Psoriatic arthritis vs MS: Symptoms, links and more

Psoriatic arthritis (PsA) and multiple sclerosis (MS) are inflammatory conditions that have environmental and genetic risk factors. However, there is limited scientific evidence that links exist between these two conditions.

Scientists have investigated whether having one of these conditions increases the risk of developing the other. Whereas up to 25% of people with one autoimmune disease develop another, evidence of a link between PA and MS is inconclusive.

This article explains what PA and MS are, possible links between these conditions, treatments and lifestyle changes that can help reduce symptoms.

The following table gives an overview of these two conditions.

PSA

PSA is an autoimmune disease in which the body’s immune system targets the joints, causing inflammation, pain and stiffness. It has an association with psoriasis — 20–30% of people with psoriasis also have PsA.

Psoriasis affects more than 3% of American adults. Scientists believe that 15 to 30% of these people then develop PsA. PSA symptoms develop frequently 7–10 years after the first symptoms of psoriasis.

However, it is possible for a person to have RP without psoriasis or to develop RP before experiencing skin symptoms.

One of the main features of PA is enthesitis, which is pain in the soles of the feet, elbows, back of the head, and other areas. Enthesitis is caused by tenderness where ligaments and tendons connect to bones.

MRS

MS damages the central nervous system by destroying the myelin surrounding nerve cells. According to the National Multiple Sclerosis Society, up to 913 925 people live with MS in the United States.

MRS affected vision, balance, motor skills, bladder and bowels, and the senses. People with MS can also suffer from mental health issues such as depression and anxiety. Cognitive symptoms, such as difficulty remembering or concentrating, affect about half of all people with MS.

Researchers continue to study the similarities and differences between PA and MS. There is evidence that these conditions have a connection; however, the data is limited and sometimes contradictory.

The authors of a 2019 review provide the following links:

Environmental risk factors

OA and MS have known and unknown environmental risk factors. Viral infections and smoking are common risk factors for these conditions.

However, scientists have identified environmental risk factors that these conditions do not share.

Fungal and bacterial infections, obesity, and increased stress levels are risk factors for PsA.

Risk factors for MS include exposure to UV rays, low levels of vitamin D, and Epstein-Barr viral infections.

Genetic risk factors

Genetic analysis shows that these conditions share variations in Th-17 cells and IL-23 receptors.

However, each condition also has distinct variations of these receptors.

Overactive immune system

Both PA and MS are autoimmune diseases, which means that the body’s immune system begins to target itself. People with either of these conditions have an increase in IL-23 receptors and TNF-alpha cytokines, which cause inflammatory and autoimmune responses.

However, IL-27 cytokine levels differ in people with these conditions. People with MS have lower levels of IL-27, while those with PsA have higher levels.

Both PA and MS are multifactorial conditions, meaning they have multiple causes, some of which have not yet been discovered by scientists.

PSA

Possible Causes of PsA to understand:

  • bacterial infections such as strep throat
  • viral infections such as HIV
  • fungal infections
  • medications such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • smoking
  • obesity
  • stress

PSA may have a genetic factor. As much as 40% of people with the disease also have a family member with it.

MRS

Possible causes of MS include:

  • exposure to high levels of UV radiation
  • low vitamin D levels
  • Epstein-Barr viral infection
  • smoking

Recent research suggests that people who have had an Epstein-Barr viral infection are up to 32 times more likely to develop MS than those who have not contracted this virus.

PA and MS require a full medical examination for diagnosis.

PSA

Doctors can perform what follows examinations and tests to diagnose PsA:

  • joint reviews
  • skin and nail analysis
  • blood tests
  • skin biopsies
  • medical imaging, such as X-rays, MRIs, CT scans, and ultrasounds

MRS

A diagnosis of MS requires:

  • evidence of central nervous system damage in at least two places
  • proof that the damage occurred at different times
  • eliminate other causes

Currently, the diagnostic process for MS may include:

  • a complete medical history
  • cranial nerve function tests
  • tests of reflexes, sensation, balance, gait and coordination
  • blood tests
  • MRI

Treatment for PA and MS depends on the type and severity of symptoms a person is experiencing.

There is little scientific research on treating people with both PA and arthritis. However, a case study found that using two different monoclonal antibodies, natalizumab and secukinumab, was effective in reducing symptoms of both conditions. While this treatment shows promise, one person’s sample size means more research is needed.

PSA

Treatment for PSA may include:

  • NSAIDs such as ibuprofen
  • antirheumatic drugs such as methotrexate, cyclosporine, and sulfasalazine
  • Organic Products

The following strategies may be helpful for people with PsA:

  • regular gentle exercise, such as walking
  • use of shoe inserts and walking aids for support if needed
  • regular stretching or yoga
  • aquatherapy
  • physiotherapy and occupational therapy

MRS

The treatment of MS generally takes place in three ways:

  • managing MS symptoms
  • find ways to avoid flare-ups and lessen their impact when they occur
  • taking medicine to slow the progression of damage from MS

Doctors can prescribe monoclonal antibodies, beta-interferon drugs such as Avonex and Refib, and immunosuppressants to reduce the severity of symptoms. People who suffer from muscle spasms or stiffness may benefit from muscle relaxants and tranquilizers such as baclofen.

Certain lifestyle habits can help a person with MS manage their symptoms. Hints to understand:

  • follow a healthy, balanced diet rich in fruits, vegetables and grains and low in processed foods
  • exercise regularly
  • avoid extreme temperatures
  • maintaining regular sleeping habits

There is currently no way to prevent PA or MS. However, people with these conditions can work closely with their healthcare team to identify and reduce the occurrence of flare-ups.

PSA

What follows can help prevent PSA flare-ups:

  • monitor symptoms
  • identify and avoid triggers
  • taking medication regularly
  • avoid injury
  • exercising regularly to support joint flexibility
  • attempt to reduce stress, possibly with the help of practices such as meditation

MRS

People with MS can work with their healthcare team to develop and follow a treatment plan to reduce the severity of symptoms. Treatment plans generally to understand:

  • disease-modifying treatments to slow the progression of MS
  • treatment to shorten relapses and reduce their severity
  • management of MS symptoms

Both PA and MS are chronic diseases, which means they are currently incurable. People with these conditions have symptoms that vary in severity.

PSA

Health professionals classify PA as an aggressive condition that can have a significant impact on a person’s quality of life. Although some people may experience less pain and inflammation than others, experts link the following factors to greater disease severity:

  • inflammation in a large number of joints
  • loss of function in the joints
  • joint damage

MRS

Symptoms of MS are often mild at first, but get worse over time. People may start to have trouble walking, even if Many people can still do it with help.

In addition, MS can shorten a person’s life expectancy by 7–14 years old compared to the general population.

PsA and MS are distinct conditions with distinct qualities. They affect different parts of the body and have different symptoms.

However, both are chronic, immune-mediated diseases that cause inflammation. Researchers continue to explore the possibility that PA and MS are linked. Currently, the scientific evidence is inconclusive.

Julio V. Miller