Kids’ Top Questions About Psoriatic Arthritis
Psoriatic arthritis (PsA) is a lot to deal with: Managing your discomfort, flares, medications, and, you know, life is quite the juggling act. Throw kids in mix and things get even tougher. While 7 million adults have the disease, a mere 0.7% of children have it—so your youngster is bound to have a lot of questions about what’s going on with Mom or Dad. (Let’s face it: Kids have a bazillion questions whether or not you’ve got PsA!) We talked with experts about Q’s kids commonly ask, so you can arm yourself with the best info to share once they do.
How Did You Get It?
“We don’t know all the how’s and why’s, but we have some good clues,” says A. Yasmine Kirkorian, M.D., assistant professor of dermatology and pediatrics at George Washington University School of Medicine. Explain that you're more likely to get PsA if Grandpa or Uncle Bob or someone else in your family has it, but that alone isn't enough: Usually it's a second illness, like strep throat or an earache, that sets off the disease, says Dawn Davis, M.D., a pediatric dermatologist at the Mayo Clinic in Rochester, MN. (But it's pretty rare, and no, just because your son's throat is sore doesn't mean he's going to get PsA, too!)
Can I Get It From You?
Assure your youngster: You can’t “catch” PsA like you could a cold, no matter how much snuggling and hugging you do. But there are these things called genes that every person is born with, and your child's genes look a lot like your own. That matters because certain genes are more common in people with psoriatic arthritis, says Dr. Kirkorian, so the risk of your child getting PsA is a little higher than his friend, but only a little. “Not every person with these genes will get psoriatic arthritis," she says. Your child can help keep tab on things by letting you know how he's feeling.
Why Can’t I See Where You Hurt?
Kids who’ve heard of psoriasis (PsO) might wonder why you don’t have those telltale red skin patches. But only about 30% of people with severe PsO go on to develop PsA. In PsA, your joints and tendons are the target, leading to pain and swelling that makes it uncomfortable to move. But just because they can't see your ouch, doesn't mean it isn't there! Describing the soreness you feel can help kids better understand why sometimes, you need to take it easy.
Why Do You Hurt So Much?
Ask your child to recall the last time she took a spill on her bike and bruised her knees. It hurt, remember?! That's sort of like what PsA feels like, except instead of just knees, it hurts your elbows, wrists, and feet, too—places where two bones meet or where ligaments attach. Swelling around your joints can also be painful and can make you feel like your ability to move is limited, says Amir Orandi, M.D., a rheumatologist in pediatric and adolescent medicine at the Mayo Clinic.
Why Do You Walk Funny in the Morning?
“If you have psoriatic arthritis and spend time asleep—or really any time that you spend stationary like sitting at your desk or watching a movie—the fluid around your joints becomes even more viscous, like the motor oil in a car,” says Dr. Kirkorian. “That can lead to morning stiffness.” Once you get going and move around, the physical activity will get that fluid to loosen up, which is why you feel better (and walk more normally) as the day goes on.
What Does Your Doctor Do?
After asking how you feel and doing some tests, your doctor will determine if you have PsA. If it's a mild case, your doc might prescribe some medicines to make the swelling in your joints go down, which will help you feel better pretty quickly. If symptoms are more severe, your doctor will use other medicines that tell the cells in your body that are annoying your joints to knock it off. Either way, the medicines will help you feel better so you can get back to doing fun family activities.
What Will Make You Feel Better?
Following healthy habits can make a big difference in how you feel, and your child can help you stick with them! Sleeping plenty of hours, going for walks, and limiting TV time are all ways to make you feel better. Staying away from cigarette smoke is important, and so is reducing stress, which can exacerbate symptoms of both PsO and PsA. “Stress can cause a skin disease to flare,” says Dr. Kirkorian, “whether it's smaller, everyday stress, or something more serious, like a divorce.”
Is It Contagious?
Absolutely not. “That’s usually the first question I get asked,” says Dr. Kirkorian. “But anybody can touch someone with psoriatic arthritis. You can hold hands. You can hug. Nothing about this disease is contagious.” Rather, it is a disease in which your immune system—the cells inside your body that usually fight off harmful viruses—attacks some of the healthy cells by accident. Even though the scaly red patches on your skin (if you have psoriasis on top of psoriatic arthritis) may look contagious, they're not.
Will You Have This Disease Forever?
Psoriatic arthritis is a chronic condition, so except in a few rare cases, it won't ever go away completely. But with your doctor's help and the right medicine, you'll be able to manage symptoms of PsA so well that a lot of the time your child won't even notice it. “Improved treatment options now make complete disease control possible for many patients,” says Dr. Orandi. Translation: Your joints and ligaments will feel good enough that you can play hide-and-go-seek and tag, no problem.
What should I tell my friends?
When Mom or Dad is sick, children can be confused about what they should say to peers. Choose an age-appropriate way to talk about the disease with your kids, so they'll be able to explain the situation better to their friends. Words like "boo-boos" and "ouches" go over well with the young crowd, while "it's really uncomfortable sometimes" is something your gradeschooler or preteen can understand. You can also look for local support groups where kids can talk to peers with the disease, to gain a new perspective on what it means to have PsA.
PsA and Statistics: National Psoriasis Foundation. (n.d.) “Psoriatic Arthritis.” psoriasis.org/psoriatic-arthritis
PsA and Genetics: National Organization for Rare Disorders. (n.d.) “Psoriatic Arthritis.” rarediseases.org/rare-diseases/arthritis-psoriatic/
PsA and Treatment: Arthritis & Rheumatology. (2019). “2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis." rheumatology.org/Portals/0/Files/PsA-Guideline-2018.pdf
PsA and Exercise: UptoDate: (n.d.) “Patient education: Psoriatic Arthritis Beyond the Basics.” uptodate.com/contents/psoriatic-arthritis-beyond-the-basics
PsA and Stress: Clinical and Experimental Dermatology. (2019). “Influence of Stress on the Development of Psoriasis.” onlinelibrary.wiley.com/doi/full/10.1111/ced.14105