Tracy Davenport, Ph.D., takes a whole-life approach to managing her psoriatic arthritis (PsA). Sure, she takes a prescription, but that's really just the beginning: “I exercise at least six days a week and try to only eat fried foods once a week, since the fatty acids in fried foods can increase inflammation,” says Davenport, who's a health coach and writer in Centreville, MD. “I also stretch once or twice a week (I just download a routine on my phone), and recently I also stopped eating wheat.”
Because psoriatic arthritis is an inflammatory autoimmune condition, the standard protocol for treatment usually involves a combination of medications that help reduce inflammation and suppress the immune system. This most often includes NSAIDs (non-steroidal anti-inflammatory drugs) along with stronger drugs knowns as DMARDs (disease-modifying anti-rheumatic drugs). But experts agree that Dr. Davenport’s approach of complementing her PsA meds with other non-traditional treatments can help quell symptoms and make Rx psoriatic arthritis treatments work better.
Here are some of the most common complementary psoriatic arthritis treatments, plus ways you can make them work even harder for you.
Autoimmune conditions tend to worsen with stress, and psoriatic arthritis is certainly no exception, which is why any stress-reducing activity can be immensely beneficial. “Yoga helps increase blood circulation throughout the body and aids in the detoxification of the lymphatic system,” explains Lynn Anderson, Ph.D., a naturopathic doctor and yoga therapist in Los Angeles. “The lymphatic system doesn't have a pump like the heart, so when you hold a yoga pose the muscles contract and send fresh blood to muscles, bones, tissues, and organs, supplying oxygen and nutrients.” This increased blood circulation helps relieve sore joints and increase flexibility, which can help mitigate psoriatic arthritis symptoms.
Supercharge it! Consider adding heat to your yoga practice. Doing so may help deepen your flexibility and the blood flow to your muscles and joints, explains Olivia Rose, N.D., a naturopathic doctor in Toronto. In addition, look for a yoga teacher who is also a certified yoga therapist with credentials from the International Association of Yoga Teachers (IAYT). These individuals are specifically trained to work effectively with PsA sufferers.
Born out of traditional Chinese Medicine, acupuncture involves inserting thin needles into the skin to reduce blockages and enhance the flow of qi (chi)—a form of energy that travels through channels known as meridians, explains Dr. Rose. A meta-analysis published in JAMA Internal Medicine found that acupuncture improved pain in 50% of patients with arthritis compared to 42% who received a placebo form of the therapy.
Supercharge it! Adding electrostimulation, or an electrical current to the needles after insertion, can be even more effective in reducing psoriatic arthritis symptoms, according to Dr. Rose. “This practice can augment traditional acupuncture, reducing muscle spasm around joints, increasing endorphins (the body's feel-good chemicals) and overall, providing a sense of well-being and pain relief,” she says. “With electroacupuncture it's important that the right intensity is used in order to get results, so you should look for a practitioner who is skilled in treating pain and arthritis, specifically a practitioner of traditional Chinese medicine or a naturopathic doctor.” Dr. Rose typically increases the intensity to the patient’s upper limit of tolerance. Research shows promising results. A recent study published in the British Medical Journal, found that patients with knee arthritis experienced alleviation of pain after two weeks of intense electroacupuncture treatment.
Vitamin D Supplement
While most of us make sure to stay out of the sun, vitamin D is a critical nutrient for a healthy and functioning immune system and can be particularly beneficial for PSA sufferers. “Research shows that individuals with autoimmune diseases such as psoriasis and psoriatic arthritis are low in this vital nutrient,” says Dr. Rose. It’s worth noting, however, that fair-skinned individuals shouldn’t stay in the sun for longer than 10 to 20 minutes, as they will likely burn. Darker skinned individuals, however, require longer to obtain adequate vitamin D levels—around 30 to 45 minutes, notes Dr. Rose. “Although sunscreen is important to wear for prolonged sun exposure, if the intention is to make vitamin D, sunscreen will block 95 percent of UV rays, so try to soak in just a little sun before applying your sunscreen.”
Supercharge it! Consider getting your vitamin D levels tested so that you know whether you’re deficient. If you are, you might experience symptoms including dry, cracked heels and a high frequency of upper respiratory infection. Your primary care physician should be able to test your levels at your yearly checkup and can prescribe a safe and appropriate supplement for you.
Like yoga, tai chi is a moving meditation practice that helps enhance flexibility, strength, and balance. It’s also shown to be effective in mitigating psoriatic arthritis symptoms. One study published in BMC Musculoskeletal Disorders found that patients suffering from psoriatic arthritis who practiced tai chi experienced enhanced functioning of their lower leg muscles, as well as less pain while exercising and living their day-to-day life.
Supercharge it! Find a place to perform Tai Chi outdoors to help aid in relaxation and score some extra vitamin D in the process (but don’t forget to apply that SPF). “There may be indoor practices to join in your community; however, traditionally Tai Chi is practiced outdoors in order to feel the connection with the elements such as air, water and earth,” says Dr. Rose.
While everyone can benefit from massage therapy, psoriatic arthritis patients tend to see relief in pain and muscle tension. “Frequent massages—monthly is ideal—can improve flexibility, reduce muscle tension, and increase blood blow,” says Dr. Rose.
Supercharge it! To get even more out of massage therapy, Dr. Rose suggests applying capsaicin cream on your painful joints, as this may help reduce inflammation and pain. “Capsaicin is the constituent in chili peppers that provides the heat sensation,” she says. “When massaged into painful joints, capsaicin cream can work as an analgesic by reducing Substance P, a pain transmitter in your nerve endings.” Consider bringing the cream with you to your massage and using at home too.
Acupuncture Study:JAMA Internal Medicine, (2012), “Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis,” jamanetwork.com
Knee Arthritis and Acupuncture:Arthritis Research & Therapy, (2019), “Effects of intensity of electroacupuncture on chronic pain in patients with knee osteoarthritis: a randomized controlled trial,” arthritis-research.biomedcentral.com
Tai Chi and Arthritis Study:BMC Musculoskeletal Disorders, (2010), “Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study,” ncbi.nlm.nih.gov
Sun and Vitamin D Info:Dermato-Endocrinology, (2013), “A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis,” tandfonline.com