An Overview of Psoriatic Arthritis Triggers

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Psoriatic arthritis (PsA) is a type of inflammatory arthritis affecting seven out of every 1 million Americans. PsA primarily affects the joints and the skin. It can be painful and debilitating and its symptoms can be set off by any number of disease triggers.

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) primarily affects people with psoriasis, an inflammatory condition where skin grows too quickly and forms red patches and silvery scales. Most people with PsA are diagnosed with psoriasis first, but it is possible to have joint symptoms before skin lesions occur.

The main symptoms of PsA are pain, stiffness, and swelling in one or more joints of the body. If severe, PsA will affect the fingers, toes, and spine. Both psoriasis and PsA are known for flare-ups—periods of high disease activity—and periods of remission, where symptoms are mild or mostly gone. 

There are no cures for PsA or psoriasis, but both can be treated and managed. Treatment involves focusing on controlling symptoms and preventing joint damage. PsA can cause disability and complications if not managed.

Understanding Triggers

The causes of psoriasis and PsA are unknown. Researchers think a combination of genes and exposure to external triggers will cause someone to develop PsA. One in three people with psoriasis have at least one relative with the disease and up to 10 percent will inherit one or more genes that predispose them. Many people with psoriasis will go on to develop PsA but having genetic risk factors does not mean someone will necessarily have psoriasis or PsA.

Some of the same external triggers are also responsible for disease flare-ups and worsening symptoms. 

Stress

Dealing with psoriasis skin symptoms is stressful enough and most people with PsA report skin outbreaks during stressful times. One 2015 study out of the United Kingdom found people with PsA were more prone to increases in joint pain, psoriasis plagues and/or fatigue when dealing with the psychological aspects of their disease.   

Illness

Certain illnesses, such as strep throat or the flu, can worsen symptoms in people with PsA. People with HIV and other conditions that compromise immune function can experience flare-ups of symptoms when their other conditions are not properly managed.

Skin Trauma

Skin trauma includes anything from bruises, cuts, scrapes, infections, sunburns, and tattoos. Skin trauma may also trigger joint symptoms as well. The link between injury and flares is related to abnormal inflammatory responses.  

People with PsA can prevent skin trauma by wearing gloves when cooking, gardening, or shaving. Wearing long sleeves when performing activities that may cause injury is also a good idea. Wearing sunscreen can prevent sunburns.

Drug Interactions

Certain medications, such as those for treating bipolar disorder, high blood pressure, heart disease, and malaria can trigger PsA symptoms. Drug interaction concerns should be discussed with a treating physician.

Alcohol and Cigarette Smoke

Both alcohol and smoking can worsen PsA and psoriasis symptoms. Quitting smoking may help to clear skin and improve overall health.

Alcohol can also interfere with the effectiveness of medications for treating PsA. One study reported in the International Journal of Dermatology confirms alcohol can exacerbate psoriasis symptoms. This report also suggests an increase in alcohol-related deaths in people with psoriasis, this compared to those without the condition.

Diet

Diet can either worsen PsA symptoms or improve them. Certain foods, including gluten, sugar and processed foods, may act as PsA flare triggers.  

There is also evidence some foods can reduce inflammation in the body. Inflammation-combating foods include omega-3 fatty acids, such as fatty fish, olive oil, flaxseed and walnuts and colorful vegetables loaded with high levels of antioxidants, including carrots, spinach, kale, blueberries, and strawberries.

Cold and Dry Weather

Both cold and dry weather can trigger PsA symptoms. Dry weather can dry out skin and increase skin symptoms. PsA pain, stiffness, and swelling may increase with cold, damp weather and barometric pressure changes.

A 2007 study from Tufts University found that every 10-degree drop in temperature caused increases in arthritis pain. Low barometric pressure, low temperatures, and precipitation were also culprits in increased pain. Researchers don’t know why this happens but suspect these conditions cause internal joint structures to expand and swell.

A Word From Verywell

There is no cure for psoriatic arthritis and flare-ups can be so painful they interfere with daily life. The best way to lessen the impact of PsA is to proactively manage symptoms, control inflammation, and avoid triggers.

Triggers of PsA are not the same for everyone. Therefore, it is important for each person with this condition to know their own triggers and how to manage these to avoid disease flare-ups. 

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Article Sources
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