Both psoriatic arthritis (PsA) and multiple sclerosis (MS) are inflammatory conditions that have environmental and genetic risk factors. However, there is limited scientific evidence that links exist between these two conditions.
Scientists have investigated whether having one of these conditions increases the risk of developing the other. While
This article discusses what PsA and MS are, the possible links between these conditions, and treatments and lifestyle changes that can help reduce symptoms.
The following table provides an overview of these two conditions.
| PsA | MS | |
|---|---|---|
| Age of onset | ||
| Gender | affects males and females equally | affects more women than men |
| Ethnicity | more common in people of European descent | |
| Symptoms | • inflammation • joint stiffness, swelling, and pain • enthesitis | • visual disturbances • fatigue • pain • loss of muscle strength • psychiatric and cognitive changes |
| Affected areas | • lower limbs • fingers and toes • spine • eyes • nails • gastrointestinal tract • ligaments and tendons | • brain • spinal cord |
| Symptom severity | varies from person to person | varies from person to person |
PsA
PsA is an autoimmune condition in which the body’s immune system targets the joints, causing inflammation, pain, and stiffness. It has an association with psoriasis —
Psoriasis affects more than 3% of U.S. adults. Scientists estimate that
However, it is possible for a person to have PsA without psoriasis or to develop PsA before experiencing skin symptoms.
One of the key characteristics of PsA is enthesitis, which is a pain in the soles of the feet, the elbows, the back of the head, and other areas. Enthesitis is due to tenderness where ligaments and tendons connect to the bones.
MS
MS harms the central nervous system by destroying the myelin around nerve cells. According to the National Multiple Sclerosis Society, up to 913,925 people are living with MS in the United States.
MS
Researchers continue to study the similarities and differences between PsA and MS. There is some evidence that these conditions have a link; however, data is limited and sometimes conflicting.
The authors of a
Environmental risk factors
Both PsA and MS have known and unknown environmental risk factors. Viral infections and smoking are shared risk factors for these conditions.
However, scientists have identified environmental risk factors that these conditions do not share.
Fungal and bacterial infections, obesity, and increased stress levels are risk factors for PsA.
Risk factors for MS include UV radiation exposure, low vitamin D levels, and Epstein-Barr viral infections.
Genetic risk factors
Genetic analysis shows that these conditions share variations in Th-17 cells and IL-23 receptors.
However, each condition also has separate variations in these receptors.
Overactive immune system
Both PsA and MS are autoimmune conditions, which means the body’s immune system begins to target itself. People with either condition have an increase in IL-23 receptors and TNF-alpha cytokines, which cause inflammatory and autoimmune responses.
However, levels of IL-27 cytokines differ in people with these conditions. People with MS have lower levels of IL-27, whereas those with PsA have higher levels.
Both PsA and MS are multifactorial conditions, which means they have multiple causes, some of which scientists have not yet discovered.
PsA
Possible causes of PsA
- bacterial infections such as strep throat
- viral infections such as HIV
- fungal infections
- medications such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- smoking
- obesity
- stress
PsA may have a genetic factor. As many as 40% of people with the condition also have a family member who has it.
MS
Possible causes of MS include:
- exposure to high levels of UV radiation
- low vitamin D levels
- Epstein-Barr viral infection
- smoking
Recent research suggests that people who have had an Epstein-Barr viral infection are up to 32 times more likely to develop MS than those who have not contracted this virus.
Both PsA and MS require a comprehensive doctor’s examination for diagnosis.
PsA
Doctors may perform the following examinations and tests to diagnose PsA:
- joint examinations
- analysis of skin and nails
- blood tests
- skin biopsies
- medical imaging, such as X-rays, MRIs, CT scans, and ultrasound
MS
A diagnosis of MS requires:
- evidence of central nervous system damage in at least two places
- evidence that damage took place at different times
- ruling out other causes
Currently, the process for diagnosing MS can include:
- a complete medical history
- tests of cranial nerve function
- tests of reflexes, sensation, balance, walking, and coordination
- blood tests
- MRI scans
Treatment for PsA and MS depends on the type and severity of symptoms a person is experiencing.
There is limited scientific research on treating people with both PsA and arthritis. However, a case study found that using two different monoclonal antibodies, natalizumab and secukinumab, was effective in reducing symptoms of both conditions. While this treatment is promising, the sample size of one person means more research is necessary.
PsA
Treatment for PsA can include:
- NSAIDs such as ibuprofen
- antirheumatic drugs such as methotrexate, cyclosporine, and sulfasalazine
- biologics
The following strategies may be helpful for people with PsA:
- regular gentle exercise, such as walking
- use of shoe inserts and walking aids for support as necessary
- regular stretching or yoga
- aqua therapy
- physical and occupational therapy
MS
Treatment for MS typically proceeds along three tracks:
- managing symptoms of MS
- finding ways to avoid flare-ups and lessen their impact when they occur
- taking medication to slow the progression of damage due to MS
Doctors
Certain lifestyle habits may help a person with MS manage their symptoms. Suggestions include:
- following a healthy, balanced, diet high in fruits, vegetables, and grains and low in processed foods
- exercising regularly
- avoiding extreme temperatures
- maintaining regular sleep patterns
There is currently no way to prevent PsA or MS. However, people with these conditions can work closely with their healthcare team to identify and reduce the occurrence of flare-ups.
PsA
The following may help prevent PsA flare-ups:
- monitoring symptoms
- identifying and avoiding triggers
- taking medications regularly
- avoiding injury
- exercising regularly to support joint suppleness
- attempting to reduce stress, possibly with the help of practices such as meditation
MS
People with MS can work with their healthcare team to develop and follow a treatment plan to reduce the severity of symptoms. Treatment plans typically include:
- disease-modifying therapies to slow MS progression
- treatment to shorten relapses and reduce their severity
- management of MS symptoms
Both PsA and MS are chronic conditions, which means they currently have no cure. People with these conditions experience symptoms that vary in severity.
PsA
Healthcare professionals classify PsA as an aggressive condition that can greatly impact a person’s quality of life. While some people may experience less pain and inflammation than others, experts associate the following factors with greater severity of the condition:
- inflammation in a large number of joints
- loss of function in the joints
- damage to the joints
MS
MS symptoms are often mild in the beginning but
Additionally, MS may shorten a person’s life expectancy by
PsA and MS are separate conditions with distinct qualities. They affect different parts of the body and have different symptoms.
However, they are both immune-mediated chronic conditions that cause inflammation. Researchers continue to explore the possibility that PsA and MS are linked. Currently, scientific evidence is inconclusive.