Psoriatic Arthritis Treatment: Medication, Surgery, Lifestyle Changes, and More

Psoriatic arthritis (PsA) is an autoimmune disease that causes inflammation of the skin, joints, tendons, and nails. It can cause pain, swelling, stiffness, and reduced range of motion.
Treatment of psoriatic arthritis aims to relieve symptoms, reduce inflammation, and prevent damage to the joints.
It’s important to get a diagnosis as early as possible, says Chris Morris, MD, a rheumatologist with Arthritis Associates of Kingsport in Tennessee. “Early control of the inflammatory processes can reduce problems like heart disease and osteoporosis, which are associated with inflammatory arthritis. Early and aggressive treatment can also reduce the risk of disability," he says. Medication is the mainstay of treatment for psoriatic arthritis, and your doctor will recommend which medication to try first according to the severity of your disease, any drugs you have tried in the past, your overall health, and your personal preferences.
You’ll need to work with your rheumatologist to make sure that you’re on the treatment regimen that best meets your needs — and if what you’re taking isn’t doing the job, it may be time to try something else.
Psoriatic Arthritis Medication
Several classes of medications are used to treat psoriatic arthritis. Most require a prescription from a medical professional. Psoriatic arthritis treatments may be taken as a pill, applied topically, injected subcutaneously (beneath the skin), or given as an IV infusion.
Nonsteroidal Anti-Inflammatory Drugs
While NSAIDs can help control symptoms of psoriatic arthritis, they don’t prevent joint damage.
- ibuprofen (Advil, Motrin)
- naproxen (Aleve)
- diclofenac (Arthrotec)
Steroids
Steroids, also known as glucocorticoids, can be used in a few ways in psoriatic arthritis treatment.
They may be injected directly into a joint to reduce pain and stiffness in that joint.
Disease-Modifying Antirheumatic Drugs
Disease-modifying antirheumatic drugs (DMARDs) work by suppressing inflammation-causing chemicals in the body. They can slow the progression of psoriatic arthritis and prevent permanent joint damage.
- methotrexate (Trexall)
- Leflunomide (Arava)
- sulfasalazine (Azulfidine)
- azathioprine (Imuran, Azasan)
- cyclosporine (Gengraf, Neoral, Sandimmune)
The most commonly used is methotrexate. Azathioprine and cyclosporine are rarely used but may be appropriate in some situations.
JAK Inhibitors
- tofacitinib (Xeljanz)
- upadacitinib (Rinvoq)
Phosphodiesterase-4 Inhibitors
Biologics
Biologics target specific cells or proteins of the immune system that play a role in the development of psoriatic arthritis. They can slow or stop the inflammatory processes in the body that lead to joint damage.
- Tumor necrosis factor (TNF)–alpha inhibitors
- Interleukin 12 and 23 (IL-12, IL-23) inhibitors
- Interleukin 17A (IL-17A) inhibitors
- Interleukin 17A and 17F (IL-17A and IL-17F) inhibitors
- Interleukin 23 (IL-23) inhibitors
- T-cell inhibitors
All of the biologics are administered as either a subcutaneous injection, which can be taken at home, or as an IV infusion, done in a medical office or hospital infusion center. .
adalimumab (Humira)
certolizumab (Cimzia)
etanercept (Enbrel)
golimumab (Simponi)
infliximab (Remicade)
Subcutaneous injection or IV infusion
Increased risk of upper-respiratory tract infections, injection site pain or irritation, headache, rash, and nausea
ustekinumab (Stelara)
Subcutaneous injection or IV infusion
Increased risk of upper-respiratory tract infections and injection site pain or irritation
ixekizumab (Taltz)
secukinumab (Cosentyx)
Subcutaneous injection or IV infusion
For ixekizumab, neutropenia (an abnormally low count of neutrophils, a type of white blood cell), hypersensitivity reaction, infections, and injection site pain or irritation; for secukinumab, increased risk of upper respiratory tract infections and diarrhea
IL-17A and IL-17F inhibitors
bimekizumab (Bimzelx)
Subcutaneous injection
Upper-respiratory tract infections, oral yeast infections, headache, diarrhea, and urinary tract infections
guselkumab (Tremfya)
risankizumab (Skyrizi)
Subcutaneous injection or IV infusion
Increased risk of infections, upper-respiratory tract infections, injection site pain or irritation, headache, fatigue, and joint pain
abatacept (Orencia)
Subcutaneous injection or IV infusion
Increased risk of infection, dizziness, fatigue, nausea, diarrhea, and headache
Psoriasis Treatments
For people whose psoriasis is not adequately controlled with their psoriatic arthritis medication, additional treatments include topical medications, light therapy, and systemic medications other than those used for psoriatic arthritis.
Surgical Options for Psoriatic Arthritis
Several types of surgery may prevent damage or may be needed in response to damage caused by psoriatic arthritis.
Synovectomy
A synovectomy is the removal of the synovium, the connective tissue that lines the insides of joints that involve two bones moving together. Normally, the synovial membrane protects the joint and helps keep it lubricated and moving smoothly.
For some people, drug treatment controls the inflammation and abnormal synovial growth, but for those who don’t respond to medication, a synovectomy is an option.
Depending on the amount of inflammation in the joint, the entire synovium may be removed, or only a portion of it.
Joint Replacement
Joint replacement surgery, or arthroplasty, may be done when psoriatic arthritis has done significant damage to a joint, limiting its functionality.
“Larger joints might be improved by replacement,” says Dr. Morris. He notes that it is important to watch for comorbidities such as cardiac issues when considering surgery.
Surgeons can replace the damaged portions of the joint with metal or plastic replacements.
Joint Fusion
Another type of surgery for joints damaged by psoriatic arthritis is joint fusion, or arthrodesis. Joint fusion can relieve pain and discomfort in the joint, but it also eliminates any movement in the joint.
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Lifestyle Changes
Exercise
Regular exercise can help strengthen muscles and keep your joints strong and flexible, which can reduce joint pain and swelling. It’s also good for your cardiovascular health.
No matter what exercise you do, it’s important to pace yourself and rest when you need to. It’s also important to get expert instruction from a physical therapist or certified trainer if you’re not sure how to do exercises, particularly strength training, with proper form.
Healthy Diet
Cutting back on processed foods can help you achieve and maintain a healthy weight, which may improve your joint health and reduce fatigue.
Stress Management
Elevated stress levels are associated with more pain and symptom flares in psoriatic arthritis. Taking steps to manage your stress may help you manage your disease.
Smoking Cessation
Stopping smoking has myriad benefits, including reducing psoriatic arthritis and psoriasis symptoms.
Natural Remedies for Psoriatic Arthritis
Few if any large studies have evaluated the safety and effectiveness of complementary therapies for psoriatic arthritis, but that doesn’t mean that all such therapies are necessarily unsafe or unhelpful. However, you should talk to your doctor before trying any new therapy, because there are some risks.
Here are a few popular methods that may have benefits.
Acupuncture
Massage
Some people with psoriatic arthritis find that their symptoms improve after a massage. A massage can relieve muscle tension and help you feel more relaxed.
Supplements
If you want to try taking a supplement to help manage your symptoms, talk to your doctor first.
Hot or Cold Packs
When your joints start to ache, treatment with an ice pack or a hot pad can help reduce the pain naturally. Which you use is up to you.
When using heat, make sure the heating pad or hot water bottle is warm but not scalding hot. Place a towel or cloth on your skin first to prevent direct contact with the heat source.
When to Contact Your Doctor
Even if you see your doctor at regular intervals, there may be times you need to seek their advice between checkups. Some of the health concerns that should prompt you to call your doctor include the following:
- Sudden worsening or flare of symptoms
- Development of a new, worrisome symptom
- New drug side effect
- Unplanned pregnancy
Any of these could call for a change in your drug regimen or overall treatment plan. But don’t stop any prescribed drugs on your own. Discuss your concerns with your doctor first.
The Takeaway
- Several classes of medication are used to treat PsA, most requiring a prescription.
- The ultimate goal of psoriatic arthritis treatment is remission.
- Surgery, including joint replacement, may be needed in response to damage caused by PsA.
- A healthy lifestyle that includes exercising, eating a healthy diet, and managing stress can help with symptoms of psoriatic arthritis.
Resources We Trust
- Mayo Clinic: Psoriatic Arthritis: Diagnosis and Treatment
- Arthritis Foundation: Treatment Options for Psoriatic Arthritis
- CreakyJoints: Psoriatic Arthritis Treatment and Care
- National Psoriasis Foundation: Why Treat Psoriatic Arthritis?
- Spondylitis Association of America: Complementary Treatments
Additional reporting by Ingrid Strauch and Barbara Kean.
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Samir Dalvi, MD
Medical Reviewer
Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout.

Julie Lynn Marks
Author
Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing.
Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.