6 signs your psoriatic arthritis treatment isn't working

Living with a chronic condition like psoriatic arthritis (PsA) can take a toll on your body and spirit. But if you’ve been receiving treatment and your PsA is still weighing you down, maybe your medication isn't working as well as it could.

"Ideally, the goal is to get every patient symptom-free," says Arthur Kavanaugh, MD, a rheumatologist in San Diego. "Medications act at different speeds. But usually by six months, treatments have done what they're going to do, and if the result isn't good enough, it could be time to move on."

Signs treatment isn’t working

After six months of taking medication, the following health issues may be warning signs that your treatment isn't as effective as it could be:

• Exhaustion: Fatigue is a lesser-known but important symptom of PsA that can make living with the condition even more difficult. Some medications are known to cause fatigue, including methotrexate. But usually, your meds should give you more energy to live your life.
• Depression: You may feel a sense of hopelessness if your treatment isn't working. Physical pain may translate into emotional pain for people with PsA.
• Psoriasis flare-ups: Even if your joints are feeling better, clearing up your skin should still be a treatment goal.
• Nagging joint pain: Your current treatment may focus on only one set of joints, such as an injected steroid treatment for hip or shoulder joints. But the rest of your body needs relief, too.
• Inflammation: Certain blood tests can show inflammation in your body, such as erythrocyte sedimentation rate or C-reactive protein tests. Dr. Kavanaugh says these tests can be helpful in some—but not all—people with PsA, depending on their signs and symptoms.
• Feeling about the same or worse: This one is simple—if you don't feel better, something needs to change.

It's important to continue taking your medications until you speak with an healthcare provider (HCP). Stopping can lead to increased symptoms or additional complications.

Communicating with your HCP

Remember, HCPs can't read your mind. They only know about the symptoms and side effects you're having if you tell them.

"Many side effects, thankfully, are not common, but they can still be scary," Dr. Kavanaugh says. He advises his patients to weigh the risk of side effects against the dangers of letting PsA run wild, including permanent joint damage and a poor quality of life. And don't worry about sounding whiny or weak, Kavanaugh says. Rheumatologists are eager to hear about your symptoms.

Tell your HCP about the improvements you want to see when planning a new treatment regimen. You can then work together to find the right medication and lifestyle changes that get you to those goals.