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Preserving Your Range of Motion With Psoriatic Arthritis

Posted on May 27, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Victoria Menard

Reduced range of motion is one of the most common symptoms of psoriatic arthritis (PsA). PsA is an autoimmune disease that occurs when the immune system mistakenly attacks healthy joint tissues. The attack causes inflammation in affected joints, preventing them from moving as far and as easily as usual.

Many MyPsoriasisTeam members have experienced decreased range of motion. One wrote that they were “losing more range of motion with each flare,” while another shared, “It is frustrating to have lost so much strength and range of motion with being so young.”

Losing range of motion can be difficult. Fortunately, there are ways to manage the symptom and prevent it from worsening — both at home and with your rheumatologist.

Treat Your PsA

A first step to preserving range of motion with psoriatic arthritis is to treat the underlying disease. There are several approaches to treating and managing PsA. You can work with your rheumatologist to find the best methods for your specific diagnosis and symptoms — including decreased range of motion.

Nonsteroidal Anti-Inflammatory Drugs

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) — such as Advil (ibuprofen) and Aleve (naproxen) — can help relieve mild to moderate PsA symptoms. These medications reduce inflammation in the body, alleviating stiffness that may limit your movements. Your doctor may prescribe stronger NSAIDs if over-the-counter options do not provide relief.

Steroid Injections

Your rheumatologist may recommend injecting corticosteroid medications directly into your affected joints.

Systemic Treatments

Treatment of psoriatic arthritis often involves medications like disease-modifying antirheumatic drugs (DMARDs), immunosuppressants, and biologics. These medications help manage the disease’s activity by suppressing all or part of the immune response responsible for your symptoms.

Some systemic treatment options include:

It may take time before you start to notice the benefits of these types of medications. One MyPsoriasisTeam member wrote, “I’ve been on [Otezla] for nine weeks and have seen minimal improvement in my joint pain and range of motion.”

Surgery

If your psoriatic arthritis has progressed and become severe, your doctor may recommend surgery to help prevent further joint damage and preserve your range of motion. Joint reconstruction (arthroplasty) is generally recommended to improve range of motion and pain in late stage PsA of the hips and knees.

Exercise

It may seem counterintuitive to exercise when your joints are stiff and sore. However, physical activity has numerous benefits for people with reduced range of motion from psoriatic arthritis. Exercise can help improve your joints’ mobility and flexibility and relieve pain and stiffness.

There are two types of exercise for people with PsA, both of which can help improve or preserve range of motion.

Recreational Exercise

Recreational exercise refers to any type of physical activity done for pleasure or health. These exercises may be done as part of a therapeutic exercise program to help strengthen the muscles and to preserve or increase range of motion in the affected joints.

Recreational activities like bicycling, swimming, and walking may be recommended for people with PsA to help improve range of motion. MyPsoriasisTeam members have also shared their recommendations. One member said that compared to walking, “bike riding is a little easier on the feet … There are always yoga exercises. They are very low-impact, and a lot of them you can do while sitting down.”

Another member recommended using online videos: “Search ‘low-impact exercises’ — there is plenty out there, and no gym membership to pay.”

No matter what exercises you choose, it is important to find one that you enjoy doing to help ensure that you stick with it, which will help you get the strongest benefit possible.

Therapeutic Exercises

Your doctor may recommend specific therapeutic exercises tailored to your unique needs and symptoms. A physiologist will design them to help you achieve a certain goal — in this case, restoring and preserving your range of motion.

Range-of-motion exercises, in particular, involve relieving stiffness in the affected joints and helping them become more flexible. You may be advised to repeat certain motions in your hands, feet, or other stiff joints. These exercises should be performed on a regular basis to ensure gradual but consistent progress.

As one MyPsoriasisTeam member wrote, a physiologist may recommend getting recreational exercise alongside your therapeutic regimen: “The hospital physiologist has given me exercises to do three times a day, as well as going for a walk,” they said.

Your physiologist may also recommend at-home exercises and therapies to help you ease stiffness and increase your range of motion. As one member suggested “some gentle massage and range-of-motion exercises” targeting affected areas may help.

What To Keep in Mind When Exercising With PsA

Before starting a new exercise regimen, talk to your health care provider. A rheumatologist or physiologist can advise you on the right exercises for you and help you maximize your benefits while reducing the possibility of injury or further strain.

Once your providers have given you the go-ahead, there are several other things you should keep in mind while exercising with PsA.

Exercising During Flares

It is important to take special precautions with exercises when you’re experiencing a PsA flare-up. During a flare, your joints will likely need more rest than normal. Some experts advise avoiding strenuous exercises during flare periods. Take care to listen to your body. Do not try to push through any pain or tension. As the Arthritis Foundation notes, it is a good idea to do shorter, more frequent exercises during flares rather than a single longer session.

Know Your Limits

Although exercise can be beneficial in preserving your range of motion, it is important that you don’t push yourself too far. In fact, too much exercise or a regimen that is too rigorous can actually trigger symptom flares in people with PsA.

A certain level of discomfort is to be expected after physical activity, but you should not feel pain. “People say, ‘You just need to exercise more,’” wrote one MyPsoriasisTeam member. “Seriously, they have no idea how bad the pain is.”

Take the time and work with your health care team to determine your body’s limits — and respect them. Allow yourself to rest when you need it. You should also reduce the intensity and length of your exercise if you feel pain for more than two hours after a session.

Altering How You Perform Daily Tasks

If you have a reduced range of motion with psoriatic arthritis, you may need to alter how you perform certain daily activities. As one MyPsoriasisTeam member wrote, “I use a back scratcher with claws to scratch my head. I can’t reach my arms up high enough to scratch it because of my lack of range of motion.”

Experts also recommend focusing on proper posture to help preserve your joints and prevent further stress and damage.

Physical Therapy and Occupational Therapy

Physical and occupational therapists can help you learn to move differently to reduce your pain. Physical therapists focus on finding exercises and stretches that make you feel better. Occupational therapists help you learn to do everyday tasks in ways that accommodate for and preserve your range of motion.

Hot and Cold Therapy

Sometimes, applying heat or cold to your joints can help reduce inflammation and pain. The two offer different benefits: Heat can help loosen stiff muscles and joints, and cold can help reduce pain and inflammation. You may need to experiment to find out what works for you. Some people find that heat is best, others prefer cold, and some prefer to alternate between the two to find the most relief.

Weight Loss

For people who are overweight or obese, even a 10 percent reduction in body weight can be as beneficial as starting a brand-new PsA treatment. Conversely, carrying extra weight increases the activity of the condition and makes it less likely that you will respond well to medications for PsA.

Meet Your Team

MyPsoriasisTeam is the social network for people with psoriatic disease and their loved ones. Here, more than 93,000 members from across the globe come together to ask questions, share stories, and find support from others who understand life with psoriasis and PsA.

Have some tips for preserving range of motion with PsA? Share your thoughts in the comments below, or by posting on MyPsoriasisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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