Care for your body, mind, and soul as you navigate everyday life with psoriatic arthritis.

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Living with psoriatic arthritis can be hard. Hear relatable stories from people who get it.

From medication side effects to symptom management, turn here for the practical support you need to help manage psoriatic arthritis.

Navigating relationships with psoriatic arthritis can be hard. Turn here for support with friendships, dating, parenting, and more.

You are not alone. These stories can help you navigate the emotional and psychological side of living with psoriatic arthritis.

Laura Todd Carns

I was terrified of biologics as a treatment for PsA — until it changed my life.

I was 19 when I started noticing patches on my elbows. I thought it was just really dry skin but, despite moisturizing, the patches grew. 

A few years later, a doctor finally identified these patches and the ones that had sprung up on my knees as psoriasis.

At the time, I knew nothing about psoriasis. I had no idea that it was an autoimmune disease. I saw it as nothing more than a cosmetic nuisance. 

Years later, when my joints began to ache, it didn’t occur to me that my pain could be related to this skin condition.

Psoriatic arthritis (PsA) is inflammatory arthritis closely related to psoriasis. Approximately 

 have psoriasis, 10 to 20 percent of whom will eventually develop PsA, according to the Centers for Disease Control and Prevention.

Most people who develop PsA already have skin symptoms, although some people develop symptoms of arthritis before skin is visibly affected. 

In my case, I first noticed stiffness in my hands and pain in the joints of my feet. The pain and stiffness were worse when I first woke up and tended to improve through the day. 

These were not symptoms that dramatically affected my ability to get through my day, and so I largely ignored them.

Eventually, I went to a rheumatologist to figure out what was going on.

PsA is typically diagnosed by first ruling out other conditions, such as rheumatoid arthritis, Lyme disease, and other issues that cause joint pain.

That rheumatologist told me, “You’re young, your symptoms are mild. I wouldn’t worry about it too much.” 

 and told me to come back when it got worse.

A few years later when my symptoms were worsening, I sought advice from a different rheumatologist. This doctor took the opposite approach. 

After listening to my history for less than 5 minutes, she declared that I needed to start more aggressive treatment immediately. 

With no discussion of pros and cons, she shooed me out the door with a prescription for 

 — an injectable drug that’s commonly used in the treatment of psoriasis. 

I did some research, got freaked out, and ditched both the prescription and the doctor.

Eventually, the psoriasis that I’d always seen as a mild nuisance had spread enough to affect my self-esteem. 

I was a middle school teacher at the time, and my students were constantly saying things like, “Wow, Mrs. Carns, is that poison ivy? What happened to you?” 

I made an appointment with a new dermatologist to see what advances there might have been in psoriasis therapies.

This new doctor felt the pockets of fluid in the knuckles of my hand and asked if I’d ever considered using 

The treatment of an autoimmune disease often involves some mechanism for suppressing the body’s immune system. The trick is to suppress only the part of the immune system that is overreacting, leaving the rest of it functioning normally. 

This is where the so-called “biologic” treatments come in. These treatments are able to target, with greater and greater specificity, the unwanted immune response.

I told the dermatologist how the rheumatologist’s suggestion of methotrexate had scared me off, and she listened patiently to my concerns.

I was in my early 40s and I was worried about starting a medication that I might have to continue for the rest of my life. Plus, the idea of suppressing my immune system, on purpose, was deeply unsettling.

What my doctor explained to me, however, was that my relative youth was itself an argument for addressing not just my symptoms, but the progression of the disease.

While I may have felt the discomfort was manageable at the time, eventually, PsA was likely to cause irreversible joint damage. This could lead to increasing levels of disability.

Still relatively young and mobile, I had the opportunity to stop or slow the disease before that damage occurred. This was the argument that finally convinced me.

Once I’d decided to go on biologics, however, I had to confront the delivery method. 

One of the drawbacks of biologics, for many, is that they are delivered via injection — and most people self-inject at home. This prospect was daunting to me, to say the least. 

Thankfully, I was able to enroll in a patient support program run by the pharmaceutical company, and a nurse came to my house and taught me how to do the injections.

At first, I felt a lot of anxiety leading up to injection day. Over time, through some trial and error, I’ve found a routine that works for me.

I make sure to remove the injection pens from the fridge at least 15 minutes before administering. I use ice to numb the area and squeeze (or “chunk up”) the injection site with my other hand. 

With my current medication, I have a choice between the front of my thighs or my abdomen as injection sites. I’ve found injecting into the abdomen to be significantly less painful because the tissue there is fattier. I’ve never been so grateful for a soft belly!

The life changing benefits of finding a treatment that works

I’ve now been on biologic treatment for over 4 years and have a wonderful rheumatologist who works with my dermatologist to coordinate treatment. 

My doctors check my blood work every few months, and so far I haven’t had any negative side effects. 

There have, however, been some benefits I wasn’t expecting. 

Until I started using biologics, I didn’t realize that the fatigue I was experiencing, which worsened considerably during flares of my joint symptoms, was related to my PsA. 

It was something I had gotten so used to, I didn’t notice until it was gone. 

This is often the case for people with chronic illnesses. We become accustomed to feeling a certain way and forget what “normal” even felt like.

If you look closely while I’m standing in the sunlight, you may notice a slight difference in the pigmentation of my arms and legs in the places once covered by large psoriasis plaques. There is no other visual clue that I am a person with psoriasis. 

As for the PsA, my hands are sometimes still stiff in the morning, and the joints in my toes ache a bit during cold and rainy weather.

In addition to my medication, I try to keep my joints limber and muscles strong with yoga and other weight-bearing exercises.

A recent set of X-rays confirmed that my primary goal of treatment has been successful: There was no indication of joint damage whatsoever. 

In the end, I’m glad I found a team of doctors who listened to my concerns and took me seriously. 

I’m also glad I was able to overcome my fears and begin treatment, improving my quality of life both today and, hopefully, for decades to come. 

I was terrified of biologics as a treatment for psoriatic arthritis — until it changed my life.

Ariane Hoehne / EyeEm / Getty Images

Stella Bard, MD

The Path to Biologics: Finding a Psoriatic Arthritis Treatment That Works for Me

Kaitlyn McInnis

Yes, we’ve tried yoga. No, acupuncture isn’t a cure.

 isn’t exactly a walk in the park. Between dealing with 

, and particularly painful days, the autoimmune disease comes with a unique set of challenges and hurdles that can make going about daily life difficult.

But it’s important to remember that while it can feel isolating at times, you’re not alone.

Rolling with the punches may help you tackle feelings of stiffness and soreness, and there are treatments available that can improve your symptoms.

Whether you have psoriatic arthritis yourself, or you want to better support and empathize with a friend or loved one, here is the good, the bad, and all the little, laughable things in between that come with a PsA diagnosis.

Waking up feeling like the Tin Man is the norm

It doesn’t matter if your PsA affects your finger joints, your feet and ankles, or somewhere else in the body, waking up in the morning is a slow, drawn-out process for most of us. 

For the first few hours of the day, moving around the house, making coffee, and getting dressed and ready feels a whole lot like being stuck in the body of the Tin Man. 

The movement is stiff, slow, and quite limited in mobility until we warm up for the day.

You have no problem asking for help to open jars and bottles (but you rarely miss a yoga class)

The extent of your mobility and comfort level probably confuses friends and family — especially if your psoriatic arthritis mainly affects your finger joints. 

Sure, you can work up a pretty decent sweat during a 

 on a good day, but finding the strength to unscrew your protein powder or peanut butter jar afterward? That’s another story.

Your energy level is as unpredictable as your achy joints

PsA can be a very tricky illness in that you never fully know how it will affect your joints day after day. However, it’s equally difficult to maintain a consistent energy level. 

Hopefully, close friends and family understand when you have to cancel plans last minute or suggest a more laid-back activity, but trying to maintain a consistent level of energy when you need it is frustrating, nonetheless.

You’ve been misdiagnosed more times than you can count on one hand

While finally having a name for your ailment can come with a lot of emotion, by the time you’ve been properly diagnosed with psoriatic arthritis, it’s more of a relief than anything else. 

You’ve likely been told you have something like 

, that you’re prone to sprains and pulled muscles, or that you’re wearing the wrong shoes.

You have a hard time finding the perfect response to, ‘But have you tried…’

Yes, you’ve tried acupuncture. You’ve tried following an anti-inflammatory diet. You’ve even dabbled with essential oils. 

Well-meaning friends and family members may be trying to help you find something that will make your pain more manageable. 

But that doesn’t make it any easier to have to explain that while diet and alternative treatments can sometimes help, they don’t do anything to lessen the effects of psoriatic arthritis.

At this point, you know more about managing inflammation than most doctors

While you know that no diet or lifestyle change will illuminate the root of your psoriatic arthritis, you’ve still read up on every little detail on maintaining an 

You probably take a turmeric supplement and avoid nightshade vegetables and sugar. Maybe you’ve even cut out gluten and alcohol or started meditating to reduce stress. 

Whatever lifestyle changes you’ve decided to commit to, chances are you’ve impressed your doctor or rheumatologist with the sheer amount of knowledge you’ve acquired doing your own research.

You dread the winter months and long to move to a hot and humid climate

, or a combination of both autoimmune diseases, you likely dread the dark, cold months more than anything else.

Between keeping joints lubricated and the vitamin D from the sun’s rays, people with psoriatic arthritis and psoriasis tend to do a lot better in hot, humid conditions. 

Most of us thrive come summertime and dream of spending our days laying out in the heat.

There’s no way around it: Living with sore, achy, and inflamed joints can take its toll.

Whether you were diagnosed in your 20s or your 70s, constantly having to worry about how you feel, whether you’ll be able to move normally, or if you’ll have the energy to tackle the day makes you feel a lot older than you really are — even on good days.

Whether it’s catching a friend glance at your swollen or misshapen knuckles, walking with a slight limp, or having to explain yet another dietary restriction or compression apparel you’re trying out, dealing with the effects of psoriatic arthritis can be embarrassing. 

This is especially true if you’re someone who doesn’t exactly enjoy being the center of attention.

You know that you’re incredibly resilient

Sure, trying to conceal your swollen joints when you ask for help opening your toothpaste in the morning or covering up your limp while picking up your groceries isn’t exactly glamorous or sexy. 

But you know more than anyone that going through life with chronic pain makes you incredibly tough and resilient. 

While some days are worse than others, you know deep down that every small accomplishment, every sweaty yoga class, and every particularly strenuous home-cooked meal means a little bit more to you because you don’t take your strength for granted.

Here is the good, the bad, and all the little, laughable things in between that come with a PsA diagnosis.

Woman doing yoga  at home with online teacher

10 Things You Only Understand If You Live with Psoriatic Arthritis

Meaghan Quirin

Committing to a dry lifestyle allows me to be a healthier, happier person.

When you’re diagnosed with a chronic condition like psoriatic arthritis (PsA), you’ll often find yourself in conversations with people who offer suggestions as to how you can better support your health: “Have you tried yoga?” “What about turmeric supplements?” or “Maybe you should go vegan!”

These are well-intended but usually unsolicited suggestions that we spoonies have all heard and often tried before. What’s interesting to me is that the one lifestyle change that’s made the most impact on my health is one that no one ever suggested: cutting out alcohol. 

Considering the social and societal expectations around alcohol that we often face as adults, transitioning to a “dry” lifestyle can be a tricky thing to navigate. 

Drinking culture is tied to many social interactions, so much so that when someone decides not to partake, they’re oftentimes met with discomfort, questions, or assumptions. 

Growing up in an Irish-Catholic, party-loving family, I viewed drinking alcohol as a rite of passage, a part of adulthood that I never questioned. I just started to partake, and it quickly became a slippery slope. I was in college at the time, so the social pressures and opportunities to drink were everywhere. 

Alcohol was a great way to self-medicate and forget my troubles for a bit. It became quite habitual, and while my arthritis progressed and symptoms worsened, I never once considered alcohol could be causing harm.

Not only was I using alcohol as a way to cope with the physical pain I was dealing with, but also to help me forget about the frustration doctors were causing me by denying my pain and chalking it up to tendonitis. 

What I didn’t realize at the time was that my drinking was setting off a chain reaction of more anxiety, stress, pain, and fatigue. I managed to ignore the domino effect and instead focus on temporary relief.

I justified it by telling myself I was just having fun and living my life as a 20-something, but my body was paying the price.

When I was 25, I had a massive flare-up, and rheumatologists still were unable to come up with a diagnosis beyond inflammatory arthritis.

Hesitant to try biologics without a true diagnosis, I began working with a holistic health coach who taught me all about gut health and inflammatory foods and pointed out the damage my drinking might have been causing. 

I decided to cut back, and I told myself I would drink only on special occasions. Once I eased up on the nights out and boozy brunches, I realized how much better my body felt.

My arthritis was still very present, but I was having an easier time managing my health without the cycle of alcohol-induced inflammation, poor food choices, and fatigue that would follow a night out. 

Even with the obvious benefit to my health, I continued to drink every so often for a couple of years. My tolerance was dwindling, leaving me hungover from just one glass of wine. I knew it was hurting me, but I still felt socially obligated to have a drink in my hand. 

I desperately wanted to be able to partake socially and feel included with my friends. Living in New York City, bars and nightlife can feel central to the social scene. I worried that if I were to totally remove alcohol from my life, I would be missing out. 

Circumstances changed when my rheumatologist suggested I add methotrexate back into my treatment plan. She explained that it can be very hard on the liver and that alcohol should be avoided while taking methotrexate to reduce the chances of liver damage. 

My rheumatologist must have noticed the concern on my face because she then told me that drinking would be OK in moderation. But I knew moderation wouldn’t come easily to me. At this point, I decided to cut alcohol out entirely. I was ready to embark on a dry lifestyle, but not without worries. 

I had to conquer my fear of socializing without booze, as well as the fear of 

People sometimes become defensive or uncomfortable around a nondrinker because of how strongly our culture is tied to alcohol consumption. When you proclaim you’re no longer drinking, it can strike a chord with certain folks who might feel judged for their own drinking habits.

I had to constantly remind myself of my own “why” and remember that others’ opinions or feelings on the matter were not relevant. 

At first, I felt uncomfortable declining someone’s offer for a drink. That might sound silly to some, but when people in your life know you as someone who loves a glass of wine, suddenly declining prompts confusion and curiosity. 

It took me some time and practice to get used to being in settings where drinking alcohol was expected. After a few events, I found my groove. 

Per the advice of my cousin, who also has PsA and no longer drinks, I started ordering fun mocktails at the bar. This helped deter unwanted questions while allowing me to feel more included. 

The positives of choosing to be alcohol-free

Now that I have over 1 year without alcohol under my belt, I’ve become confident in my choice. I’ve realized that I’m actually able to enjoy myself 

 in most social settings without drinking. 

I feel more present and less anxious. I can socialize more frequently because my recovery time from a night out is now a fraction of what it used to be.

, I now like to take any opportunity I can to normalize 

 drinking by proudly announcing, “No, thank you, I do not drink anymore.”

Choosing to eliminate alcohol has allowed me to have important conversations with friends and family about drinking culture and how we view alcohol — despite the negative impacts drinking can have on our health.

I no longer care how it makes anyone else feel when I reject a drink because it makes me feel healthier, happier, and more in control. I will never judge any person for choosing to drink — I’ve simply come to learn that my body functions better without alcohol in the mix.

The one lifestyle change that has improved my life with PsA is one that no one ever suggested: cutting out alcohol. 

bottle-shadow-drinking-concept-1520x855-header-bezzy

Nancy Carteron, M.D., FACR

Methotrexate and drinking alcohol: How risky is it? (2018). 

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