First for Psoriasis .just the skin try a Natropath Doctor. My sister brother in law was one...he took complete physical plus mental history ..emotional as some say....studied it at home than sent her what supplements to buy. It went completely away and she had it so bad that if she wore nylons the bottoms of feet bled.
Most insurances now include these kind of doctors. As to the pain, if you are walking around and being active you, with arthritis of any kind, you are going to be in pain. I hope you are telling your doctors this so they can treat your pain issues. Now if pain is there but tolerable...well you are going to have pain that is just arthritis. But if it so severe that it is affecting how you sleep, ability to concentrate than you need more.
A good pain specialist, I feel is usually better idea than most other doctors. But i have had doctors who took my pain seriously and even told me if this does not get me on top of it to let them know so they do something stronger.
I also used ibuprofen at prescription strength and i swear it works better than narcotic pain drugs like Vicodin Give you example i was on 800 and at time 1000 mg and took it at least 4 times or more a day. JUST EAT on it...i was at work and just did not want to always stop and get something to eat ...now my stomach is damaged and so i cannot use it but very rarely.
Creams do not work except one that i am using Voltran but even that can upset my stomach so i must use it only at extreme break though pain.
You can get shaky hands from pain drugs, caffeine and if you are not doing those...show your doctor just in case it can be signs of other problems.
One last thing, a TEN's unit work wonders on my mother. SInce i have RA in feet and just all over it just will not work on me they said.
I can say this..i know now why my older brother just to live in the bath at night.....now i am doing it with epsom salts, baking so day and dash of bubble baths...keep heat in....and just read for hours. So far it is only place i do not hurt. I been considering a hot tub...but i would like the real ones..not huge spas. The bubbles jets ..i have them in bath and do not really help unless it is not arthritis type of pain but more like muscle soreness.
I am so sorry ...i do not believe pain has anything to do with flares...flares are more.
I wish all with much luck in finding answers to your pain...one last thing..those of us with arthritis tend to think if it is in our joints it must be arthritis...i have shoulder right now that is so messed up...and it is rotor cuff has nothing to do with my arthritis..but since i been holding it weird due to pain now both my elbow and wrists plus hands are inflamed with my RA. SO be careful about assuming it is arthritis.. orthopedic doctors sometimes who you need. Again good luck to all!