• Treating a psoriatic arthritis (PsA) flare early may prevent symptoms from becoming severe.
• Psoriatic arthritis can have many different triggers that vary from person to person.
• Taking proactive steps can help you manage psoriatic arthritis and potentially limit the number of flares you experience.

Psoriatic arthritis is an autoimmune disease and a chronic form of inflammatory arthritis that commonly affects people who have already been diagnosed with psoriasis. The main symptoms of PsA are similar to those of rheumatoid arthritis, including joint pain, swelling, and stiffness. These symptoms can become progressively worse over time. However, most people diagnosed with psoriatic arthritis go through periods when their symptoms improve or resolve (remission) and return or worsen. A period of worsened symptoms is called a flare or a flare-up.

When you feel psoriatic arthritis symptoms returning, it’s important to get a handle on the condition quickly. Treating a flare early may prevent symptoms from becoming severe or interfering with daily life. Here’s what you need to know about living with psoriatic arthritis flares so you can work with your doctor to treat them effectively.

What Do Psoriatic Arthritis Flares Feel Like?

When psoriatic arthritis flares, some people experience not only painful, swollen joints, but also less-characteristic symptoms, such as extreme fatigue and rashes. Some individuals experience flare-ups as a general feeling of discomfort before more acute joint pain sets in.

Sometimes, comorbidities (other coexisting health conditions) can trigger or signal a psoriatic arthritis flare. As one MyPsoriasisTeam member shared, “PDD [premenstrual dysphoric disorder] sucks! Stomach impaction makes it flare, which in turn flares the psoriatic arthritis.”

Other times, psoriatic arthritis seems to flare on its own. One member who experienced this wrote, “I have plaque psoriasis, psoriatic arthritis, and psoriatic nails. At the present time, my psoriasis is under control, but my arthritis flares. I just never know when it’s going to happen.”

Because flares can come up at any time, they can disrupt life significantly. One member told others, “My feet are burning and stinging. Just did a little shopping; that’s all it takes.” Another said, “Psoriatic arthritis makes you feel so tired and drained that you feel like every step is so heavy and tiring.”

Managing Psoriatic Arthritis Flares

There are many ways that you and your doctor can work together to manage your psoriatic arthritis flares and minimize how many you experience. Some of these approaches are proactive, meaning they should be done even before PsA flares begin. Taking steps proactively may help prevent or minimize symptoms should a flare-up occur. Proactive treatment can also help you avoid long-term complications, such as joint damage, that can come from not treating the condition.

Other methods for managing psoriatic arthritis flares involve treating symptoms during flare-ups themselves. If your PsA does flare, you’ll need to take additional steps beyond those for managing the condition on a daily basis.

Proactive Management of PsA Flare

If you’ve been diagnosed with psoriatic arthritis, taking the following actions can help you manage the condition, limit the number of flares you experience, and improve your quality of life:

• Take medications.
• Know your triggers.
• Exercise regularly.
• Practice sun protection.
• Avoid injury.
• Manage stress.

Take Medications

You have many medication options when it comes to treating PsA. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help you manage mild to moderate pain and inflammation. Prescription NSAIDs are also available. If a particular joint is causing you pain, corticosteroid injections can help provide immediate, short-term relief.

Systemic treatments can help you manage disease activity and prevent flares from occurring.

Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate or biologics, can help to manage psoriatic arthritis.

Some examples of biologics used to treat PsA include:

• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Adalimumab (Humira)
• Risankizumab-rzaa (Skyrizi)
• Ustekinumab (Stelara)

The phosphodiesterase 4 (PDE4) inhibitor apremilast (Otezla) or the Janus kinase (JAK) inhibitor tofacitinib (Xeljanz) may also be appropriate treatment options.

The right medication will depend on the severity of your condition and which therapies you’ve tried previously. Your doctor will help you understand your options and which treatments may work best for you.

Know Your Triggers

Psoriatic arthritis can have many different triggers. These triggers can vary from person to person. One MyPsoriasisTeam member said, “I find that stress is my main trigger,” while another shared that coffee triggers their flare-ups. The key is to get to know which triggers cause PsA flare-ups for you.

You may want to keep a diary to track everything from the foods you eat to the temperature and the weather. Logging your PsA symptoms alongside these factors may help you identify what leads to or worsens your symptoms. Once you know your triggers, you can do your best to avoid them or limit their impact on your life.

Exercise Regularly

Consistent exercise can help reduce flares for several reasons. Regular exercise can help keep you at a healthy weight, which is important because excess weight or obesity can prevent your medications from working properly. Physical activity can also keep your affected joints working well, help you get good sleep, and reduce your stress levels. All of these benefits help prevent psoriatic arthritis flares.

After having been recommended specific exercises by a health care provider, one member shared, “The exercises are really helping!”

Practice Sun Protection

Sunburn can be a significant trigger for many people with psoriatic arthritis — especially for those who also have psoriasis. Their skin may be extra sensitive to the sun, and prolonged exposure may lead to psoriatic arthritis flare-ups, too. When you’re in the sun, wear sunscreen and sun-protective clothing.

Avoid Injury

Any sort of injury can trigger psoriatic arthritis flares, including skin injuries, skin infections, bumps, and bruises. These injuries might trigger psoriasis flares before arthritis also flares up. Take care to avoid bumping your joints or inflicting another injury.

Manage Stress

Stress is a major trigger for many people diagnosed with psoriatic arthritis. Although dealing with a chronic illness is stressful enough, life stress can add to the equation. It’s important to look at your life and your schedule and see where and when you might experience extra stress. You and your doctor can develop a plan for what you will do to avoid a flare during those stressful times.

Finding effective techniques for reducing your stress levels is key. You may want to try progressive muscle relaxation, biofeedback, meditation, or mindfulness, as they have all been shown to lower stress.

Active Management During PsA Flares

If you find yourself in the middle of a psoriatic arthritis flare, there are a few actions you can take to help manage your symptoms at the moment.

Reduce Your Activity Levels

Start by decreasing your physical activity. Less activity doesn’t necessarily mean staying in bed or sitting completely on the sidelines, but you may need to do the minimum instead of pushing yourself. Stepping back may help you lower your stress levels and allow your body time to recover.

Adjust or Change Your Medications

When psoriatic arthritis flares up, it’s time to talk to your rheumatologist. Your medications may not be working as effectively as they once were, or your body may need more support to get you through this difficult period.

If one type of medication isn’t working, you may need to try another one. Ask your doctor for advice, as they will help you find the right medication while minimizing potential side effects.

Try Heat and Cold Therapy

Both heat and cold can help alleviate the symptoms of psoriatic arthritis during flares. The heat helps alleviate pain and tension by loosening the muscles around the joints and increasing flexibility and circulation. Cold, on the other hand, helps reduce inflammation, swelling, and pain.

For hot therapy, the Cleveland Clinic recommends showering or soaking in a warm bath for 20 minutes or using a heating pad. Applying a moist dishcloth warmed in the microwave for 20 seconds can work in the same way.

For cold therapy, apply a gel-filled cold pack, bag of frozen peas, or a baggie filled with ice for 20 minutes at a time.

Take Your Pain Seriously

Don’t let your pain get worse and worse. Talk to a rheumatologist about managing your pain as soon as it begins. Your doctor can advise you on the best medical and at-home treatments to help manage your discomfort. They may even recommend trying a splint or a brace to reinforce painful joints.

Find Support Today

MyPsoriasisTeam is the social network for people and their loved ones with psoriasis and psoriatic arthritis. More than 108,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic disease.

How do you manage PsA symptoms during flares? Share your tips in the comments below or by posting on MyPsoriasisTeam.