The practitioner did not ask
Lifestyle
Adopting a healthy lifestyle can significantly impact the management of PsA and its symptoms.
Research continues to explore how specific lifestyle changes can contribute to better health outcomes. It is important to remember to prioritize patient-centered care when discussing lifestyle modifications, as individuals have unique habits, customs, and traditions that shape their approach to health.
Lifestyle choices—including supplements, exercise, diet, and family planning—play a vital role in holistic management of PsA. Understanding and incorporating these elements can empower patients in their journey to better health and improved quality of life.
Key principles
Understand the relationship between health beliefs and practices and individual identity
Supplements1,2
It is essential that clinicians actively inquire about past, current, or potential dietary supplements patients may be using to ease their joint pain.
Patients may not disclose their supplement use for common reasons:
A belief that the practitioner did not need to know
Past or potential discouragement of use by practitioners1
Common supplements that patients may use include, but are not limited to2:
Glucosamine and chondroitin
Vitamin D
Turmeric
Fish oil and other omega-3 supplements
Probiotics
To assess supplement use while respecting their patient’s beliefs and practices, clinicians can ask thoughtful, open-ended questions such as:
Do you take any vitamins, minerals or other supplements for your PsA?
Can you tell me more about any supplements you have been taking, and what you believe they do for your health?
How did you learn about the supplements you use? Were they recommended by family, friends, or a healthcare provider?
Are there any beliefs that influence your decisions about using certain supplements?
Content informed and developed with input from people living with PsA and an expert steering committee.
Exercise3
Exercise can help disease activity, well-being, and comorbidities for patients with PsA.3 When talking to patients about the importance of exercise for their PsA, it is important to acknowledge their individual values, respect their individual preferences, and recognize that PsA may lead to physical limitations. This will help create an individualized and patient-centered approach to managing PsA.
To better understand the patient’s exercise habits, preferences, and any factors that may impact their ability or willingness to engage in exercise, clinicians can consider the following open-ended questions:
Are there activities that you feel are important for your well-being but are difficult for you due to your PsA?
How do you feel about exercising, given your current health and condition?
What kind of exercise do you like to do?
Do you have any concerns about how exercise might affect your joints or flare-ups? If so, what would help address those concerns?
Are there any specific types of exercise that you’ve been told are helpful or harmful for your PsA?
In your community, are there any traditional forms of exercise or physical activities that are commonly practiced?
How would you feel about working with a physical and/or occupational therapist to address your mobility/functional limitations?
Would it be helpful for us to discuss how exercise could complement any other treatments or therapies you are currently using for your PsA?
Content informed and developed with input from people living with PsA and an expert steering committee.
Diet4,5
A healthy diet may help patients with PsA control their symptoms by reducing inflammation.4 When seeking to better understand and support a patient’s nutrition and dietary needs, the following checklist may be useful for providers.
Checklist for providers:
Collaborate with dietitians
Work with dietitians familiar with different dietary habits for a comprehensive approach to nutritional therapy.
Understand dietary basics of different cultures
Familiarize yourself with common foods and dietary practices relevant to the patient’s background.
Awareness of access issues in rural areas
When discussing dietary changes with a patient, keep in mind that certain areas of the country may have limited access to fresh fruits and vegetables.
Ask open-ended questions
Instead of making assumptions, ask patients about their typical meals, access to fresh food, food preferences, and any dietary restrictions (reminder: these things may be related to their beliefs and practices).
Recommend alternatives
When suggesting dietary changes, provide culturally appropriate alternatives. For example, if advising a reduction in red meat for a patient who consumes halal meat, recommend halal poultry or fish. Additionally, ask the patient for a suitable alternative.
Awareness of lactose intolerance
Certain populations may have higher rates of lactose intolerance. In a reported analysis, the highest rates were observed among African American, Hispanic/Latino, and Asian populations.5
Respect fasting practices
Some religions have fasting periods (eg, Ramadan for Muslims). Understand these practices and work with patients to manage their PsA during these times.
Be open-minded
Understand that dietary habits are deeply rooted and can be tied to individual identity. Changes may be difficult for some patients, so it’s essential to be understanding and offer support.
Content informed and developed with input from people living with PsA and an expert steering committee.
Family planning6,7
Patients with PsA of childbearing age may have concerns about the impact of their treatment during conception, pregnancy, and breastfeeding.6,7
To better understand the patient’s family planning preferences while also considering their PsA, clinicians can ask the following questions:
How do you feel about starting or expanding your family, considering your current health and PsA?
Are there any family traditions or values that influence your decisions around having children?
Are there any specific treatments for PsA that you’re concerned about in relation to pregnancy?
Do you have any concerns about the genetic aspects of PsA, especially if you’re thinking about having children?
Are you currently using any form of contraception, and do you have any preferences or beliefs regarding contraception methods that I should be aware of?
Would it be helpful for us to revisit this conversation later, as you continue to think about family planning, treatment options, or pregnancy?
Content informed and developed with input from people living with PsA and an expert steering committee.
Related patient resources
Supplement and herb guide for arthritis symptoms
A webpage from the Arthritis Foundation dedicated to the use supplements for PsA. This page provides an overview of the most popular supplements and herbs used for PsA.
Active and mindful lifestyles
A webpage from the National Psoriasis Foundation that provides general information about exercise and physical activity in PsA, including suggestions on how to get more physical activity.
Dietary modifications
A webpage by the National Psoriasis Foundation with information on healthy eating for patients with PsA. This page provides an overview of different healthy eating approaches and a guide with steps patients can take to make healthy eating a part of their PsA management plan.
Psoriatic arthritis and pregnancy
A webpage by the Arthritis Foundation that is dedicated to what patients should know if they are pregnant, planning to become pregnant and breastfeed. This page provides information on pregnancy planning, pregnancy, and after delivery.
- Jou J, Johnson PJ. Nondisclosure of complementary and alternative medicine use to primary care physicians: Findings from the 2012 National Health Interview Survey. JAMA Intern Med. 2016;176(4):545-546. doi:10.1001/jamainternmed.2015.8593
- Supplement and Herb Guide for Arthritis Symptoms, Arthritis Foundation. Accessed May 22, 2026. https://www.arthritis.org/health-wellness/treatment/complementary-therapies/supplements-and-vitamins/supplement-and-herb-guide-for-arthritis-symptoms
- Kessler J, Chouk M, Ruban T, et al. Psoriatic arthritis and physical activity: A systematic review. Clin Rheumatol. 2021;40(11):4379-4389. doi:10.1007/s10067-021-05739-y
- Gopalarathinam R, Sankar R, Zhao SS. Role of anti-inflammatory diet and fecal microbiota transplant in psoriatic arthritis. Clin Ther. 2024;46(7):588-596. doi:10.1016/j.clinthera.2024.05.005
- Goosenberg E, Afzal M. Lactose intolerance. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025
- Remaeus K, Johansson K, Granath F, et al. Pregnancy outcomes in women with psoriatic arthritis in relation to presence and timing of antirheumatic treatment. Arthritis Rheumatol. 2022;74(3):486-495. doi:10.1002/art.41985
- Pregnancy and Psoriatic Disease Guide, National Psoriasis Foundation. Accessed May 22, 2026. https://www.psoriasis.org/pregnancy-psoriasis-psoriatic-arthritis