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The National Psoriasis Foundation's Dr. Tell Me Blog is written by experts in dermatology, rheumatology, mental health and wellness as a way to deliver the latest information on psoriasis and psoriatic arthritis care.

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Difficulty Dressing

I’m having a very difficult time buttoning my shirt. What can I do about it? The first thing I would suggest is see a physical therapist or an occupational therapist. They can evaluate you and help you come up with ways to make that task much easier for you. There is a lot of adaptive […]

Psoriatic Arthritis Flares After Exercise

When I exercise it often causes a flare. How do I avoid causing a flare when I exercise? You want to make sure when you’re doing particular exercises that your pain is not increasing to an intolerable level. You don’t want to have any sharp sudden pain with exercise. Simple range of motion or flexibility… Read more »

Effectiveness of Biologics After Stopping and Restarting

When someone using a biologic stops it and uses no other systemic drug, can they go back on a biologic a few years later and have it still be effective for them? The answer is yes, but it’s not a good plan. There are several reasons why you should stay on a biologic and continue… Read more »

Treatment vacations and psoriatic arthritis

Should someone with mild psoriatic arthritis only take meds during a flare? If one has a modest case of psoriatic arthritis is it necessary to treat and will there be joint deterioration if it’s not treated? I will tell you that you can completely get rid of the pain of psoriatic arthritis and continue to… Read more »

Methotrexate and alcohol

I’m on low-dose methotrexate. Is it OK to have a single glass of wine each night, not on a day of dosage? When I put a patient on methotrexate I tell them they should never drink, ever. I figure if I tell them that they might have one or two drinks a year. Some of… Read more »

Biologics for Older Patients

How do biologics affect patients 65 years or older? They do just as well in contrast to some of the older treatments such as methotrexate and cyclosporine, which were very problematic in older patients and had side effects that were really difficult in older patients. The biologics are much better tolerated and have many fewer… Read more »

Heat or Cold for Psoriatic Arthritis Pain Relief

Is heat or cold recommended for pain relief? I find heat much better but some say that increases the inflammation and I should use cold. I find cold makes me ache more. Can you advise? I would go with what you’re using. If it’s comfortable, I don’t see any reason not to recommend the heat…. Read more »

Skin Sores and Back Arthritis

I have a collection of psoriasis sores on the lower back portion of my back and that is where the pain generally is. Can it be due to the sores that my back hurts so much? It might, but it might not. Sorry to hedge, but it depends. If you have very severe psoriasis with… Read more »

Psoriasis, Psoriatic Arthritis and Gastrointestinal Symptoms

Do you see patients that come in with psoriasis and psoriatic arthritis and GI issues, and can you give examples of some of the symptoms? I do, I’ve had patients that have had colitis or microscopic colitis associated with psoriatic arthritis. Anybody that I am seeing for psoriatic arthritis I’ll usually screen for any of… Read more »

Physical Therapy to Help Walking

Does physical therapy help someone to walk better? I am almost waddling now because of the pain I’m in. It might. It may not though. If you’re waddling because you have severe involvement of the hips, you’re already on maximal therapy and there’s already damage, then unfortunately it might be one of those cases where… Read more »

Splints for Fingers with Psoriatic Arthritis

Do splints help prevent problems with the finger joints? Splints can be helpful in correcting deformities. If someone is already starting to exhibit some deformities, an occupational therapist can fit them with splints that might prevent it from getting worse, especially if they are being treated at the same time. Howard Blumstein, M.D. Rheumatology Associates… Read more »

Long-Term Effects and Progression of Psoriatic Arthritis

Will this disease continue to progress even though I am on a biologic? How fast does this disease progress and if you are treating, can you stop the long-term effects of psoriatic arthritis? Good news, bad news. The good news is that most people that are on a biologic, in particular, won’t see much progression…. Read more »

Psoriatic Arthritis Effect on Tendons and Ligaments

Why is there pain not only of the joints but throughout the body? Can psoriatic arthritis affect only the muscle tendons and not the joints? I’ll answer the second one first. It definitely can just affect tendons or ligaments, it doesn’t have to affect joints. If you had someone who had a tendonopathy that was… Read more »

Differences Between Psoriatic Arthritis and Osteoarthritis

How can I tell the difference between my psoriatic arthritis and my osteoarthritis, and does it really matter? I would say it definitely matters because if you have active psoriatic arthritis, there are going to be medications that your doctor might want you to take. You can actually get into big trouble if you are… Read more »

Joint Pain Improved But Skin Symptoms Worsening

I have been on Humira for three years. My psoriasis is worsening but my joint pain is under control. I am tempted to stay on Humira because I would rather have unsightly skin but little joint pain. Does this sound typical or reasonable? Let’s start with the second question, does this sound reasonable? Well, absolutely,… Read more »

Psoriatic Arthritis and Repetitive Exercise

Do repetitive exercises, like typing for hours for example, help or hurt stiff joints? In general, any type of excessive, repetitive motion is not going to be helpful, because it leads to repetitive use injuries. If you are talking about really sitting there and banging away for hours and hours, that probably wouldn’t be the… Read more »

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