Lifestyle changes for psoriatic arthritis: Exercise, diet, and more

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For many people with PsA, psoriasis develops first, and joint pain begins within 10 years. People can have PsA without psoriasis, although this is uncommon.

Researchers cannot identify which people will develop PsA. However, some risk factors for PsA include:

• having a family history of PsA
• having psoriasis
• being overweight or having obesity
• smoking
• being 30–50 years old
• having exposure to infections such as streptococcal infections and HIV
• experiencing physical trauma

Individuals with psoriasis may experience warning signs of PsA, such as:

• back pain at the sacroiliac joint, where the spine connects to the pelvis
• changes in fingernails or toenails
• eye inflammation
• fatigue
• joint redness and swelling
• morning joint pain that improves with activity
• reduced range of motion
• sausage-like swelling of an entire finger or toe
• scalp psoriasis
• skin rash
• tendon or ligament pain in the Achilles tendon, the bottom of the foot, or elbow

Doctors recommend treating PsA using a combination of strategies. There is no cure for PsA, so treatment focuses on:

• relieving symptoms
• helping maintain quality of life
• treating skin symptoms
• keeping joints mobile

Treatment with medication may involve over-the-counter (OTC) and prescription treatments, including:

• nonsteroidal anti-inflammatory drugs (NSAIDs)
• corticosteroids
• disease-modifying antirheumatic drugs (DMARDs)

Each person with PsA will experience it differently, and doctors will prescribe treatment specific to the person’s symptoms and general health.

A doctor may also recommend dietary and lifestyle changes to relieve symptoms of PsA, including:

• performing regular exercise
• making dietary changes
• minimizing stress
• limiting alcohol intake
• quitting smoking

There is more detail on these dietary and lifestyle changes below.

Joints contain a particular kind of fluid that protects them, known as synovial fluid. Exercise increases the circulation of synovial fluid, which lubricates the joints, allowing them to move past one another smoothly.

The Department of Health and Human Services recommends that people exercise at least 150 minutes weekly at a moderate pace. This includes people with PsA.

Physical activity such as walking, swimming, and biking has a low impact on the joints and may ease stiffness. Exercising builds muscles that surround the joints, helping to support them.

Eating well can play a significant role in maintaining overall health. Certain foods have anti-inflammatory effects and protect against problems that may accompany PsA, including cardiovascular disease.

Excess body fat contributes to inflammation, so eating well and reducing the risk of obesity are important in controlling PsA flares.

Foods that may reduce inflammation and help lower the risk of cardiovascular disease include:

• fatty fish such as salmon, trout, mackerel, and sardines
• nuts such as flaxseeds, walnuts, and pumpkin seeds
• olive oil
• lean protein such as skinless chicken and pork
• cruciferous vegetables such as broccoli, kale, and Brussels sprouts

Stress can contribute to increased activity of PsA flares. Stress is a natural indicator for the body to jump into overdrive, promoting its inflammatory response. This inflammatory response may result in joint inflammation and pain.

Chronic stress can lead to a cycle of mental distress and physical pain. Some strategies that can help manage stress include:

• talking to a therapist
• speaking with a friend
• following a doctor’s recommendations for arthritis relief
• exercising
• relaxation techniques

PsA may cause fatigue, so rest is essential to allow the body to heal. When joints are sore, a person should rest them.

Treating fatigue involves a combination of factors, including:

• exercise
• diet
• physical or occupational therapy
• other therapies

For better sleep, a person should consider incorporating the following habits into their sleep hygiene:

• Going to bed and getting up at consistent times.
• Making sure the bedroom is dark, relaxing, and at a comfortable temperature.
• Removing all electronic devices such as TVs, computers, and cell phones from the bedroom.
• Avoiding large meals, caffeine, and alcohol before bedtime.
• Getting plenty of exercise during the daytime.

Medications for PsA may increase the risk of liver damage, so people should not mix them with alcohol.

The American Academy of Dermatology Association (AADA) notes the following effects in males who have more than two alcoholic beverages and females who have more than one alcoholic beverage each day: Psoriasis medications may not work as well or stop working, and there may be fewer remissions.

By limiting alcohol, treatment is more effective, there are more remissions, and there is a decreased risk of liver damage from medications.

The AADA also recommends quitting smoking to:

• reduce the chances of developing diseases of the liver, heart, blood vessels, and gums
• decrease the risk of autoimmune diseases such as Crohn’s disease
• reduce psoriasis flares
• increase remissions

Other diseases may be more likely to co-occur with PsA. Cardiovascular disease is the most prevalent, although inflammatory bowel disease and eye conditions may also develop.

Managing the related conditions will help control overall stress and lower inflammatory responses.

Some people experiencing their first PsA flare may develop symptoms on their skin or nails before noticing pain or stiffness in their joints. Others may not have any skin-related symptoms at all.

People with PsA should contact a doctor when flares occur, new symptoms develop, or medications are no longer working effectively.

Lifestyle changes and alterations can help symptom management and significantly impact the effectiveness of PsA treatment.

Combined with pharmaceutical treatment and physical, occupational, or alternative therapies, lifestyle changes can significantly contribute to improved wellness and reduce the severity of flares.

PsA is a chronic, autoimmune condition that may develop with psoriasis. It impacts the joints, causing pain, swelling, and redness, and can severely limit mobility.

Treatment can include OTC and prescription medications such as NSAIDs, corticosteroids, and DMARDs. However, lifestyle changes, such as alterations to diet, exercise, rest, and stress management, may also positively impact PsA.

Making lifestyle changes may significantly affect the frequency and severity of PsA flares.