What Happens If Psoriatic Arthritis Goes Untreated?

The joint pain caused by psoriatic arthritis (PsA) can be very painful on its own. Some people find that it prevents them from fully participating in life. It may be painful to engage in their usual activities, to exercise, to go to work, or to even get out of bed.

However, without treatment, PsA can cause even more problems. Treatment for PsA aims not only to reduce PsA symptoms, but also to reduce the risk of complications caused by uncontrolled inflammation in the body.

How might psoriatic arthritis cause joint damage?

Psoriatic arthritis is an autoimmune disease. This means the immune system — which is supposed to protect the body against external threats — is mistakenly attacking your own body. In the case of PsA, the immune system is attacking the joint space. This creates inflammation.

The continuous presence of inflammation may also start to damage the joint. You may have a reduced range of motion, meaning your joint movement is more limited. You may not be able to flex or extend them as fully as you used to.

Over time, psoriatic arthritis may also lead to bone erosion. This is when the bone in the joint starts to wear away. There may also be new bone formations and/or fusion that further limit your mobility and worsen pain.

How does psoriatic arthritis increase the risk of other conditions?

Psoriatic arthritis is linked to other comorbidities. This refers to having two or more conditions at the same time.

For example, people with psoriasis and PsA have an increased risk of depression. In general, depression is more common among people with chronic illnesses, potentially due to the stress of dealing with the illness itself. However, there’s also some evidence to suggest that depression could be linked to inflammation as well.

People with psoriatic arthritis are also more likely to experience heart problems. This includes high blood pressure, high cholesterol, and coronary artery disease. These can also increase the risk of heart failure, heart attack, and stroke.

Other conditions that may be associated with psoriatic arthritis include:

• Type 2 diabetes

• Osteoporosis

• Inflammatory bowel disease

• Autoimmune eye disease

• Liver disease

• Fibromyalgia

How does psoriatic arthritis treatment help?

Today’s advanced treatments for PsA work to not only reduce pain, but to control inflammation. One of the most effective treatments for moderate-to-severe PsA is biologics, a type of disease-modifying antirheumatic drug (DMARD). 

Some examples of biologics that help treat psoriatic arthritis include:

• TNF inhibitors

• Interleukin inhibitors

• T-cell inhibitors

Biologics generally target parts of the immune system that contribute to inflammation. Biologics have a few treatment benefits: 

• Decrease inflammation in the joints, which should help reduce pain, improve swelling, and minimize long-term joint damage

• Slow the progression of the disease

• Reduce the risk of complications attributed to chronic inflammation in the body

If you are not receiving treatment — or your current treatment isn’t working — see a doctor (ideally a rheumatologist). A doctor can help you find the right treatment regimen to help reduce your risk of joint damage and other complications.