Some people with psoriasis may develop a condition called psoriatic arthritis. This can cause them to experience joint pain.
There is a link between psoriasis and joint pain, as psoriatic arthritis is a type of inflammatory arthritis that develops in some people who have psoriasis. However, it can also occur in those without psoriasis.
This looks at what psoriatic arthritis is, possible causes, triggers, symptoms, diagnosis, treatments, when to contact a doctor, and the outlook for the condition.
Psoriatic arthritis is a type of inflammatory arthritis that develops in some people with psoriasis. This type of arthritis causes inflammation in the joints and surrounding tissues, leading to symptoms such as:
- pain
- stiffness
- swelling in the affected areas
The severity of psoriatic arthritis can vary widely in individuals and can develop at any time. However, it often appears after psoriasis has been present for 5–12 years.
The exact cause of psoriatic arthritis is unknown, but it appears to have a link to the following factors:
- genetic
- environmental
- immune system
People with psoriasis are more likely to develop psoriatic arthritis than those without psoriasis. Around 85% of individuals with psoriatic arthritis have psoriasis. Approximately 30% of those with psoriasis will develop psoriatic arthritis.
Additionally, around 40% of people with psoriatic arthritis have a first-degree relative who also has the condition. This means a biological parent, sibling, or child.
Doctors do not fully understand the link between the two conditions, but some believe psoriasis and psoriatic arthritis may share common risk factors.
When a person experiences worse than expected symptoms, it is called a flare. Common triggers of flares include:
- allergies
- alcohol intake
- bacterial infections, such as strep throat
- changes in the weather
- some medications
- skin injuries
- smoking
- strenuous physical activity
- stress
- changes in the gut or skin microbiome
Symptoms of psoriatic arthritis can be similar to those of other types of arthritis, such as rheumatoid arthritis. Psoriatic arthritis can also cause symptoms such as:
- pain and stiffness in the joints, especially in the:
- fingers
- toes
- ankles
- knees
- hips
- spine
- swelling in the joints
- redness, or skin is darker in color in darker skin, and warmth in the affected joints
- fatigue and a general feeling of being unwell
- reduced range of motion in the joints
- nail changes, such as pitting, thickening, or separation from the nail bed
- tenderness or pain in the tendons or ligaments, especially in the heel or bottom of the foot
- spondylitis, or inflammation of the spine, may cause back pain and stiffness
- dactylitis, or inflammation of the fingers or toes that causes them to swell
- psoriasis symptoms on the skin, such as red, scaly patches in lighter skin or darker and thicker discoloration in darker skin
- changes in the eye, such as:
- redness
- pain
- light sensitivity
Diagnosing psoriatic arthritis can be difficult, especially early in the disease, because the symptoms may mimic those of other types of arthritis. Therefore, a doctor may refer a person to a rheumatologist — a specialist in arthritis and other inflammatory conditions — for further evaluation and management.
The process usually starts with taking a thorough medical history and performing a physical examination.
To help confirm the diagnosis, the doctor may also order several diagnostic tests, including blood tests, which can help identify certain inflammation markers and rule out other types of arthritis.
Doctors may carry out imaging tests to help to detect joint damage and inflammation, such as ultrasounds, X-rays, or MRI scans.
Treatment options for psoriatic arthritis include the following:
- nonsteroidal anti-inflammatory drugs
- for peripheral arthritis, disease-modifying antirheumatic drugs, such as:
- for spine, skin, and peripheral symptoms, biologic medications such as:
- tumor necrosis factor inhibitors
- interleukin inhibitors
- a new class of drugs called Janus kinase inhibitors
- physical therapy and exercise
- occupational therapy
- splints or braces
- topical medications
- steroids
- surgery
Doctors tailor treatment options to the individual. The treatment plan will depend on the severity and progression of the disease, whether the symptoms affect the peripheral joints or the spine, and a person’s response to therapy.
They can adjust the treatment plan as the condition changes over time, usually working closely with a rheumatologist or a physician specializing in this field.
If a person thinks they may have psoriatic arthritis, they can speak with a healthcare professional to receive a diagnosis and treatment plan. This can prevent more severe symptoms and joint damage in the future.
People with psoriasis have a higher risk of developing psoriatic arthritis. Therefore, it is essential that anyone with the condition who is experiencing symptoms resembling psoriatic arthritis consult a doctor.
The outlook for someone with psoriatic arthritis can vary widely depending on the severity of the disease, how well they can control it, and their overall health.
With proper treatment and management, many people with psoriatic arthritis can lead active, productive lives. However, flare-ups can still occur, meaning some individuals’ symptoms may sometimes worsen.
Treatment can help reduce inflammation and pain, slow the progression of the disease, and prevent joint damage.
If a person has psoriasis and joint pain, there is a risk of them developing psoriatic arthritis. However, experts suggest that not everyone with psoriasis will develop psoriatic arthritis. Additionally, many with psoriatic arthritis have no skin symptoms of psoriasis.
Most individuals with psoriatic arthritis can live otherwise typical lives with appropriate treatment and symptom management, but as psoriatic arthritis is a progressive condition, there is no cure.