Psoriatic arthritis (PsA) is a chronic condition that occurs in people with psoriasis. Psoriasis is an inflammatory disease that affects the skin and nails and can also affect the joints. Finger PsA may cause pain and swelling in one or more finger joints.
In most cases, psoriasis occurs in early adulthood, with one-third of people going on to develop PsA after the age of 30. A milder form of psoriasis can also develop later in life, but typically, this form does not cause arthritis.
Once PsA develops, it can start to damage the bones after a few months, so it is important to seek medical advice and treatment for the condition.
In this article, we will look at PsA in the fingers, including the symptoms, treatment, and management.
It is common for PsA to affect smaller joints, such as those in the fingers. Often, the condition affects the joint closest to the nails.
People who develop PsA in the fingers may experience:
- pain and swelling
- difficulty bending the finger
- reduced range of motion
- misshapen finger joints
- white or silvery patches on the skin that may itch
- pitted or indented nails
PsA typically affects joints asymmetrically, which means it may develop in one hand and not the other. The symptoms can range from mild to severe and may progress, decrease, or remain the same for long periods of time.
The condition often affects the area of the hands closest to the nails, causing swelling that resembles gout.
In the later stages of PsA, the spaces between joints may narrow or completely disappear due to a loss of cartilage.
Yes, people can have PsA symptoms in just one finger, or just in one hand, according to the Arthritis Foundation.
PsA affects everyone differently. Doctors are not sure what causes it or why some people with psoriasis develop joint problems where others do not.
However, it is likely that a combination of genetic and environmental factors plays a role.
Trigger finger, also known as tenosynovitis, occurs when a pulley in the hand becomes inflamed. Each finger has a sheath, or “tunnel,” of tissue that acts like a pulley, holding tendons in place as they move. If this part of the finger thickens, the finger will become stuck in a bent position.
Tenosynovitis can occur in many places around the body, but it
However, trigger finger does have other causes, including infections. Sometimes, infections that cause the condition are serious and spread quickly.
That is why it is important to seek guidance from a doctor if a person develops trigger finger, especially if redness and swelling are present.
When diagnosing PsA in the fingers, doctors will begin by taking a medical history.
If an individual already has psoriasis or if their family has a history of the condition, this may help determine the cause of finger pain and swelling.
Next, doctors may examine the hand. They will look for:
- inflammation and swelling in the joints
- inflammation in places where tendons attach to bones
- difficulty moving the fingers, including trigger finger
- nail changes
- skin changes
- skeletal disorders in other parts of the body
Doctors may also order imaging tests, such as radiography, ultrasonography, and MRI scans.
Treatment for PsA may entail:
- corticosteroid medication or injections
- nonsteroidal anti-inflammatory drugs (NSAIDS)
- disease-modifying antirheumatic drugs
- anti-tumor necrosis factor agents
Doctors choose treatments based on the severity of a person’s symptoms. Some people may only need NSAIDs or to take medications during flare-ups, while those with more advanced PsA may need more intensive treatment.
In some cases, surgery may be necessary to address damage.
Not all of these drugs are suitable for everyone. That is why doctors will take into account any other medical conditions a person has, any medications they are taking, their individual response to different treatments, and risk of side effects.
Living with PsA can be challenging, particularly if it inhibits movement in the hands.
People can look after the health of their joints and manage the symptoms of PsA by trying:
- hot and cold therapies, which can ease pain and swelling
- stretching and flexibility exercises to improve the health of the joint
- an anti-inflammatory diet that contains plenty of fruits and vegetables
- avoiding things that worsen inflammation, such as tobacco, alcohol, saturated fat, and sugar
- reducing sources of stress, which can aggravate PsA flare-ups
- learning relaxation techniques to relax the muscles, slow breathing down, and boost mental well-being
It is important to look after the health of other joints in the body, even if they have not become affected by pain and swelling. Regular low-impact exercise, such as walking or swimming, can improve health without placing strain on the joints.
It is also advisable to protect the skin if a person has psoriasis on the affected joint. People can do this by:
- taking warm, but not hot, baths or showers
- using colloidal oatmeal, Epsom salts, or Dead Sea salts in the bath
- applying moisturizers after getting the skin wet, particularly ones that contain aloe vera, zinc, or jojoba
- wearing rubber gloves to protect the hands while washing the dishes or cleaning
- using unscented products to avoid skin reactions
If a person struggles to move their finger much or if PsA affects multiple joints, they may benefit from consulting an occupational therapist. These are medical professionals who can help a person adapt their home and learn how to use assistive devices so that everyday tasks become easier.
There are other conditions that can cause symptoms similar to those of PsA. If a person does not have psoriasis, the cause of finger swelling may be something else.
Some examples of conditions that could result in finger joint inflammation include:
- rheumatoid arthritis
- reactive arthritis, which occurs as a response to infection in another part of the body
- ankylosing spondylitis, which causes inflammation and fusion of bones in the spine
- trigger finger
If a person suspects they have psoriasis or PsA, they should contact a doctor for diagnosis and treatment as soon as they can.
Without treatment, the symptoms may continue or get worse over time. PsA can also cause damage to bones, which is irreversible.
Additionally, people should seek guidance from a doctor if they have any other unexplained symptoms, such as:
- pain or swelling elsewhere in the body
- morning joint stiffness
- fever or hot flashes
- general malaise, or feeling of being unwell
These could be signs of other conditions that resemble PsA.
Finger PsA causes pain and swelling in the finger joints. It can affect just one finger or one hand. While PsA occurs in people with psoriasis, doctors do not know the exact cause of the condition.
Doctors can diagnose PsA with the help of physical examination and diagnostic and medical imaging tests.
Treatment can depend on how severe the symptoms are but may include a combination of medications and diet or lifestyle changes.