Psoriatic arthritis (PsA) can cause pain, swelling, stiffness, and other issues in the feet and toes, affecting mobility. Medication and lifestyle choices can help manage them.
This article examines how PsA can affect the feet, including symptoms, risk factors, and diagnosis. It also covers how to manage and treat the foot-related symptoms of PsA.
PsA can affect any of the 26 bones in the foot, plus the ankle bones and synovial membranes that surround the joints.
The condition can develop in just a few joints or several. It can make the joint or joints it affects inflamed, sore, and tender.
PsA commonly affects the feet and toes. Symptoms of PsA in the feet include:
- foot swelling
- stiffness in the feet and ankles
- pain and difficulty walking, especially in the morning or after a long period of rest
- dactylitis, also known as sausage toes or sausage digits, which is a condition that causes entire toes to swell up
- heel pain, similar to plantar fasciitis, which is inflammation in the Achilles tendon
- bending and shortening of the toes, making them look like claws
- overextending of the big toe
- painful calluses or sores over the joints
- flattening of the foot arch, leading to a tendency to roll the foot inward when standing or walking
- limited range of motion and a tendency for the joints to lock
- the skin of the affected area turning red or purple
The joints that PsA affects typically worsen with inactivity. People often experience stiffness in the morning. This difficulty can last for more than 30 minutes.
PsA symptoms come and go in periods called flares and remission. People should maintain their treatment throughout both of these phases. Treatment can prevent the condition from progressing.
In the later stages of the condition, the joints can become so damaged that the toe bones fuse together.
The process typically begins when a person visits a doctor about pain in their joints. To determine the cause of the issue, the doctor may try:
- looking for a history of psoriasis, which is associated with PsA
- looking for pitting and other changes in the nails
- looking for signs of dactylitis, heel pain, and other symptoms of the condition in the feet
- using MRI, ultrasound, or X-ray scans to look for any PsA-related joint injuries
- using blood tests to rule out other types of arthritis
In addition, the doctor may also look for signs of asymmetrical joint pain. The joint pain of PsA affects the two sides of the body differently. This is a key difference between PsA and other conditions, such as rheumatoid arthritis, which tends to affect both sides of the body symmetrically.
People cannot take direct action to prevent PsA from developing, but they can take some measures to limit flare-ups and the effects of this condition on their lives.
For example, people may find it helpful to work with a doctor or podiatrist to help them find the right footwear for their condition. Using shoe inserts may provide symptom relief and make it easier to walk.
Strengthening exercises and stretches may also prevent more severe symptoms. Doing exercises that involve slow, gentle, strength-building movements, such as yoga and tai chi, can be safer for the joints than higher-impact exercises, such as running.
Trying physical therapy can also help build strength, work through stiffness, and maintain foot mobility.
When a person is experiencing pain, treatment can help them feel more comfortable, slow the condition’s progression, and prevent joint injury.
The sections below look at some treatments and home remedies in more detail.
A treatment plan for PsA-related foot problems aims to reduce pain, lower inflammation, and prevent permanent joint damage.
- For milder pain, people can get nonsteroidal anti-inflammatory drugs over the counter or as a prescription medication from a doctor.
- A doctor can also prescribe corticosteroids as an oral medication or as an injection. These medications can reduce inflammation when the symptoms are more severe.
- There are also more powerful medications called disease-modifying antirheumatic drugs (DMARDs) for long-term use. People can get these as oral medications, injections, or infusions. DMARDs include traditional DMARDs, which target the whole immune system, and other types, such as biologics, which only target specific parts of the immune system.
- A person can also try oral small molecule drugs, which are an
alternative to biologics.
When the effects of PsA are severe, a person may need surgery.
Since psoriatic disease, which includes psoriasis and PsA, is an inflammatory process in the body, it may affect more than the skin, joints, or feet.
People who are prone to psoriatic inflammation may be more at risk of health issues such as obesity, higher cholesterol, higher blood pressure, heart disease, and insulin resistance. A person with PsA should consult a doctor and attend regular checkups to monitor their overall health.
In addition, a person may choose to eat a balanced diet and maintain a moderate weight. Foods that may help reduce inflammation include:
- fish rich in omega-3 fatty acids
- green tea
- fiber-rich foods such as beans
- nuts and seeds
- fruits and vegetables
At the same time, a person may wish to limit foods that can trigger inflammation, such as:
- processed meats
- white bread and rice
- fried foods
In addition, some people with arthritis have also found the following remedies helpful:
As with many alternative healthcare practices, scientific research does not fully back up these techniques. People with psoriatic foot pain should consult a doctor before trying any of these remedies.
Below are common questions relating to PsA in the feet.
How do you know if you have psoriatic arthritis in your feet?
The hallmark symptoms of PsA in the feet are:
- joint swelling
- skin discoloration
- joint stiffness
What part of the foot hurts with psoriatic arthritis?
PsA affects the joints, but the pain can radiate throughout the toes, midfoot, and into the heel.
What are the early warning signs of psoriatic arthritis?
PsA is a progressive disease, so symptoms may appear mild at first. Mild pain, swelling, and skin discoloration are not warning signs but indications of the condition in its early stages.
The feet are among the areas most often affected by PsA. The condition can cause:
- joint pain
- stiffness and movement limitation
- skin discoloration
- toe clenching
PsA is a chronic, progressive condition, and there is currently no cure. However, the wide range of treatments available can help relieve pain and inflammation and prevent permanent joint damage for most people.