Psoriatic arthritis (PsA) is a heterogenous disease with multiple manifestations and comorbidities, and requires a collaborative management with other specialists. The major symptoms bordering patients are pain stiffness, and swelling, but fatigue, depression, embarrassment and fear are frequent and not always assessed by treating physicians. Non-steroidal anti-inflammatory drugs and local glucocorticosteroid injections remain important treatment options that should be used, although with caution, in the appropriate patient. Since the pre-biologic era, physical therapy has been part of non-pharmacological treatment in patients with rheumatic disease. Unfortunately there is little evidence of the efficacy of rehabilitation in PsA with no study with high grade of evidence. Surgery should be reserved for advanced cases as the new paradigms in the treatment of PsA (early diagnosis and treatment, remission as an objective, and treat to target), would very probably reduce the already low number of patients that need this last treatment option. In PsA patients surgery outcomes are similar to those of surgical management of other forms of arthritis. Symptomatic and non-pharmacologic management of PsA remain as important adjuvants of PsA treatment, although with little evidence.
