Psorio Arthritis

[Jessica J]

Hi everyone...
I am a student and have an acquaintance who is going to see me on a weekly basis for massage. I am so excited about this awesome learning opportunity, and she's thrilled for the opportunity for weekly massage! My pt. has Psorio Arthritis, which is an autoimmune disease. It involves, as the name implies, psoriasis and arthritis. Right now her main joints affected are her foot, esp her big toe. She also has dry patches of skin but nothing severe. She also suffers headaches frequently.

Her main secondary complaint is catching colds, due to her suppressed immune system as a result of her meds.

I am wondering about a few things:

1. Anyone have any experience treating this condition? I would love to map out a care plan so we can set some therapeutic "goals." Perhaps this will give her some hope and me some way to measure what works and what doesn't.

2. I would love to incorporate aromatherapy to help boost her immune system but don't want to contraindicate with her meds. She is on a weekly steroid shot and daily Naproxen dose. Any ideas? Any other energy or other modalities you'd recommend?

3. One of her goals is to become active physically again (she loves sports and is a volleyball coach) but is having a difficult time doing this because of her pain. How can our therapy approach this problem?

Thanks for your ideas in advance!

 

[Marysa]

In a situation like this, during the first few sessions I simply go slowly, use lighter Swedish, and maybe do only a half-session at first -- because the first goal is to assess how well she tolerates massage. I don't make any care plan beyond that for autoimmune patients, until we see how they do.

What have you studied so far? And does that include aromatherapy yet? Just trying to get an idea where you are. You and your acquaintance will probably have a great time together -- enjoy!

 

[Latin Guru(Retired)]

Thanks for the reply. I have studied pathology so far and A&P and a short evening course on aromatherapy and other various modalities.

I know very little about EOs except that I don't want to use anything that might interfere with her meds. I believe clove would be on the list of no-no's for sure.

I am looking forward to working with her, and know that even if we don't make any major "medical breakthroughs" with our time together we are still holding a healing space for her. Also, the benefits of massage will go a long way in treating her symptoms and day-to-day stresses. So it's all good!

 

[Eman G]

it sounds to me like she may want to talk with her doctor about her meds. if she getting sick a lot and she thinks it's because of the meds, she needs to have them change the dose or the type of meds. how bad is her inflammation? are the meds helping at all? how bad is her pain?

how bad is her psoriasis? what does she do to control it? it's very common to have inflammation in the joints of the toes with psoriatic arthritis.

self-care can include - eating a good diet, maintaining a healthy weight, using cold packs, proper body mechanics & of course massage (and other relaxation techniques)!

has she been tested for gout?

 

[josho]

Steroids do supress the immune system. That is the plan, when treating psoriasis with steroids. Bleck. I can't even imagine weekly steroid shots!

I would do as BJB suggested, and just go very slow and easy, see what she tolerates well, and only carefully add to the treatment plan. It would take a few assessment/comfort appointments to develop a plan with goals, but you will probably hear that she felt wonderful after the initial appointment!

 

[Elaine]

steroid shots to treat psoriasis are not recommended by dermatologists. they can have long term serious side effects. in addition to that it only temporarily relieves the psoriasis and it often times gets much worse once the med's are stopped.

chritine, i thought i'd cut & paste this in here too for you...you may want to ask her more info on her med's (how long she's been taking them etc).... this is from a website on psoriasis & psoriatic arthritis -

Corticosteroids. These medications can reduce inflammation and slow joint damage, but they're not usually recommended for long-term treatment of psoriatic arthritis. When used for many months or years, they may become less effective and cause serious side effects, including easy bruising, thinning bones (osteoporosis), cataracts, diabetes, high blood pressure and decreased resistance to infection. What's more, stopping therapy can aggravate skin symptoms and even trigger pustular psoriasis, a severe form of the disease. For these reasons doctors usually prescribe oral corticosteroids only to relieve acute symptoms, with the goal of gradually tapering off the medication (steroid taper). Injecting cortisone directly into aching joints can provide almost immediate relief and improve range of motion — sometimes for months. But because injected steroids can cause damage, their use is usually limited.

 

[Gloss]

That bothered me too, Tera. Steroid shots are serious....and damaging. I just can't imagine having that done weekly.

I wish that instead of suppressing the immune system whenever someone's goes haywire, they would support it and try to get it healthy. A healthy immune system does not attack its own body's tissues.