Tender joints. Body aches. Fatigue. If you have psoriatic arthritis (PsA), you might recognize these as signs of an oncoming flare, yet these are also common complaints as we age.
While most people develop PsA between the ages of 30 and 50, for those of us whose onset occurs later in life, it’s hard to distinguish the early signs of a flare from what we may dismiss as a normal part of the aging process.
Because I was diagnosed with PsA in my early 50s, I sometimes struggle to differentiate between typical wear and tear on my older body and what might be related to PsA.
For years, my only symptom was a mild case of psoriatic toenails. While this was frustrating and sometimes embarrassing, it wasn’t physically uncomfortable. When I began having pain in my hands, I dismissed this as the result of repetitive use, simply part of growing older as a person who worked on a keyboard all day.
But everything changed when I had my first real flare, which resulted in major stiffness and swelling in my index finger (the classic PsA “sausage finger”) and, later, so much pain in my heels that I hobbled to the bathroom every morning.
Identifying these as serious symptoms of PsA led to a difficult lesson in reassessing how often I dismissed my pain as part of aging and “something I can’t do anything about.”
PsA presents distinct symptoms, including the aforementioned psoriatic nails and swelling. But a flare often begins with the aching joints and fatigue that are also part of living in an older body. So how do we assess the difference?
One way is to make a clear distinction between signs of normal aging and the symptoms of PsA. While osteoarthritis is not a guaranteed part of the normal aging process, it’s fairly common as we age, affecting over 30 million older Americans.
Stiffness, as well as grinding or clicking sounds at the joints during movement, are telltale signs of osteoarthritis (OA), the result of cartilage wearing down over a lifetime.
But even if we don’t have serious osteoarthritis, most of us lose some of the cushion between our joints as we age, and after we exercise, we need more time to recover. So, here are some steps you can take to alleviate all these symptoms, which may also protect you from an oncoming PsA flare.
Gentle exercise, such as swimming, yoga, cycling, walking, or gardening, is better for us as we age, and these rarely aggravate PsA. But long hikes on back-to-back days or lifting heavy weights can inflame joints and tendons, so take it easy.
Generally, 30–45 minutes of low intensity, low impact exercise daily is all you need to maintain good health. Make sure to warm up and cool down too.
If certain foods tend to cause inflammation for you, such as alcohol or sugar, limit the amount you ingest. For some people, red meat, soy, or corn can bring on a flare. Know what foods are triggers for you, and while we all need to indulge sometimes, avoid these foods as often as you can.
Paying attention to emotional stressors will also help limit the chances of a flare. Give yourself space to say no: Don’t overobligate or overschedule.
Find time to quiet your mind by reading, writing in a journal, listening to a favorite podcast, sitting in park, or meditating. And seek counseling if you need help managing stress, anxiety, and depression.
As an older adult, you have more experience with self-care. And if you’ve dealt with PsA for a while, you have a collection of tools to help you cope when your joints begin to feel painful or irritated. These include ice packs, heating pads, warm baths, and over-the-counter (OTC) and prescription anti-inflammatories.
You might find OTC creams containing arnica work for you, as well as other topical gels or creams that help with pain. Use all the tools you have at your fingertips, especially when symptoms begin to increase, because these may escalate to a full flare.
While talking with a professional can ease stress, so can confiding in a close friend. One of the benefits of growing older is we often form long-term relationships.
A heart-to-heart with someone who knows you well can help you problem-solve and leave you with a general sense of well-being. Even a lazy afternoon of window shopping or a leisurely lunch on a sunny patio with someone you trust can ease stress.
And bodyworkers can also help. Find a massage therapist who can release the stiffness and pain associated with an oncoming flare, and work with them on a pressure level that won’t aggravate your symptoms.
Being older often means having been self-sufficient and resilient when life has challenged us, and we take pride in this. But as we age, it benefits us to be more gentle with ourselves, and pushing ourselves physically the way we used to when we were younger just isn’t sustainable.
Living as an older person with PsA only increases the need to ease up a bit, especially when symptoms worsen. Along with all of the suggestions above, allow yourself adequate time to rest, and you may be able to head off a flare.
You don’t need to do this on your own. When flares are especially bad or you or happening more and more frequently, call your rheumatologist. You’ll often feel relieved after an appointment.
A doctor who knows you and your condition can help you consider new treatment options and may prescribe steroids or administer a steroid injection to help you get through a rough patch.
While none of these tips are foolproof, we can use them to help us slow down, take stock, and reconsider our options and our actions. As we age with PsA, we may need more self-care.
The good news is we often have more resources and knowledge about how to do this well and larger support systems that enhance our ability for self-care. While it may not be a silver lining for living with PsA, it’s one of the many gifts of growing older.
So take good care of yourself. As we age with PsA, this old adage has never been more apropos.
Medically reviewed on November 21, 2023
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