People with psoriatic arthritis deal with chronic joint pain, particularly in the larger joints of the lower body and in the fingers and toes. If inflammation in the joints goes untreated or unmanaged, the joint damage can become permanent. A review published in May 2013 in the journal Nature Reviews Neuroscience found that chronic pain not only changes how certain parts of the brain function, but it also erodes those parts of the brain. If this happens in the gray matter of the brain, a person can become more sensitive to pain signals and their brain will be unable to generate its natural painkillers. However, if chronic pain can be treated or managed, these effects could be reversible. Practicing mind-body techniques can help ease this pain, as well as manage stress, which is crucial for people with psoriatic arthritis. Here are five mind-body activities worth trying if you have psoriatic arthritis.

  1. Acupuncture A common therapy used by people living with chronic pain, acupuncture is the insertion of extremely thin needles into specific areas of the skin. When the needles are inserted, the body is cued to release its own natural painkillers in the form of endorphins, serotonin, and adenosine, which can temporarily relieve chronic joint pain in people with psoriatic arthritis. The National Center for Complementary and Integrative Health suggests that acupuncture helps by stimulating the activity of pain-killing chemicals such as endorphins and immune-system cells. Various endorphins block incoming pain information through the release of serotonin and norepinephrine. “Acupuncture can be very effective for arthritis pain relief,” says Polly Liontis, a licensed massage therapist, shiatsu practitioner, yoga instructor, and meditation instructor in North Shore University Health System’s integrative medicine program in Chicago. “Acupuncture can affect muscle relaxation and induce a deep relaxation response throughout the whole body, which can help alleviate pain.” Limited research supports acupuncture in the treatment of chronic pain, such as psoriatic arthritis–related joint pain. A review published in 2017 in the journal Archives of Internal Medicine pooled the results of 29 studies comprising 18,000 participants — a mix of people who had acupuncture, “sham” (or simulated) acupuncture, or no acupuncture at all. Acupuncture was found to be better than no acupuncture or simulated acupuncture for relieving some types of chronic pain. If you’re considering acupuncture, find a certified acupuncture therapist who is familiar with treating psoriatic arthritis pain. The needles used should be sterile so they don’t aggravate your skin. You may experience soreness where the needles are inserted. Be sure to choose an NCCAOM National Board-Certified Acupuncturist (NBCA) who is certified and uses only disposable needles.
  2. Biofeedback Biofeedback consists of listening to and controlling your own body’s functions. During biofeedback, you’re connected to electrical sensors that give you information about your heart rate, brainwaves, muscle contractions, and more. During a biofeedback session, a therapist will attach the sensors to different parts of your body and measure various body functions. If you have psoriatic arthritis, you can figure out what joints are in the most pain and learn how to relax the tense muscles surrounding them to provide relief. Biofeedback teaches you how to adjust or control your body’s reactions to pain by changing your thoughts or behavior. A study published in August 2016 in the international journal Acta Dermato-Venereologica found that eight weeks of biofeedback combined with cognitive-behavioral therapy increased the effectiveness of medical treatments and improved quality of life for people with psoriasis.
  3. Guided imagery Guided imagery makes use of the power of imagination. It’s a way of directing your thoughts and emotions toward a more relaxed, focused state of being. You can practice guided imagery by yourself or use a therapist or recorded tapes to guide you, according to the National Center for Complementary and Integrative Health. “When used with guided imagery, yoga can also be particularly helpful [for people with psoriatic arthritis] because it consists of a lot of stretching and also involves strengthening of core muscles, with the added benefit of the mind-body connection,” says Sandeep K. Agarwal, MD, PhD, an associate professor and the interim chief of rheumatology at Baylor College of Medicine in Houston. For people with psoriatic arthritis, guided imagery may involve focusing on where the pain and tension is happening in your body, thinking about the pain, and trying to change the sensation of pain to something else. It may be imagining that your fingers are warm and relaxed instead of in pain. This can help both your mind and body relax and lose focus on the joint pain. A study published in February 2017 in the journal Critical Care Nurse found that guided imagery can help reduce pain, anxiety, and insomnia in hospitalized patients. It’s often used to reduce stress in people with cancer, and others with chronic pain may find it helpful as well. According to the National Psoriasis Foundation, yoga may be helpful to get movement back into an area that has been contracting. Yoga not only provides the benefits of relaxing your body, but its various components of posture, breathing, and meditation can help improve your balance, flexibility, and overall health. Because the chronic pain of PsA is influenced by emotions, thoughts, and behaviors, yoga’s mind-body focus may be successfully used to ease pain and improve mental outlook. Ask your doctor or physical therapist to recommend a pain-focused yoga class, or go to the International Association of Yoga Therapists to find a class near you.
  4. Hypnotherapy During a hypnotherapy session, a therapist uses techniques to help you reach a state of deep relaxation and even an altered state of consciousness, or “trance.” This state of mind can help you focus on an idea or image, and in turn influence the responses of your body and your mind. That way, even when you’re not in a hypnotherapy session, the suggestion of that image can trigger the feeling of relaxation and pain relief. A review published in the February–March 2014 issue of American Psychologist found that hypnosis can help reduce chronic pain, as well as help improve sleep and increase overall satisfaction with life. The review does note that results can vary among individuals. Hypnotherapy could help people with psoriatic arthritis learn to focus their attention away from chronic joint pain. The Arthritis Foundation notes that people usually see positive results from hypnotherapy within four to 10 sessions, although some people with arthritis may not see any benefit at all.
  5. Mindfulness meditation Meditation is a simple practice that you can do anywhere to help with pain relief, and it’s often used in conjunction with a technique called mindfulness. It typically involves sitting in a quiet space, focusing your breathing, and then concentrating on the present moment. “Deep, diaphragmatic breathing is one of the most effective techniques for calming the nervous system and taking the body out of the ‘fight or flight’ stress response,” Liontis says. “Studies have shown other benefits such as muscle relaxation, which improves oxygen delivery to all cells in the body and helps every system in the body to function more efficiently.” Breathing is one of the few activities of the body that we can consciously control. According to therapist Loren Gelberg-Goff, a licensed clinical social worker, breathing is the number one strategy we all have to take us out of reaction mode and put us into response mode. “Before any other strategy can work effectively, you need to be centered and grounded,” Gelberg-Goff says. “You need to breathe consciously and purposefully, so that your mind can clear and you can be aware of your feelings, fears, and needs before you start acting on any of them.” By simply taking that slow, deep breath, your body and mind will have a chance to relax (even just a little) so that you can think more clearly. For people with psoriatic arthritis, meditation may involve focusing on the areas of your body where you’re having pain, observing them, and then letting go of the struggle of dealing with the pain. This may help you feel like you have some control over your psoriatic arthritis pain and that it’s not taking over your life. Practicing meditation and mindfulness can also make it easier to let go during stressful situations. A study published in April 2015 in the journal Pain Medicine randomized 109 people with chronic pain into either a mindfulness meditation program or a control group. It found that the mindfulness meditation program helped with pain management and also helped reduce anxiety and improve mental well-being. Debra Fulghum Bruce, PhD, contributed to this report.