Background/Purpose: For over 30 years, I have been living with Psoriatic Disease, diagnosed with Psoriasis at 2 years old and Psoriatic Arthritis at 14. My disease has progressed, luckily with the advancement of treatments. With chronic diseases, you get used to treating with pharmaceuticals, and at the beginning, you are sometimes spoiled with the ability to take a single medication, but usually not. I progressed from creams and ointments and phototherapy to DMARDs to biologics. I was lucky for 7 years to use one biologic to treat both my psoriasis and psoriatic arthritis. Those 7 years convinced me that I could always manage my disease with one medication. Of course, that has not been true since. I tried for many years to find another medication that worked as well as that one biologic did, but had no success. I have seen some that treat most of my symptoms or give me more good days than bad, but nothing is 100%, and nothing relieves all of the pain.

Intervention: After several years of exploring biologic after biologic and JAK 2 inhibitors with my rheumatologist, we turned to functional medicine and complementary therapies. For two years, I have been trying various other treatments to not only see what works but to see if any of my symptoms are actually unrelated to Psoriatic Arthritis and have just been lumped in over the years or due to overcompensating for pain. On this journey, I have tried chiropractic care, massage therapy, acupuncture, functional medicine interviews, autoimmune protocol diet, food sensitivity testing, CBD topicals, traditional Chinese medicine, supplements, herbs, and physical therapy. I have also come to terms with the need for assistive devices such as compression gloves, ergonomic accessories like a mouse, cushions for my workstation, and a plethora of kitchen gadgets.

Maintenance: This complementary therapy journey, although years long already, will never be over. Depending on the state of my disease, different therapies will be needed and effective. Sometimes I do chiropractic care every day, sometimes it’s once a week, or once a month. Sometimes I do physical therapy, chiropractic care, supplements, and massage all in one day or week. What I have developed is a toolbox of complementary therapies that I know work sometimes for certain flares that I can pull from when I need them. I know that some of my pain can be better managed and even eliminated by relearning how to use all of my muscles properly in physical therapy and reducing stress and tension with regular acupuncture and massage.

Quality of Life: Simply knowing there are other options to relieve symptoms and improve my day without adding more drugs has improved my outlook on my disease and, therefore, my mental health. I can better cope in a flare, accomplish more, and feel more productive. I can say yes to more opportunities and more fun things. The only drawback is the number of activities I have to juggle to maintain my version of good. Keeping the pills and doctors’ appointments straight with work is hard enough, and sometimes adding in PT and other appointments is too much, and I have to pick and choose which, in the short term, gives me more free time or mental capacity, but backfires in flares or pain.

Takeaway: Adding in complementary therapies might seem like a no-brainer, but it took me almost 20 years for a rheumatologist to suggest it and help me find options. I had brought it up a few times over the years, “should I try changing my diet” “should I try PT” and was met every time with no, I don’t think that will make a difference for you and then we would proceed to chase the next biologic that hit the market. I would like to see both patients and rheumatologists find a balance in therapy options and regularly challenge the status quo. We are taught in Western medicine to treat with drugs or to dismiss problems and say exercise more or eat better. While all of those things can be helpful, they can be more of a hammer approach. Each symptom needs to be examined and determine possible root causes and offer multiple ways to treat them, especially with the rate of comorbidities in chronic disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/beyond-the-medication-creating-a-toolbox-of-complementary-therapies/