What is PsA?

Welcome back!

Today the weather is just as it was yesterday - grey and gloomy. But there's hope that the day will brighten. According to the weatherman, it's supposed to become warmer and sunnier as the day goes on. On one hand, that's awesome but I still won't get to enjoy it. Since I'm feeling the pressure from the upcoming weather fronts, I tend to be stiff and swollen on the nice days. It seems to be a rare thing that I have both nice weather and feeling good joint-wise. So my plans for the day will probably involve some crafting and working on a few things here and there as I can. One step at a time, one day a time.

This post will focus a bit more on what Psoriatic Arthritis is and what it does to people like me. First off, PsA is like a two-headed dragon of sorts. On one side, you have the head named Arthritis. The other is named Psoriasis. With the arthritis, you get the usual symptoms - joint pain, swelling, stiffness. This can happen anywhere in the body where you have joints. I'm talking neck, elbows, fingers, knees, even your little toe. All of them can be affected to some degree. The pain can range from a slight tenderness when touched to very sharp, stabbing pains that last for hours. With the psoriasis, you have a possibility of having areas of red, scaly skin or plaques. Some have just small little plaques that can be hidden by clothing or treated by over the counter remedies found at your local drugstore. However, some plaques can grow to be quite large. In fact, it is possible that a majority of the body can be covered by plaques. Unfortunately this is one of those diseases that varies from person to person due to genetic and environmental influences. The most important thing to remember is that you are only responsible for your body and how the disease affects you. Try to keep focused on that and the fact that not everyone goes through the same experience with this disease.

According to the Arthritis Foundation, there are five types of PsA. Just as PsA is a subgroup of arthritis, these sub-subgroups make up the whole. Each are similar in a lot of ways even though they tend to have distinct symptoms. That can make it a little more difficult to diagnose without a proper evaluation from a rheumatologist. I would most definitely suggest consulting with your family doctor or rheumatologist if you feel you may fall into one of these categories.

• Symmetric Arthritis ~ This is more like the rheumatiod arthritis that we all know. Although it has the joint swelling, pain and stiffness, the symptoms tend to be milder than the other types of PsA. It also tends to have less deformity within the joints. What sets this type of PsA is that it strikes the joints on both sides of the body at the same time. However, it can be disabling over time. Some reports say that 50% of the reported cases are disabling. 
• Asymmetric Arthritis ~ This particular type of PsA is kinda like that person who walks into a restaurant and has no clue what they want. It doesn't have a set pattern to the joints that it will affect. The joints that it picks can be varied and on the same side at the same time. Most often people develop sausage digits (or duck fingers as I mentioned in the previous post) where the toe/finger swells. This is also called dactylitis. Even though this form of PsA is generally mild, there are cases where it is very disabling. It usually responds to medical treatment.
• Distal Interphalangeal predominant ~ Also known as DIP. This type is seen in only about 5% of the cases of PsA. It does involve the joints closest to the nail on the fingers and toes. These joints are known as distal joints. While this form of PsA is often confused with Osteoarthritis, the difference is within the changes of the finger/toe nail. The nails can undergo pitting, discoloration, have white areas, crumble or even be detached. 
• Spondylitis ~ There is about 5% of people with PsA who have this type. It's characterized by inflammation and stiffness within the neck, lower back and sacroiliac or spinal vertebrae. Most definitely, this makes moving very painful and difficult in almost all cases. At times, it can be found in the hands, feet, legs, arms and even the hips. 
• Arthritis Mutilans ~Affecting fewer than 5% of all PsA cases, this condition is the most severe, destructive and deforming of the five subgroups of PsA. It will mainly attack the joints of hands and feet, making it hard to care for one's self. Some people can experience neck or lower back pain as well. Arthritis mutilans is sometimes also known as chronic absorptive arthritis and at times found in patients with rheumatiod arthritis.
 

Out of all these, I would say that right now I fit into the asymmetric arthritis. I do go see my rheumatologist near the end of the month, so I can ask for sure. I don't really ever remember being told which one I was part of. However, I know that I have only had one or two joints get red and tender at a time. They're not always on the same side or same area such as my hands or feet. After eleven years, both my hands and feet are pretty much ruined by the arthritis. My toes really do look like little sausages. My left hand has a couple of fingers that are deformed but the worst of it is in my right hand. I can no longer fully open it. There will forever be a bend where my fingers meet the palm of my hand. My wrists are affected severely as well. I can't flex or rotate my right wrist and my left has definite diminished ability. My knees are starting to ache with the weather we've been experiencing. Since it's turning to fall, the drop in temperatures and rainy days aren't helping matters at all.

The psoriasis - I think we'll cover that another day. To be honest, going back through all the information on this disease has made me overwhelmed all over again. Of course, I'm so glad that there's an internet to turn to when all I had before was what the doctor chose to tell me. Now I feel more empowered with the information so close at hand. Just be sure to look at information from trusted sources such as the ones below.

Arthritis Foundation  ~ www.arthritis.org 
Mayo Clinic ~  http://www.mayoclinic.com/health/psoriatic-arthritis/DS00476
WebMd ~ http://arthritis.webmd.com/psoriatic-arthritis/default.htm

As the years go by, I have seen an increase in information available for patients such as myself. I do wish for a lot more in the way of treatments, medications and therapies. Those can only come from more awareness and more funds being made available to help with development. With knowledge comes power. I hope to spread the knowledge and power around for all of us with PsA and beyond.

Until next time,
Kay