How does psoriatic arthritis affect the hands?
When psoriatic arthritis affects the hands, it can break down the joints and limit a person's mobility. It may cause swelling, stiffness, and inflammation in the hand and finger joints.
Pictures of symptoms
Image credit: Lamiot, 2017.
X-ray of psoriatic arthritis in hands.
Symptoms of psoriatic arthritis in the hands
Psoriatic arthritis symptoms can range from mild to severe. Many people experience flare-ups, or periods in which their symptoms are much worse, as well as periods in which symptoms lessen or disappear.
When psoriatic arthritis affects the hands, it tends to affect the joints closest to the nails, which can cause swelling in the fingers. As a result, some people confuse psoriatic arthritis with gout.
The symptoms of arthritis in the hands can disrupt daily life. Psoriatic arthritis may affect one hand more than the other.
Symptoms of psoriatic arthritis in the hands can include any combination of the following:
- stiff, painful finger and hand joints
- swelling along the entire length of the fingers
- swelling that mainly affects the middle finger joint
- abnormal finger joint shape
- pain where the tendon or ligament attaches to the joint
- areas of scaly, silvery-white skin buildup, called plaques, that may be itchy
- pitted nails
- fungal nail infections
- a reduced range of motion in affected joints
Aside from the hands, psoriatic arthritis may also affect the following areas of the body:
- lower back
Moisturizer may help ease the symptoms of psoriatic arthritis.
People can use certain home remedies to relieve the symptoms of psoriatic arthritis and prevent the condition from getting worse.
When someone experiences a psoriatic arthritis flare-up, the following home remedies can help:
- moisturizing often, especially after washing the hands
- applying ice to the hand joints for 10 minutes at a time, repeating as needed, to reduce inflammation and swelling
- treating fungal nail infections with antifungal creams or tablets
- keeping fingernails trimmed and smooth to prevent injuries that can cause flare-ups
- avoiding pulling or trimming the cuticles, as this can lead to injuries and flare-ups
- limiting the time spent soaking the hands in water, as this can dry out the skin
- avoiding acrylic or fake nails, as they can injure nail beds
- carrying out exercises that a physical therapist has recommended
People with psoriatic arthritis may also notice their symptoms improve if they have a healthful lifestyle, which may include the following factors:
- eating a balanced, nutrient-rich diet
- getting regular exercise
- maintaining a healthy weight, or losing weight to reduce the stress on joints
- managing and preventing stress
- quitting smoking and avoiding second-hand smoke
- avoiding alcohol
- keeping the skin moisturized and protected
There is not yet a cure for psoriatic arthritis, but biologic and systemic drugs aim to treat the underlying causes.
Biologic drugs are a first-line therapy for many people with a new diagnosis, but they can have severe adverse effects and may not suit everyone.
People who cannot use biologic drugs may benefit from oral small-molecule drugs, which is another form of emerging treatment, or a disease-modifying antirheumatic drug.
These drugs can change the way the immune system works, reduce inflammation, or both. They can reduce the severity of symptoms and frequency of flares, and they may also reduce the long-term impact of psoriatic arthritis.
Treatment that can relieve symptoms include:
- anti-inflammatory medications for joint swelling and pain
- corticosteroids to reduce inflammation and ease joint pain
- creams to relieve skin itchiness and discomfort
- phototherapy to help prevent skin flares
- antifungal treatments for fungal infections in nails
Some people with psoriatic arthritis in their hands may benefit from surgery. Surgical treatment varies based on the joints affected and an individual's specific symptoms. Speak to a doctor about surgical options.
When to see a doctor
A person should see a doctor if they have undiagnosed joint pain and stiffness alongside any other symptoms of psoriatic arthritis.
An individual should also contact a doctor during flare-ups and inform them of any changes to symptoms over time.
A doctor may inspect the hands for signs of psoriatic arthritis.
Doctors may need to perform certain tests to diagnose psoriatic arthritis, because the outward symptoms can be similar to other conditions, including:
- rheumatoid arthritis
To diagnose psoriatic arthritis in the hands, a doctor will first review a person's symptoms, medical history, and family history. They will then closely examine the wrist, hands, and fingers to look for swelling, skin rashes, and nail pitting
If the doctor suspects psoriatic arthritis, they may refer the person to a rheumatologist. This type of specialist focuses on arthritis and other musculoskeletal diseases.
A medical practitioner may order X-rays to check for joint damage and blood tests to look for markers of the condition. They aim to rule out other conditions that may cause similar symptoms.
According to the National Psoriasis Foundation, delaying treatment for psoriatic arthritis, even by 6 months, can lead to permanent joint damage. Early diagnosis and treatment can greatly improve a person's outlook.
A comorbidity is a condition that is likely to occur alongside another condition. The exact link between two comorbidities is often unclear, but inflammation appears to play a role in many of these conditions.
The following symptoms of metabolic disorder are also more likely to appear in people with psoriatic arthritis:
Current guidelines urge doctors to monitor people with psoriatic disease for these conditions.
Other conditions that may occur with psoriatic arthritis are:
- uveitis, which is an inflammatory eye condition
- Crohn's disease
- nonalcoholic fatty liver disease
Psoriatic arthritis can cause discomfort in the hands and other affected areas of the body. The condition does not currently have a cure and may become worse over time if it is not treated and managed effectively.
People can control their psoriatic arthritis symptoms using home remedies, medical treatments, or both. Moisturizing the hands regularly, treating fungal nail infections, and leading a healthful lifestyle can help.
Proper treatment can slow the progression of the disease, help ease symptoms, and prevent permanent joint damage.