Psoriatic Arthritis Flare-Up? 6 Ways to Get Symptom Relief

While medications help keep symptoms under control, flare-ups can’t always be avoided. Spotting the signs of a flare-up quickly and knowing how to manage the symptoms can ease your discomfort.

During a flare, your joints might start to feel swollen, tender, and stiff, and you might develop areas of tendinitis or swelling of an entire finger or toe, says Theodore Fields, MD, a rheumatologist at the Hospital for Special Surgery in New York City.

But it’s also possible that you won’t have swelling during a flare-up. Your main symptom might be fatigue, Dr. Fields says.

It’s important to be in tune with how you feel every day so you can recognize the signs of a flare-up and alert your doctor right away.

“We have many medications that can help stop the progress of psoriatic arthritis and dramatically ease symptoms,” Fields says. The sooner you address symptoms, the faster you can get relief and prevent joint damage.

To deal with psoriatic arthritis symptoms during a flare-up, take these steps.

1. Take Steps to Decrease Pain and Stiffness

• For occasional discomfort, Fields says, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve) can be beneficial. Ask your doctor about increasing the dose during a flare-up.
• You can also try heat or ice at the source of discomfort, Fields says. Wrap cold packs in a towel and apply for no more than 15 or 20 minutes. Similarly, try a warm compress or heating pad for 20 minutes.

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• If pain persists, Fields adds, your doctor may recommend prescription pain medication or a steroid injection at the affected joint.

2. Check in With Your Doctor

If you’ve stopped taking your medication, call your doctor to work out a plan for restarting and adjusting doses. Or if you're not sure how to handle the flare on your own, seek advice from your rheumatologist.

3. Moderate Your Exercise Routine

4. Reduce Stress During a Flare

Reach out for emotional support. Let your family and friends know you’re having a flare and that you could use some help or even just an ear to listen.

5. Get Extra Rest When Symptoms Are Flaring

It’s also important to pace yourself during the day and not overdo it. Conserve your energy by prioritizing what you need to do and taking breaks.

6. Consider Using Assistive Devices

Your doctor may recommend various devices to provide additional support for an affected joint. A splint can be used to hold a joint in the best position for improved function or to relieve pain and swelling. If foot or heel pain are concerns, wear comfortable, supportive shoes and consider foot orthotics such as shoe inserts or pads that may provide relief and improve your gait. Talk to your doctor about your specific symptoms.

“Some patients have severe psoriasis and mild arthritis, and the treatments are guided by the skin problem,” Fields says. “Some patients have severe arthritis and not such severe skin problems, and in that case the arthritis will determine the therapy.”

Here are some ways to address psoriasis symptoms during a flare-up.

• Moisturize. During a flare-up, locking in moisture with rich creams and ointments can help the itch.

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   “Have a good skin-care regimen, especially in dry weather,” says Delphine Lee, MD, PhD, the director of dermatology at the Los Angeles County Department of Health Services and a clinical professor at the UCLA David Geffen School of Medicine. “Furthermore, in winter months you may flare and should see a board-certified dermatologist for topical or systemic prescription medications if itching is not relieved with your usual regimen.”
• Avoid skin injury. “Psoriasis can develop at sites of trauma or skin injury,” Dr. Lee cautions. When you are experiencing a flare, protect your skin from chafing and additional irritation by wearing soft, breathable cotton fabrics.

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• Address the stress. Stress is a common psoriasis trigger and can worsen itchiness.

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   Keeping a journal is one way you can release some of the stressful feelings you may be feeling. You can also look over recent journal entries during a flare-up to identify stress triggers. Consider sharing your findings with a professional therapist who understands the emotional impact of psoriasis and who can help you better manage your stressors.

• Psoriatic arthritis flare-ups can be triggered by stress, infections, or ceasing medications, so it's crucial to monitor symptoms and seek medical guidance promptly to prevent joint damage.
• Utilizing nonsteroidal anti-inflammatory drugs, along with heat or cold packs, can offer relief from pain and stiffness during flare-ups, but it's essential to discuss NSAID dosage adjustments with your healthcare provider.
• Emphasizing gentle exercise, like walking or swimming, and stress reduction techniques, such as meditation and breath work, can be effective for symptom management during flare-ups.
• Persistent or severe symptoms should always be addressed by consulting with a rheumatologist, who can tailor a treatment plan and recommend useful interventions.

Additional reporting by Brian P. Dunleavy.