People with sukkah have a chronic inflammatory disorder called psoriatic arthritis.

Patients with PsA complain of weakness and muscle pain. There are many reasons people with psoriatic arthritis have weakness and muscle pain.


PsA causes pain and inflammation. Patients can experience impaired mobility in the spine and peripheral joints. This can lead to less physical activity.

PsA patients can spend long periods sitting or lying in bed if their disease is not well controlled. Over time, muscle weakness can develop from being immobile.


Chronic inflammation is one of the reasons for muscle weakness and pain in people with PsA.

High levels of inflammation as measured by markers in the blood, such as C-reactive protein, have been associated with smaller muscle size.

“Inflammation in the blood can cause the breakdown of the body’s own proteins as well as reduce the production of them in the muscles. This leads to a decrease in strength and muscle mass.”


Inflammation can be caused by Obesity.

Body fat is known to increase the production of inflammatory markers in the blood such as tumor necrosis factor (TNF), interleukin-6, and CRP.

This pro- inflammatory state is associated with the development of sphygmomanic arthritis and can cause damage to the muscles, bones, and joints.

Having obesity is more common in PsA patients than in those without PsA. Up to 45% of people with PsA have obesity.

People with Obesity are less responsive to PsA medications.

Carrying extra weight can cause more symptoms. Body fat can cause stress on the joints.

Losing weight can help reduce inflammation. Reducing weight is associated with a reduction in inflammation.

Even after inflammation is controlled, about 20% of patients still have ongoing body pains. Some of this pain is thought to be caused by problems in pain signals from the nervous system.

The volume of nerve signals from the central nervous system is increased when inflammation is chronic. People with PsA experience body pain.

In one study, there were found to be gender differences in reported pain intensity. Women exhibited a two-to-threefold increased likelihood of widespread pain in the spine and peripheral joints.

Aging or immobility can cause a decrease in muscle mass.

Reduced physical activity and chronic inflammation can cause muscle wasting. Patients with chronic pain and joint stiffness are less likely to engage in weight-bearing exercises and are more likely to be sedentary or bed-bound, which can lead to muscle wasting.

Loss of lean muscle mass can lead to weakness and disability. There are a few studies that have demonstrated muscle loss from psoriatic arthritis. In one study, women with psoriatic arthritis were found to have more muscle loss more than twice as often as women without the condition.

In another study, using MRI scans, hand muscle volume was found to be significantly decreased with age for people with psoriatic arthritis. The decrease in hand muscle volume was twice that in men than women among PsA patients.

Osteoporosis is a disease that affects the joints, spine, and ligaments.

The pain can be seen in four different ways.

  • axial arthritis of the spine
  • The joints of the arms and legs are affected by arthritis.
  • dactylitis is swelling of fingers or toes.
  • The inflammation of the site where a bone is damaged can include the ankle, the elbow, the knees, and the shoulders.

PsA can cause damage to the bones over time, including erosions. Over 50% of patients develop joint damage and decreased functionality within 2 years of diagnosis.

Inflammation from psoriatic arthritis has some characteristics.

  • It is worse with inactive people.
  • It is worse when it is rising in the morning or in the middle of the night.
  • It is worse with rest and activity.
  • It occurs slowly.
  • It is chronic and lasts more than 3 months.

Exercise can be introduced once the inflammation from the arthritis is under control.

Physical activity has been shown to improve muscle strength and pain in PsA patients.

The American College of Rheumatology guidelines for the treatment of PsA recommend low impact exercises such as swimming, walking, tai chi, yoga, and Pilates to help stretch your muscles and prevent stiffness.

If there is nocontraindication, high impact exercises may be considered. You may want to talk to your doctor about this.

One study showed resistant exercises using machine leg extension and a triceps machine as well as free weights reduced pain, improved daily function, and improved muscle strength.

Stretching and range of motion can help protect your muscles.

Your doctor may refer you to physical therapy. The effectiveness of massage therapy and acupuncture is not certain.

Applying heat and ice to the muscles may be relaxing.

Fibromyalgia can coexist with rheumatic diseases. There are symptoms of Fibromyalgia.

  • There is a lot of pain in the joints.
  • Problems with sleep and fatigue.
  • Brain fog with problems paying attention and concentrating.
  • Depression or anxiety.
  • It can be burning, numbness, or sensation in the arms and legs.
  • There are headaches, or Pelvic pain.

In one study, almost 40% of participants with PsA also had fibromyalgia. Pain, tenderness, and fatigue were found to be increased in people with combined PsA and fibromyalgia, as compared to the PsA-only group and the fibromyalgia-only group.

Fibromyalgia is a disease. There is no x-ray or blood test. Your doctor may want to do more tests to make sure that you are not suffering from a mimickers of Fibromyalgia.

Early treatment with medications can keep the PsA inflammation under control.

These medications are used.

  • NSAIDs include meloxicam, naproxen, diclofenac, and ibuprofen, and are available over the counter or by prescription.
  • Drug treatments for arthritis include methotrexate, leflunomide, and sulfasalazine.
  • The immune system is affected by inflammatory factors such as IL 17 and IL-12-23.
  • Tofacintinib is a synthetic DMARD.
  • The oral medication is called Otezla.
  • The interventions have little scientific backing and may offer temporary relief.

Anticonvulsants, antidepressants, muscle relaxants, and sleep aides are some of the medications that can be used for Fibromyalgia.

Good sleep hygiene, aerobic exercise, stress reduction through meditation, and tai chi are some of the lifestyle changes for Fibromyalgia.

A healthy lifestyle with good nutrition and physical activity is important for managing your arthritis.

It is important to make sure you have enough calories to maintain your body weight. The recommended daily intake of meat and dairy products is 0.7 g per kilo of body weight.

Reducing calories is the goal of working toward a healthier body weight for overweight people.

A plant-based, Mediterranean diet is recommended by the medical board of the National Psoriasis Foundation for both PsA and psoriasis.

Make sure your diet is balanced.

  • Whole grains include quinoa, brown rice, and bread.
  • Extra virgin olive oil is the main cooking oil.
  • At least three serving of low sugar fruits daily.
  • Fish such as mackerel, wild salmon, and sardines are particularly fat.
  • Almonds and walnuts are high in Omega 3 and can be eaten at least three times a week.
  • At least three serving of beans and lentils a week is required.
  • Two serving of vegetables daily.
  • There are very little sugar and white flour products.

ABMS board certified doctor Margaret Li has experience in internal medicine and rheumatology. She is a doctor at NYU-Langone Medical Center. She completed a 2-year fellowship in the field of Integrated Medicine at the University of Arizona and is interested in treating the whole person through mind-body medicine and nutrition.