Psoriatic arthritis (PsA) is a long-term joint condition that mainly affects people who have the skin condition psoriasis. It affects each person differently. Someone with mild PsA will usually have occasional flare-ups in four or fewer joints.
Around 30% of people with psoriasis also develop PsA. When someone has PsA, their immune system attacks their joints and entheses. The entheses are the points in the body where tendons and ligaments connect with a bone.
PsA currently has no cure, and it can be progressive, meaning that it worsens over time. However, several treatments are available to help people manage the symptoms.
This article will explain what mild PsA is, its symptoms and possible causes, and how doctors may treat it. It will also look at how mild PsA differs from more severe forms of the condition and when it might be a good idea to consult a doctor.
According to the National Psoriasis Foundation, people can develop PsA at any age, including in childhood. In most cases, it appears when people are between ages 30 and 50.
PsA can be different for everyone. Some may find that the condition starts slowly, with mild symptoms. In others, it may develop quickly and cause severe symptoms.
In mild PsA, symptoms tend to come and go. When symptoms occur, doctors often call this a flare. Flares can last for days or months, but this can vary.
Common symptoms include pain, tenderness, warmth, and swelling in the:
- finger joints, usually those closest to the fingernails
Other symptoms include:
- stiffness in the lower back or buttocks
- tiredness and fatigue
- changes to the skin
Sometimes, PsA can affect the neck or hips. Doctors may call this spondylitis.
Can PsA affect the nails?
Some people develop PsA nail disease. It can cause cracking, pitting, or white spots on the nails. Sometimes, the nail may lift away from the nail bed.
Can PsA affect the feet?
PsA can affect the entheses, the points in the body where tendons and ligaments connect with a bone. Doctors call this enthesitis. It causes pain, tenderness, and swelling.
Enthesitis occurs in about 50% of people who have PsA. It commonly affects the back of the heel and the bottom of the foot.
Can PsA cause a rash?
PsA tends to develop in people who have psoriasis, an autoimmune condition that affects the skin. Psoriasis causes the immune system to attack the skin cells.
- lower back
- palms of the hands
- soles of the feet
Sometimes, these patches may also develop on the fingernails and toenails and in the mouth.
Doctors tend to classify PsA by the severity of the symptoms and how many joints it affects.
People with mild PsA tend to experience symptoms only from time to time, during flares. Those with severe cases of PsA may experience symptoms more consistently.
Doctors sometimes describe mild PsA as oligoarticular, which means it affects four or fewer joints in the body. They often describe more severe PsA as polyarticular, meaning that it affects five or more joints.
Researchers do not yet know what causes the immune system change that leads to PsA.
However, several risk factors increase a person’s likelihood of developing this condition, including:
- having a family member with PsA
- having psoriasis that affects the scalp and groin
- having overweight or obesity
- having severe psoriasis
Stressful events, such as joint trauma and infections,
There is currently no cure for PsA. However, people can take certain measures to manage the symptoms.
Learn more about PsA medications.
Is treatment always necessary for mild PsA?
Treatment for PsA depends on whether a person displays symptoms and how severe the symptoms are. According to the American College of Rheumatology, people with mild PsA may need treatment only during a flare.
The right treatment plan will be different for everyone. For mild PsA,
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be enough to manage pain and swelling. Applying a cream-based medication directly to the joint may be beneficial. Examples of NSAIDs include:
- aspirin (Ascriptin)
- ibuprofen (Advil, Motrin)
- naproxen (Aleve)
Doctors may even provide corticosteroid injections during flares. These are strong medications, so doctors start by giving a low dose to relieve inflammation and pain. Corticosteroid injections are suitable for short-term use only.
The National Psoriasis Foundation advises anyone who suspects they may have PsA to consult a doctor as soon as possible. This includes anyone who is experiencing symptoms, such as joint problems, or has any concerns about their risk of developing this condition.
The earlier a doctor can diagnose PsA, the earlier people can take steps to protect their joints. This can help prevent the condition from getting worse.
PsA is a long-term autoimmune condition that affects the joints and entheses. It tends to affect people who have the skin condition psoriasis.
In mild PsA, the symptoms tend to affect four or fewer joints and can come and go. Symptoms include swelling, joint pain, and psoriasis rash on the skin.
People with mild PsA may need treatment only during a flare. Doctors may recommend OTC anti-inflammatory drugs such as ibuprofen.
Anyone who suspects they may have PsA should consult a doctor as soon as possible.