Start replacing these common bad habits with healthier alternatives.

1. Being Too Stoic

Ignoring your symptoms and pushing through joint pain and discomfort can have serious repercussions. According to the National Psoriasis Foundation, not treating your psoriatic arthritis can lead to irreversible joint damage. Making sure you get the right treatment can help reduce joint pain and stiffness and lower your risk of developing related health conditions.

2. Tuning Out Your Doctor

You may not always like what your doctor has to say, but it’s wise to listen, even if it feels like your doctor is asking a lot of you. “We ask you to take medications, lose weight, and many other things that really mean a whole lifestyle change,” explains Petros Efthimiou, MD, FACR, medical director at New York Rheumatology and Care and clinical professor of medicine at Ross University School of Medicine in Barbados. But there’s a reason, he says: “It gets results.” If you have questions about your treatment or potential alternatives, be sure to discuss them with your doctor.

3. Holding on to Excess Weight

When you have psoriatic arthritis, the more you weigh, the more pressure you’re putting on your joints — especially your knees — with every step. Obesity can also impact the effectiveness of your treatment. “Various studies have shown that weight loss improves the response to medications used for psoriatic arthritis,” says Samardeep Gupta, MBBS, a rheumatologist and clinical associate professor at the University of Michigan Medical School in Ann Arbor. The good news? A study published in January 2019 in the journal Arthritis Research and Therapy found that weight loss can improve psoriatic arthritis disease activity. If you’re overweight, work with your doctor to come up with a weight-loss goal and discuss steps you can take to achieve it.

4. Eating Whatever You Want

There are no definitive dietary guidelines for psoriatic arthritis. “There is no compelling evidence that any diet other than a healthy, balanced one is consistently helpful,” says Dr. Gupta. “But there is very good evidence to support weight reduction with a hypocaloric diet for overweight or obese adults.” So reducing your caloric intake to help you reach and maintain a healthy weight can be beneficial for your psoriatic arthritis as well as your overall health. Not sure where to start? According to Dr. Efthimiou, current research is leaning toward a plant-based Mediterranean-style diet. That means limiting foods that promote inflammation, like processed foods, dairy, red meats, and nightshade vegetables, and introducing protein-rich nuts and seeds — all high in omega-3 fatty acids. Talk to your doctor or work with a dietitian to come up with the right eating plan for you.

5. Skipping Exercise

Movement improves the circulation of blood throughout the body, including to your joints, which can help prevent joint degeneration. And because there is a connection between psoriatic arthritis and metabolic issues such as hypertension, high cholesterol, and obesity, exercise is critical, emphasizes Efthimiou. Aim to get 150 minutes of exercise each week — just make sure you get the green light from your doctor before you start a regular routine.

6. Lighting Up

Smoking can increase your risk of developing psoriatic arthritis to begin with. Those living with psoriatic arthritis who smoke may also experience worse symptoms like joint pain and fatigue compared to nonsmokers who have the condition. What’s more, a study published in January 2019 in the journal Expert Review of Clinical Immunology found that smoking may be linked to poor treatment adherence in people with psoriasis and psoriatic arthritis. “Research has shown that if you stop smoking, your psoriatic arthritis improves,” adds Efthimiou. So it’s best to avoid smoking altogether. Talk to your doctor about strategies for quitting and staying smoke free.

7. Drinking Alcohol 

While drinking in moderation may have an anti-inflammatory effect, the downsides of drinking can quickly outweigh the benefits for people who have psoriatic arthritis. Combining alcohol with any type of medication carries some risk, but the warnings are particularly strong for methotrexate, a disease-modifying antirheumatic drug frequently prescribed to treat psoriatic arthritis. According to guidelines from the American College of Rheumatology, alcohol should be avoided while taking methotrexate. Ask your doctor if you have any questions about alcohol use, or how it may interact with your psoriatic arthritis medications.

8. Stressing Out

Stress is a known psoriatic arthritis trigger and can contribute to an increase in symptoms like joint pain. When you’re stressed, your body releases the hormones adrenaline and cortisol, which cause the muscles to tense up. Stress also triggers the immune system’s inflammatory response, adds Efthimiou. Try practicing stress-management techniques such as meditation, yoga, and tai chi to help keep stress at bay and psoriatic arthritis in check.

9. Skipping Out on Sleep

A good night’s sleep can be hard to come by when you have psoriatic arthritis. “There’s decreased sleep quality due to inflammation, and then there are sleep disturbances due to generalized pain and anxiety,” says Efthimiou. Though a lack of sleep can make it harder to manage your condition and keep symptoms in check. Aim to get seven or eight hours of sleep each night. Your mattress should be comfortable and support your hips and shoulders to keep you in alignment. Make sure your pillow supports your neck properly. Wear something comfortable to bed, and make sure your sheets and blankets aren’t constricting.

10. Wearing the Wrong Clothes

It may be fun to be fashionable, but not at the expense of flares, mobility, and comfort. Restrictive shoes and clothing can trigger new disease activity in the affected area, known as the Koebner Phenomenon. So it’s important to choose shoes that are comfortable and well-fitted. And make sure items of clothing aren’t binding or constricting circulation and are easy to put on and take off.

11. Hiding Your Feelings

“There’s a major connection between depression and psoriatic arthritis,” says Efthimiou. According to a study published in 2020 in the journal Rheumatology and Therapy, depression and anxiety are seen in about one-third of people who have psoriatic arthritis. The study has shown a significant link between inflammation and depression. If you’re feeling depressed, don’t hide it. It’s important to talk about it and get the help you need — both for your mental health and your psoriatic arthritis. “Depression needs to be addressed because it affects adherence to treatment,” says Efthimiou.

12. Not Advocating for Yourself

Tell your doctor all your symptoms, especially if you’re experiencing skin lesions, as many people don’t make the connection between psoriasis and arthritis, explains Efthimiou. Be the CEO of your own health — no one knows your symptoms better than you, so be sure to tell your doctor about everything you’re experiencing so you can work together to find ways to address it. Additional reporting by Nina Wasserman.