The purpose of this psoriatic arthritis case report was to analyze the treatment of a patient using acupuncture and natural supplements. A 73-year-old woman complained of psoriatic arthritis (PsA) in her second and third fingers, which had gradually developed over the previous six months. Her symptoms included moderate to severe stiffness and swelling in her finger joints and surrounding soft tissue. In addition, X-rays revealed narrowing of the finger joints and arthritis.
Case Overview
The patient in this psoriatic arthritis case report received:
- Acupuncture treatment (details described below).
- 500 mg of turmeric curcumin with 3 mg of black pepper extract.
- 425 mg of sarsaparilla root powdered capsules.
- 10,000 IU vitamin D3 capsules.
After receiving acupuncture and the supplements, the patient experienced an increased range of motion and reduced edema and stiffness. In addition, she maintained these benefits by continuing to take these supplements over the next year.
This regimen likely reduced her symptoms of PsA and helped maintain them at a tolerable level. Therefore, providers should consider acupuncture, turmeric, sarsaparilla root, and vitamin D3 as viable natural alternatives for treating PsA.
What is Psoriatic Arthritis?
Psoriatic arthritis is an autoimmune condition presenting as chronic inflammation of the joints with or without skin lesions. Several different forms of PsA exist, including oligoarthritis, polyarticular arthritis, arthritis mutilans, distal interphalangeal joint arthritis, and axial disease.
Oligoarthritis is the most common form of PsA involving asymmetric arthritis of 2 to 4 joints in the first six months of the disease. The patient in this psoriatic arthritis case report had oligoarthritis. Polyarticular arthritis is the next most frequent condition, accounting for 20% of cases and presenting in 5 or more joints.
PsA typically targets people between 40 and 50 years old. It can strike young children and older adults as well. The condition is rare – less than 1% of Americans develop PsA, with an incidence of 7.2 per 100 000 people. However, the costs are high. 40% to 60% of people who develop the condition experience severe joint deformity. Furthermore, PsA is not gender specific, with a male-to-female ratio of 0.7:1.
Unfortunately, the evidence explaining the risk factors and onset of the condition is minimal. Possible risk factors include drug use, joint trauma, emotional stress, and bacterial and viral infections.
Western Medical Treatment for Psoriatic Arthritis
In conventional medicine, treatment consists of pharmaceuticals, specifically anti-rheumatic drugs, to slow the progression of the disease and alleviate pain. Their mechanism of action varies depending on the agent given. However, their principal effect is reducing inflammation and calming the autoimmune response.
Unfortunately, these medications are less available to patients due to high costs. Nonsteroidal anti-inflammatory drugs can be used, but they typically only help mild cases of PsA. Natural therapies may be a more affordable alternative for treating PsA. However, there is a limited amount of evidence supporting the use of such remedies.
Natural Therapies for PsA
Turmeric, sarsaparilla, vitamin D, and acupuncture are known to reduce inflammation. Turmeric suppresses the effects of nuclear factor kappa B and other inflammatory mediators, such as tumor necrosis factor-α, interleukin, and IL-6. In addition, some sarsaparilla species reduce inflammation, and Vitamin D decreases the activity of transcription factor NF-кB and inflammatory mediators TNF-α and IL-6.
Lastly, research has demonstrated that acupuncture inhibits the expression of NF-кB and the release of TNF-α, C-reactive protein, and other inflammatory cytokines. In addition, acupuncture potentiates the effects of IL-10, which is an anti-inflammatory cytokine.
In addition to their anti-inflammatory effects, turmeric, sarsaparilla species, vitamin D, and acupuncture may have the potential to mitigate symptoms associated with autoimmune inflammatory disorders like psoriatic arthritis.
Psoriatic Arthritis Case Report
A 73-year-old woman complained of PsA in her left hand’s second and third fingers. She noticed the gradual onset of edema and stiffness in her finger joints and the surrounding soft tissue over the previous six months. Her rheumatologist diagnosed her with PsA, categorized as oligoarthritis, and recommended anti-rheumatic drugs.
However, the patient wanted a more natural approach due to the expense and potential adverse effects associated with the medication. The patient rated her stiffness as a 5/10, pain with movement as 1/10, and swelling as 7/10. In addition, she was postmenopausal and experienced night sweats and stress incontinence. Her tongue was red and swollen with teeth marks and a thin yellow coat, and her pulse was wiry.
Chinese Medicine Diagnosis and Treatment
Her tongue and pulse indicated a Traditional Chinese Medicine (TCM) diagnosis of kidney yin deficiency and blood stagnation with damp heat. The treatment strategy used a combination of acupuncture and supplements to reduce inflammation and calm the autoimmune response.
The practitioner selected acupoints to nourish the kidneys, improve circulation, and resolve damp heat. The points included ear points shen men, kidney, spleen, and fingers, yintang, PC 6 (Neiguan), LU 9 (Taiyuan), HT 7 (Shenmen), SP 6 (Sanyinjiao), SP 10 (Xuehai), KD 3 (Taixi), KD 6 (Zhaohai), ST 36 (Zusanli), LR 3 (Taichong), LR 5 (Ligou), and LI 4 (Hegu). In addition, the practitioner added 2 Ashi (tender) points on both sides of the joints on the second and third fingers.
Psoriatic Arthritis Treatment Results
The patient in this psoriatic arthritis case report began taking the supplements after the first acupuncture treatment. Immediately following the session, pain with movement ceased, stiffness reduced to 3/10, and swelling reduced to 4/10. Directly after the second treatment, stiffness reduced to 3/10, swelling to 4/10, and range of motion significantly increased for her second and third fingers.
A follow-up telephone call four weeks after the second treatment revealed that the patient was still taking the supplement once a day. After one year, the patient had continued taking the supplements and reported that her pain was 0/10 with movement, and swelling and stiffness remained controlled at 1/10.
Conclusion
The results of this psoriatic arthritis case report clearly indicate that a combination of acupuncture and supplements naturally reduced the patient’s joint inflammation, calmed her immune system, and significantly reduced her pain.
Next Steps
At Raleigh Acupuncture we have good success treating patients with psoriatic arthritis. Our treatment focuses on addressing the underlying autoimmune condition, joint pain, and psoriasis. Patients feel less pain, more joint mobility, improved skin quality, more energy, and better digestion. As with all acupuncture, treatments are safe and the sessions are relaxing.
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Reference
Martin B. R. (2020). Treatment of Psoriatic Arthritis With Acupuncture, Turmeric (Curcuma longa), Sarsaparilla (Smilax officinalis) and Vitamin D: A Case Report. Journal of chiropractic medicine, 19(3), 194–200. https://doi.org/10.1016/j.jcm.2019.12.005
https://pubmed.ncbi.nlm.nih.gov/33362443/
Focus Keyphrase: psoriatic arthritis case report
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