Prehabilitation in rheumatology: a missing link in psoriatic disease management

Rheumatic and musculoskeletal diseases are chronic, heterogeneous conditions shaped by complex interactions between immune, metabolic, behavioural, and environmental factors. Despite substantial advances in pharmacological therapies, many patients continue to have pain, fatigue, functional impairment, and accumulating comorbidity burden, highlighting the need for complementary strategies beyond inflammation control. Prehabilitation is a proactive and multimodal approach aimed at optimising physical, metabolic, and psychological health before periods of increased vulnerability. Although originally developed in surgical and oncological settings, its principles might be relevant across the continuum of chronic inflammatory diseases. Psoriatic disease represents a particularly attractive model given its identifiable preclinical phases, heterogeneous course, and strong influence of modifiable lifestyle factors. In this Personal View, we discuss the rationale for translating prehabilitation to psoriatic disease, explore potential windows of opportunity and intervention domains across the disease continuum, and consider the conceptual challenges, current evidence gaps, and uncertainties surrounding its application in this clinical setting.