Psoriasis is known for uncomfortable itchy and dry patches that develop on the skin, and some may think these are the only things to know about the condition. However, certain patients will develop the more internal symptoms of psoriatic arthritis as time goes on.
According to the American College of Rheumatology (ACR), around 15 percent of psoriasis patients will develop psoriatic arthritis.
Both of these conditions flare up when the body’s immune system begins to attack either the skin (in psoriasis) or the joints and skin (in psoriatic arthritis).
Inflammation occurs in the joints in response to this immune system attack, causing a range of symptoms from patient to patient, often involving pain and stiffness.
Any joint can potentially be affected, including the knees, back, neck, fingers, toes and elbows. The level of severity also varies widely from patient to patient.
While this disorder can cause discomfort in the joints and perhaps spark a desire in patients to move them as little as possible, there is no need for the disease to cut out exercise or physical activity.
In fact, doctors stress that patients should make a focused effort to stay active.
According to ACR, being sedentary can actually make the condition worse. “Many people with arthritis develop stiff joints and muscle weakness due to lack of use,” reports the college. “Proper exercise is very important to improve overall health and keep joints flexible.”
As psoriatic arthritis patients try to stay active, it is helpful for them to know the right way to approach exercise while living with their painful condition.
The Psoriasis and Psoriatic Arthritis Alliance (PAPAA) out of the United Kingdom reports there are two main kinds of exercise when thinking about psoriatic arthritis: therapeutic and recreational. These two types of exercise are often used together.
Working With the Joints Through Therapeutic Exercise
As PAPAA explains it, “Therapeutic exercises are activities based on your exact needs.” A physical therapist can help individual patients determine which specific exercises are best for their unique needs.
Therapeutic range of motion exercises that increase flexibility and strengthening exercises to build up the muscles are commonly used by people with psoriatic arthritis.
Examples include stretching the fingers, neck, toes, knees and jaw in specific ways as far as it takes for patients to feel a stretch and move towards the joints’ current limit, but not so far as to cause intense pain.
For example, an exercise provided by PAPAA for psoriatic arthritis affecting the neck and back is as follows: “Tilt your head towards one shoulder until you feel the stretch on the opposite side. Hold for approximately five seconds. Repeat to the other side.”
Again, working with a professional is the best method for determining which movements will help based on specific patients’ needs and how far to take these movements.
Recreational Exercise: Staying Active and Having Fun
In recreational exercise, you aim to enjoy yourself and relax while at the same time completing a physical exercise.
When thinking about what type of recreational exercise to do, PAPAA recommends patients think about recreational exercise as an opportunity to work and strengthen the joints that psoriatic arthritis affects while having fun.
“Consider what you can currently do (sit for 20 minutes without pain in your back or walk round the park with your dog) and decide on what you would like to be able to do,” suggests PAPAA. “You can then set yourself goals to work towards, for example you may aim to participate in a local charity walk, learn to swim or be able to walk to the local shop.”
Walking is a good option for many people with psoriatic arthritis, and shoe inserts and high quality shoes can help ease stress on the feet or knees.
Riding a bicycle or using an exercise bike is another popular exercise choice, one which can be easier on feet than walking, which is a bonus for people whose psoriatic arthritis affects the joints in their feet.
ACR also suggests trying yoga and stretching exercises for a low-impact recreational exercise option.
“Some people with arthritis find it easier to move in water. If this is the case, swimming or walking laps in the pool offers activity without stressing joints,” reports ACR.
If your skin feels dry and itchy after exercising in a pool, PAPAA recommends applying barrier cream both before swimming and after your post-swim shower. However, chlorine does not aggravate psoriasis in most people.
Fighting the Pain
Though sometimes the joint pain caused by psoriatic arthritis may make patients inclined to move as little as possible, it really is important to work with the painful areas.
As PAPAA reports, “You must try to do some exercise every day. On days when your joints are swollen or painful you should aim to move the affected joints through as big a range as you can, regularly throughout the day.”
However, it is important to note that while physical activity can make joints and muscles sore as you work them out, sharp pains or swelling should not occur. Physical therapists can help make sure you are exercising with proper form.
PAPAA provides psoriatic arthritis patients with various tips for physically making exercise easier and for mentally motivating themselves.
For example, ice packs can help ease the pain of joint inflammation, while heat (perhaps delivered through a hot shower or a heat pack) can help reduce stiffness and make moving easier. Massage can help increase blood flow to affected areas.
If patients are facing mental blocks to exercising more than physical obstacles, PAPAA suggests methods like working exercise into your daily schedule and keeping a diary to track progress.
Exercise is also easier when it is seen as a fun activity, so patients should get a friend to join in, enjoy physical activity outside in beautiful places when weather is nice, exercise to music they enjoy and reward themselves on occasion for their efforts.
Though the discomfort associated with psoriatic arthritis can make the mere thought of exercising painful, it is through starting to gently move, strengthen and exercise affected joints that the condition will improve. And hopefully, painful symptoms will start to subside as the joints become more flexible and surrounding muscles become stronger.
Patients should ask their doctor for a physical therapist referral to get started on the path to staying physically active with psoriatic arthritis.