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What are Ways to Manage Symptoms and Treat Psoriatic Arthritis?

Treatment for psoriatic arthritis (PsA) varies depending on the severity of the disease and specific symptoms that are the most problematic at the time. Many people with PsA have to try more than one treatment option to find the best one or combination of approaches to manage their symptoms. The goals of treatment for psoriatic arthritis are:

While there is no cure for PsA, there are many treatment options that can help, and in some cases, lead to long-term remission of symptoms. Remission implies the reversibility of functional impairment, minimal or no further progression to joint destruction, and, at least in theory, potential to heal a damaged joint.3

Psoriatic arthritis treatment options based on severity

The severity of PsA determines the treatment approach. Mild disease is generally characterized by oligoarticular PsA (only a few joints are affected) and has minimal impact on the person’s quality of life. Moderate disease has more of an impact on the daily tasks of living and physical functions. Moderate disease may also impact the mental well-being of the patient and often doesn’t respond to mild treatment. Severe disease greatly impacts the patient’s quality of life. With severe disease, a patient cannot perform major daily tasks of living without pain or dysfunction, and there is a large impact on both physical and mental well-being.4

Treatment recommendations for psoriatic arthritis

While several professional physician organizations have created separate guidelines for treating PsA to provide strategies to healthcare professionals, there is no single standard of care for PsA and the treatment varies as greatly as the disease across different patients. In January 2019 the National Psoriasis Foundation and the American College of Rheumatology released A Guideline for Treatment of Psoriatic Arthritis that use a treat to target approach which may become the standard of care for psoriatic arthritis. Since guidelines do frequently change as new treatment options and new research becomes available, it is important for each person with PsA to speak to their doctor about which treatments are best for their situation.

What treatment options are there for psoriatic arthritis?

There are several treatment options for PsA, including:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), both over-the-counter and prescription
  • Corticosteroid injections
  • Traditional, or non-biologic, Disease-Modifying Anti-Rheumatic Drugs (DMARDs), which may reduce inflammation and attempt to slow or stop joint and tissue damage and progression of psoriatic arthritis
  • Biologic DMARDs, which have been genetically designed to work upon specific immunological targets, such as tumor necrosis factor (TNF) and interleukins (IL)
  • Biosimilars, which are a type of biologic therapy that are highly similar to an already approved biological product
  • Target-specific DMARDs, which work on specific cellular enzymes, such as phosphodiesterase type 4 (PDE4), to reduce inflammation and help relieve joint pain, swelling and stiffness
  • Other medications, including cyclosporine (brand names: Sandimmune®, Neoral®, Gengraf®), Xeljanz® (tofacitinib), Imuran® (azathioprine), and others

In addition, common non-pharmacological treatment options used in PsA include physical or occupational therapy and phototherapy (light therapy) for psoriasis lesions. Physical and occupational therapy are often critical interventions to protect the involved joints and maintain function.

What is combination therapy?

Combination therapy, or using multiple treatment options at the same time, will sometimes be recommended by your healthcare provider. The goal of combination therapy is to optimize treatment outcomes. For example, one medication may be used to boost the efficacy (or minimize the side effects) of another drug. Combination therapy also offers an opportunity for your healthcare provider to work with you to tailor a treatment in situations where there is a concern that traditional PsA treatments may be less effective. For instance, people who have PsA and psoriasis or those who are at risk of organ damage due to long-term use of systemic therapies, are most likely to be good candidates for combination therapy.

Is surgery a treatment option for psoriatic arthritis?

In severe cases of PsA, surgical care may be indicated. Arthroscopic surgery of the synovial capsule has shown to be effective, and joint replacement or reconstructive surgery is occasionally necessary.5

Complementary and alternative medicine treatment options for PsA

There are several complementary and alternative medical (CAM) treatments that some people with PsA find helpful, including massage, acupuncture, and herbal remedies.2 Before starting treatment with any type of CAM therapy, it is important to talk with your healthcare provider. While most CAM therapies are safe, some of them can interact with PsA treatments and require adjusting the dose of medications or consideration of a different medication.

Lifestyle changes

Lifestyle changes or “self-management,” of psoriatic arthritis including diet, exercise and physical therapy are also important ways that individuals with psoriatic arthritis can manage symptoms. It is also recommendation for individuals with PsA to avoid smoking or to stop smoking.

Written by: Emily Downward | Last reviewed: June 2019.
  1. Acosta Felquer ML, FitzGerald O. Peripheral joint involvement in psoriatic arthritis patients. Clin Exp Rheumatol. 2015 Sep-Oct;33(5 Suppl 93):S26-30.
  2. National Psoriasis Foundation. Accessed online on 5/11/16 at
  3. Saber TP, Ng CT, Renard G, Lynch BM, Pontifex E, Walsh CAE, Grier A, Molloy M, Bresnihan B, FitzGerald O, Fearon U, Veale DJ. Remission in psoriatic arthritis: is it possible and how can it be predicted? Arthritis Res Ther. 2010:12(3):R94.
  4. Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY, Van Voorhees AS, Elmets CA, Leonardi CL, Beutner KR, Bhushan R, Menter A. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 2. Psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol. 2008 May;58(5):851-64.
  5. Psoriatic arthritis. Medscape. Accessed online on 5/11/16 at