We Are All Different: A Look at Variations in Psoriatic Arthritis
Last updated: August 2021
We are all made, each and every one of us, differently. No two people are alike. Our life experiences, our bodies, and yes, even how our bodies handle psoriatic arthritis are all very different.
While we all may live with the same disease, there are many variations of the disease that impact our lives differently.
A look at the unique PsA experiences
These differences cause our experience of life with psoriatic arthritis to be completely unique. We are all different and it is these different variations in disease activity and progression that we need to be aware of, especially when we speak to one another.
From pain in different areas of the body to different treatment experiences, let's take a look at some of the unique ways psoriatic arthritis can present itself.
Areas of the body
Many days it can be like playing an obnoxious game of, “Head, Shoulders, Knees, and Toes.”
While my feet may be one of my primary sources of pain, for others it could be their back or hands. Yes, it is true that psoriatic arthritis tends to strike primarily the distal joints, that doesn’t mean that it is in any way limited to those. Joints, organs, nails, you name it and it is susceptible to attack by psoriatic arthritis.
Let's talk pain levels
Not only will psoriatic arthritis attack pretty much any part of your body, but it also attacks with many varying levels of intensity or severity. While we typically classify it as mild, moderate, or severe, that usually applies to the damage and not actually the RATE of damage. Meaning how quickly or to what level your body is actually eating itself.
Perhaps one person’s body is working on let’s say a “snack” level, while another person’s body is having a full-blown all-you-can-eat buffet. When it comes down to it, there are so many possible variations and differences with psoriatic arthritis, it is a wonder that science can keep up at all!
A look at treatment variation
Whether we like it or not, the fact of the matter is that we don’t all have equal access to many of the medications. Insurance, income, and even region of the world all impact our access to different medications. Not to mention our access to the good rheumatologists that prescribe the medicine.
We are much luckier today than we were even 10 years ago when you consider the widening range of options to manage our psoriatic arthritis. But how we respond to the medications are all different as well. I’m very active in several different PsA communities. I find it very interesting that we all have the same disease, but what works for one person, may not work at all for another.
Even medications that are considered “biosimilar” seem to work differently for some people. Somehow even “name brands” work differently than generic ones. It simply blows my mind.
Comorbidities and pre-existing conditions
Autoimmune disease is the gift that keeps on giving. They tend to cluster together and rarely are found alone. Not to mention the comorbidities inherent to psoriatic arthritis, like metabolic syndrome and fibromyalgia. All of these related conditions and our own experiences change how psoriatic arthritis will impact us.
Different comorbidities and different pre-existing conditions not only make diagnosis difficult but also make choosing treatment options difficult. For example, I have psoriatic and rheumatoid arthritis. There are good ones to treat PsA and there are also good ones that treat RA, yet the ones that effectively treat both are few. And it is unlikely that you can effectively be on two different biologics at once.
Respecting each other's PsA journey
So with all of these differences, how come we still continue to compare? We compare ourselves to others and them to us. Why? We say, “Well, he doesn’t have it as bad as I do, I don’t know why he complains so much.” Or we say, “What’s wrong with me? Others respond to medication and achieve remission.”
I have even heard, on several occasions, a person with psoriatic arthritis actually berate another patient because they simply couldn’t understand how psoriatic arthritis was so limiting to their body. Or they say things like, “I just push through it.” Implying, of course, that another might not be as strong= or capable as they are. This makes no sense at all to me.
So please, my friends, despite the fact that everyone suffers from psoriatic arthritis differently, always speak kindly to each other, and to yourself. Always do your best to understand that this disease is difficult for everyone on varying levels. Be accepting of each other, and yourself, just as you are.
Do you have any questions about PsA?