Psoriatic arthritis causes inflammation in your joints. It happens because your immune system is overactive. It affects mostly people who have psoriasis, a skin disease that’s also related to the immune system.
Psoriatic arthritis is inflammatory arthritis that is seen in association with skin psoriasis. It causes joint pain and swelling that can lead to damage to the joint if the inflammation is not controlled. Joint damage can be prevented with the appropriate medications. Usually, psoriatic arthritis is blood test negative. The diagnosis is typically made by a rheumatologist after reviewing a clinical history and performing a physical exam. X-ray studies can show changes specific to psoriatic arthritis but these are rarely present at the onset of symptoms.
Psoriatic arthritis can affect any joint in the body, and it may affect just one joint, several joints or multiple joints. For example, it may affect one or both knees.
- Affected fingers and toes can resemble swollen sausages, a condition often referred to as Dactylitis. Finger and toenails also may be affected by thickening or nail pitting
- Psoriatic arthritis in the spine, called spondylitis, causes pain in the back or neck, and difficulty bending.
- Psoriatic arthritis also can cause tender spots where tendons and ligaments join onto bones. This condition is called Enthesitis, it can result in pain at the back of the heel, the sole of the foot, around the elbows or in other areas. Enthesitis is one of the characteristic features of psoriatic arthritis.
Medications are used to reduce inflammation caused by arthritis reducing pain, swelling, and stiffness. Many of the medications suppress the immune system and lead to a potential increased risk of infections. The majority of the medications treat both the skin and joint disease, but some medications may work better for one compared to the other. Non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil) or naproxen (Aleve) are the initial treatment for very mild arthritis.
Newer biologic therapy has been developed to block molecules and/or their receptors leading to decreased inflammation. Many of these medications are given by injections at home or by an infusion at the doctor’s office. These medications suppress the immune system to a great degree. They have been proven to stop joint damage as well as pain and swelling in moderate to severe psoriatic arthritis.
COMMON SYMPTOMS OF PSORIATIC ARTHRITIS
- Backache, neck pain, stiffness
- Difficulty in bending the neck downward
- Enthesitis (Tender spots, where ligaments and tendons join giving rise to the formation of the bones).
- Pain in the heel, elbow and around foot sole
- Dactylitis (Swelling in the toes and fingers)
- Scaly skin lesions
- Extreme exhaustion, fatigue, and tiredness
Ayurvedic Treatment of Psoriatic Arthritis
Ayurveda has the view that psoriatic arthritis can be put into a component between Vatarakta ( a joint disorder caused due to the pathological amalgamation of morbid vata and rakta i.e. blood) and Kushta (skin disorders).
It is seen in practice that the medicines and treatments applicable to Kushta are also beneficial in Vatarakta. When the Kushta, especially complicated skin conditions not responding to any medicines or treatments advised in Kushta when treated with some formulations explained in the treatment of Vatarakta have found to give stunning results.
Ayurvedic treatises give a clear idea that certain skin disorders are related to joint disorders and they can be dealt in identical ways by identical approaches in terms of formulations and treatment strategies.
Thus Psoriatic arthritis is treated either on the lines of Kushta or Vatarakta or both.
If the skin component is more i.e. if the psoriasis is evident by the skin picture and if the patient also has joint involvement, we shall treat on the basis of Kushta treatment line up.
If the skin component is less or if it has been treated so that the lesions are not available or feebly available and if the patient has developed the arthritis component on a later period (as a complication of kushta), we shall treat that condition on the lines of Vatarakta. In these conditions, the joint manifestations are superseding those of skin.
If the joint pains or arthritis has been diagnosed as Psoriatic arthritis by modern parameters (in the absence of skin psoriasis), our job becomes easy. In these conditions we can skilfully mix up the treatments of both Vatarakta and Kushta, giving importance to Vatarakta line of treatment.
Vatarakta can be effectively handled with:
- Lepa – external application of medicinal pastes
- Abhyanga – herbal oil massage
- Parisheka – stream pouring or sprinkling or showering of medicinal liquids like decoctions, medicated milk, oil etc over the afflicted areas
- Avagahana – dipping the afflicted parts or joints in the medicinal liquids
- Upanaha – poultice
These treatments are of immense use in Psoriatic arthritis.
Clinical experience has shown that the above-mentioned treatments have shown tremendous results in combating Psoriatic arthritis, especially those which are not very severe or not complicated. The results are outstanding. When skilfully combined they reduce pain and swelling and give good relief to the patients. Of course, they should be combined with disease-modifying medicines and formulations according to the involved dosha along with a regular laxative for detoxification.
Internal medications are also administered like:
- Khadirodaka – Juice, decoction, powder of Khadira (Acacia catechu) should be used for anointing, upward massage, application, bathing, drinking and eating (mixed with food)
- Khadira rasa – pieces of bark, wood, leaves, roots of Khadira plant (Acacia catechu) should be boiled in a big vessel, when they are processed well, filter, mix juice of Indian gooseberry, ghee and honey and should be used internally
- Nimbadi Kalka – eating mixture of leaves of Nimba (neem plant) and Amalaki (Indian gooseberry)
- Vidangadi Kalka – Paste of Vidanga (Embelia ribes) and Bakuchi (Psoralea corylifolia)
- Vidangadi Churna – Powder of Vidanga (Embelia ribes), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Pippali (long pepper) mixed in hot oil.
Panchakarma methods that are proved to be very useful are:
- Snehapana – internal administration of medicated ghee and oils
- Swedana – sweating treatment or steaming
- Vamana – therapeutic emesis
- Virechana – therapeutic purgation
- Niruha Vasti – decoction enema
The Panchakarma treatments keep flushing out the toxins and morbid doshas and malas (waste products) on regular basis. This makes sure that the disease doesn’t progress further and the pathogenesis takes a halt at the initial stages. As the treatments are repeated on a regular basis we can see the regression of pathology and the skin getting its normal texture, color, complexion, and contour. The inflammatory symptoms, pain, itching etc come down in due course of time. When combined with external treatments like Abhyanga (massage), dhara (stream pouring of medicated liquids) etc, the pain and inflammation in the joints will reduce and the movements are seen to improve. Vasti comprehensively combats psoriatic arthritis and is, therefore, a preferred line of treatment in the later stages of the disease.
External Treatments for Psoriatic Arthritis
External treatments should essentially be conducted in Psoriatic arthritis. When combined with Panchakarma treatments and oral administration of disease-modifying formulations and medicines, the results are fortified.
To sum up, the results for psoriatic arthritis with ayurvedic medicines and panchakarma can be declared to be ‘good and great’ if the disease is not too complicated (to the level of irreversible damage to joints and soft tissues) and if the immunological component of the patient is good. If the patient is obedient enough and has a will to recover, then the results are bound to magnify!!
Though Ayurveda provides best and unparalleled cure in psoriatic arthritis, the patients with psoriasis or psoriatic arthritis cannot take ‘cure’ or ‘relief’ for granted. They need to be double cautious regarding their lifestyle, food, and stress. ‘Conscious living’ is a key. The disease has left its imprint on the body and they are bound to get darker at any time. But regular cleansing in the form of Panchakarma and keeping up with the immunity and metabolism, being choosy about good foods and keeping away the incompatible or allergic foods away, good exercise and stress-free life can guarantee a ‘long-standing and long sustained relief’. Ultimately it depends on how determined the patients are ‘to keep the disease’ away forever
There’s no cure for the condition, but newer medications can control it so well that it goes into remission, which means you have no symptoms. Proper exercise is very important to improve overall health and keep joints flexible. This can be quite simple. Walking is an excellent way to get exercise. A walking aid or shoe inserts will help to avoid undue stress on feet, ankles, or knees affected by arthritis. An exercise bike provides another good option, as well as yoga and stretching exercises to help with relaxation.