### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, I have been struggling with psoriasis since around 09 and over the last few weeks have developed lots of joint pain in hands, feet, elbows, shoulders,wrists,back,and knees. I ve been seeing a Dr. since January of this year about the skin and had a visit again today. I ve had labs done 3 times now and recieved like a naproxon shot today, but already struggling again with aching. I ve been reading about psoriasis and psoratic arthritis, and have had some chest pain when taking a deep breaths neglected to tell my Dr. today. Should I notify him right away, or wait until next visit? Also how much can be learned from so many labs? Will the X-ray s taken of my hands, feet, and knees show any indication of this arthritis?

### output:

Hello, With such presentations, I would first advice to have an ECG done to rule out any cardiac involvement.  Once I am sure that this is Psoriasis arthritis and is not a life-threatening one then I would suggest the following Ayurvedic medicines.  1. Mahamanjishtadi Ashram 3 teaspoon with three teaspoons of water thrice a day before food. 2. Kishore Juggle - 2 tablets (chewed) thrice a day with the Ashram (Item 1) before food.  3. Siddhartha Sana Churn - made into a paste by mixing it with water and applied all over the body before bath.  The same powder is to be mixed with gram flour at the ratio 1:2 teaspoon and used for bathing instead of soap.  If it is not relieved then I would recommend Classical Vacant and Air China treatment (Panchakarma) and then continue the above medicine.  As this involves specialized treatment and monitoring I suggest you meet an Ayurvedic specialist and discuss the condition. Please let me know if you have any further doubts before you meet the doctor. Hope I have answered your query. Let me know if I can assist you further. Take care 