Does Psoriatic Arthritis Cause Dizziness?

Psoriatic arthritis (PsA) is an autoimmune disorder where the body’s immune system attacks its healthy cells and tissues. With PsA, these attacks are mainly targeted at the joints, leading to joint pain, swelling, and stiffness.

But joint symptoms are not the only way PsA will affect you. The condition can also cause systemic (whole-body) symptoms, such as dizziness and vertigo.

Keep reading to learn about PsA, dizziness, and vertigo, how these symptoms and PsA are connected, and how vertigo in people with PsA is treated. 

Dizziness vs. Vertigo

The terms dizziness and vertigo are often used interchangeably, but these terms describe two different symptoms or sensations. Dizziness and vertigo also have different causes.

Dizziness describes a general feeling of being off-balance. It is an impairment of spatial orientation—the ability to perceive and adjust your location with objects in your external environment.

A person can feel dizzy when they are moving, standing, sitting, or lying down. People who feel dizzy might also faint and feel lightheaded, nauseous, and/or unsteady.

Vertigo, on the other hand, makes you feel as if you or your surroundings are moving. When vertigo is severe, you can also feel nauseous and shaky. It can make activities like walking or driving difficult. Vertigo is often described using the terms “floating, spinning, swaying,” or “tilting.”

Vertigo is often related to causes that affect the vestibular system, which is located in the inner ear. The vestibular system senses motion and helps you to manage your balance.

Research has found that people living with PsA and other autoimmune arthritis can have damage to the inner ears. For some, this damage can affect hearing. It can also cause problems, including vertigo, severe and ongoing dizziness, and balance issues. 

A 2019 study in the Journal of Rheumatology looked at adults aged 20 up with PsA, many of whom reported general hearing and mental health concerns. From the data collected, the study’s authors found that PsA was significantly related to hearing loss, and the risk was higher for people who were also experiencing a psychiatric condition.

A 2014 study found that 60% of people with PsA had balance issues related to inner ear damage. The participants were asked about their frequency of other symptoms, including vertigo, dizziness, and tinnitus (ringing or noises in the ear). These symptoms were significantly higher in the people with PsA compared to the control group. 

Twelve people (20% of the study participants) reported vertigo. No control group participants reported vertigo. Fifteen people (25% of the study participants) reported dizziness as a symptom, and only one participant from the control group reported dizziness. 

Psoriatic Arthritis and Vertigo 

Autoimmune diseases like PsA cause the body to create inflammatory proteins that attack the body’s healthy tissues. When these proteins attack your middle and inner ear, the result is damaging inflammation that leads to hearing loss and balance issues.

With inflammatory autoimmune diseases like PsA, the inner ear and vestibular system are especially vulnerable to inflammation, and vertigo is a complication of this response. The main feature of vertigo in autoimmune diseases is an abnormal immune system response directed at the delicate parts of the inner ear. 

Treatment  

If you are experiencing vertigo or dizziness with PsA, you should reach out to your doctor. Your doctor will want to adjust your treatment plan or add medication to reduce PsA inflammation to reduce any further problems to the inner ear.

In addition, your doctor will create a plan for treating both vertigo and dizziness, which will include self-care remedies, medications, and physical therapy.

Self-Care

Some people with vertigo can benefit from self-care remedies, including diet changes, staying hydrated, vitamin D supplementation, and yoga.

Diet: Some foods in your diet might aggravate vertigo. Common diet culprits that contribute to vertigo are salty and sugary foods, alcohol, and caffeine.

Hydration: Being dehydrated can cause vertigo to flare up. Make sure you drink plenty of water throughout your day, especially when being active or when outside on a hot day.

Check vitamin D levels: Having low levels of vitamin D can contribute to vertigo symptoms regardless of the cause. Studies have shown vitamin D supplementation can reduce the number of vertigo attacks.

If you are experiencing vertigo symptoms as you manage PsA, talk to your doctor. Vitamin D deficiency is commonly observed with both psoriasis and PsA, and people with PsA seem to have higher incidences of vitamin D deficiency.

Yoga: Yoga is mind and body practice that incorporates physical postures, breathing techniques, and meditation and/or relaxation. It can help people who experience vertigo regain balance and coordination. It can also help you to cope with symptoms of vertigo.

Meditation can further help to calm the mind and reduce anxiety. By reducing stress levels, you might experience less dizziness and vertigo.

Medicines 

Acute dizziness and vertigo are often medicinally managed with vestibular suppressants, antiviral medicines, and antiemetic medicines. Corticosteroids are also prescribed for some people, and over-the-counter (OTC) options may help as well.

Medications include:

• Vestibular suppressants: These drugs can help to reduce the intensity of vertigo. They can also reduce motion sensitivity and motion sickness. Conventional vestibular suppressants fall into three groups—anticholinergics, antihistamines, and benzodiazepines.
• Antiemetic medicines: Antiemetics can help prevent and treat vertigo, nausea, vomiting, and dizziness. For people with severe vertigo, Phenergan (promethazine) is given by injection. Another commonly prescribed antiemetic drug is meclizine. It is given orally, but it does not always work fast enough for acute cases of vertigo.
• Corticosteroids: Some research suggests that corticosteroids can help to manage symptoms of vertigo, including dizziness, balance problems, nausea, and vomiting. They help by reducing inflammation that is attacking the inner ear.
• OTC medicines: Some versions of meclizine are available OTC as an ingredient in different products, including Dramamine. OTC antihistamines are another option for managing dizziness and/or vertigo, although non-drowsy antihistamines are less effective for treating symptoms of vertigo.

Physical Therapy 

Vestibular rehabilitation is a type of physical therapy that can benefit people with vertigo and inner ear problems. It helps the brain learn ways to use other senses to reduce the effects of vertigo.

A therapist can customize exercises based on the symptoms you are experiencing. Exercises might include eye and head movements, balance exercises, and other maneuvers, including a technique called the Epley maneuver. Vestibular rehabilitation is usually done on an outpatient basis. 

When to See a Doctor 

Anyone who has multiple episodes of vertigo should see their doctor. For most people, vertigo isn’t harmful, but its underlying cause needs to be determined and treated. 

If your doctor has prescribed treatments for vertigo, let them know about any new signs or symptoms you might experience. The source of vertigo may not be an inner ear problem, so it is important to rule out other problems. 

About 25% of people who experience vertigo and dizziness have a potentially life-threatening diagnosis. You should seek emergency medical attention for some symptoms of vertigo, including: 

• Sudden symptom onset
• Double vision or abnormal eye movements
• Severe headache
• Slurred speech
• Weakness of the arms or legs 
• Altered level of consciousness
• Difficulty walking or not acting as you normally would

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Outlook

The outlook for most people who experience vertigo is good. In people with PsA, it is important to get the inflammation under control so PsA does not continue to cause damage and problems in the middle and inner ear. 

Recovery from vertigo can mean decreased dizziness, improved balance, decreased fall risk, and a return to prior levels of movement and function. 

Vertigo can sometimes go away on its own without treatment. Most people will notice symptoms dissipate over a few weeks or months. But it is always wise to reach out to your doctor when you experience symptoms of vertigo that appear to have no known cause.

Frequently Asked Questions 

What are the symptoms of psoriatic arthritis?

Most people with PsA develop psoriasis first, with a buildup of skin cells that form scales and itchy, dry patches. But it is possible to have joint symptoms before skin patches appear. Joint pain and swelling are the main symptoms of PsA, but the condition can affect any part of the body, including the fingertips and spine.

How bad can psoriatic arthritis get?

Severe symptoms of PsA can affect your daily life. Untreated or severe PsA can cause permanent joint damage. Extended periods of inflammation can cause affected bones to erode, and the joint space may begin to narrow. All of these things will make it harder for you to move. 

PsA is also associated with many different comorbid (coexisting) conditions that are indicators of disease progression. Comorbid conditions associated with PsA include cardiovascular disease, obesity, diabetes, and gastrointestinal inflammation. PsA can also shorten life expectancy and lead to a decreased quality of life.

How do you treat psoriatic arthritis?

There is no cure for PsA, so treatment will focus on controlling inflammation and preventing joint damage and disability. Treatment options include drug therapies, steroid injections, and surgery.

Summary

Psoriatic arthritis produces inflammation that can affect the inner ear and cause dizziness and vertigo. These symptoms can be treated with self-care, medications, and physical therapy. If your symptoms are due to active psoriatic arthritis, the main goal will be to control this disease.

A Word From Verywell 

Psoriatic arthritis is a serious condition that affects many body systems. It needs comprehensive care to reduce the potential for all types of damage to the body, including damage to the inner ear and vestibular system. Make sure you work with a rheumatologist to get the best possible care for psoriatic arthritis.