for me at all so I kept digging. Here's what I found.

Psoriasis and arthritis are two separate conditions that couple the pain of swollen joints and the irritable red patches of psoriasis and create psoriatic arthritis (PsA). Psoriatic Arthritis is an autoimmune disease and is characterized by the body's immune system attacking (and I like to think of it as attaching) itself to joints, tendons and ligaments of the body.

Based on statistics from America 30% of people who have psoriasis will end up getting PsA. However, skin changes consistent with psoriasis (red, scaly, and itchy plaques) frequently occur before the

onset of psoriatic arthritis but psoriatic arthritis can precede the rash in 15% of affected individuals. It is classified as a type of seronegative spondyloarthropathy. PsA symptoms can be mild or severe and can affect multiple joints at the same time.

Ok, so what causes PsA?!?

Although psoriasis is a precursor to PsA, scientists don't know why or how this condition develops. The most common theory is a combination of genes and environment. PsA is said to be passed through families. Around 40% of patients to have PsA have a family member who has it as well (this has not been my experience, I don't have anyone in my family who has it but I am curious if you have someone in your family that does?) That being said, an environmental factor typically triggers the condition (i.e. high stress levels, viral infection or injury).

Types of Psoriatic Arthritis!!

Now this one I have personally witnessed talking with so many people with PsA however I have never heard it talked about until recently!

There are 5 different types of PsA

• Symmetric PsA makes up around half of all PsA cases. It affects both sides of the body and it's symptoms are very similar to rheumatoid arthritis. This condition is usually mild but can be disabling.

• Asymmetric PsA which is exclusive to one side of the body. The symptoms are often mild and often don't go beyond soreness and redness of the skin.

• Interphalangeal Predominant PsA occurring in around 10% of cases where inflammation occurs in the distal joints close to the fingertips.

• Spondylitis PsA is quite painful as it affects your spine, from your neck down to your back making movement difficult.

• Psoriatic Mutilans is the rarest and most dangerous as it affects the hands and feet and can cause deformation. The pain can also travel to your neck and back.

What are the symptoms of PsA?

The symptoms of PsA differ from person to person and can be mild or severe depending on the case. Your symptoms will also differ depending on what type of PsA you have. For me personally I know that I have Psoriatic Mutilans and Asymmetric PsA. My pain is all throughout my spine and neck, and affects the right side of my body (right shoulder, hand, fingers and feet).

Some symptoms that you are likely to experience are : fatigue, swollen joints, inflammation on tendons and ligaments, feeling stiff when you wake up, pain in tendons and muscles, swollen toes or fingers, psoriasis on the scalp (flaky scalp), eye pain, eye redness, nail pitting, stiffness and pain in the spine, pain, weakness, swelling in other joints and limbs.

Treatment for PsA?

Treatment for PsA is different for everyone as everyone experiences their pain and symptoms differently. Likewise everyone has a different medical team. I will list the standard Western medicine protocol and what doctors will prescribe as medications and then I will talk about some holistic things that have helped me reduce inflammation and treat my PsA. My Rheumatologist is always impressed at how good my progress is since treating my PsA with medicine and with a holistic approach.

Standard Protocol at the doctors office include :

• Steroids (Prednisone is the most common)

• Non Steroidal Anti-inflammatory Drugs

• Disease-Modifying Antirheumatic Drugs

• Immunosuppressants

• Biologic Drugs (Most common Humira, Cimzia, Enbrel, Simponi, Remicade)

Most Rheumatologists will also encourage you to change your lifestyle habits, such as adding healthy movement and reducing stress levels.

Holistic Approach and How I think it works well in combination with Western Medicine

I started working with a holistic doctor almost 5 years ago and it was a major game changer in my PsA journey. She really looked at my body as a whole and wasn't just treating my PsA symptoms. We have been working to heal my body from the inside out and reduce inflammation in the gut which has in turn reduced inflammation all throughout my body. She has helped by balancing out my hormones, she had made me a sleep tincture that is crucial since sleep is when our bodies recover! She discovered that I had SIBO (Small Intestine Bowel Overgrowth) which was causing lots of discomfort and inflammation in my body. Due to that she put me on a SIBO LOW FODMAP diet (protocol is on the resources tab if you are interested in checking it out). I have been eating in that was since October of 2020 and my body has been the best in a really long time. I quit my stressful job and started my own business. I started doing being conscious of what type of movement (exercise) felt good for me and my body and do what I can when I can. Sometimes I can do long, intense, heavy weight workouts and some days I can do yoga or a walk. It has taken me a long time but I am working every day to learn more about my body, to listen to my body and do what's best for me each and every day.

Something else that has been a game changer for me if finding peace and happiness. It might sound a little "woo woo" but I started seeing a counselor in January of 2019 and started working through my Postpartum Depression and Anxiety and really worked through childhood trauma, I learned healthy communication habits and so much more. Just doing that has brought so much more peace and happiness into my life. It also has allowed me to trust myself and believe that I deserve to be happy. I realized that living with chronic pain for so long I lived in a negative mindset because I was in so much pain all the time. At my core I am a really happy, light hearted person but I couldn't escape the pain, frustration and anger. I really started to lean into gratitude and I have to say... finding gratitude even in the hardest times has truly saved my life and has made me a much happier person. But we will talk more about gratitude in another post because it's a lot to dive into.

The biggest thing that I want to stress is that we are all so different but that does not minimize your pain. You are seen here. You deserve to feel good. Start small and try to find a team of people who are willing to help feel your best!