Psoriatic arthritis (PsA) is a type of arthritis that causes joint pain and swelling. It is also known as arthropathic psoriasis or psoriatic arthropathy. It can happen with psoriasis.
Psoriatic arthritis, sometimes referred to as PsA, also causes swelling and pain in areas where ligaments and tendons connect to bone. Without treatment, psoriatic arthritis can lead to permanent joint damage.
This article will look at the symptoms, risk factors, and complications of psoriatic arthritis. It will also address treatment options.
Psoriatic arthritis is an autoimmune condition. With autoimmune conditions, the body falsely recognizes healthy tissues as foreign invaders and produces antibodies to attack them. This leads to pain, inflammation, and damage.
According to the National Psoriasis Foundation (NPF), people can develop psoriatic arthritis at any age. However, it is most likely to occur between 30–50 years.
Psoriatic arthritis types
There are different manifestations of psoriatic arthritis. They include:
- Spondylitis or axial disease: An inflammation of the spinal joints and sacroiliac joints of the lower back affecting 7–32% of people with psoriatic arthritis.
- Enthesitis: An inflammation of the enthesis, which is the area where the ligament, tendon, or fascia connect to bones, such as those of the feet, back of heels, or hips. This affects about 50% of people with psoriatic arthritis.
- Dactylitis: Puffy sausage-like swelling of fingers and toes affecting 40% of people with psoriatic arthritis.
- Peripheral arthritis: Inflammation of the large or small joints of the upper and lower extremities.
- Skin and nail disease: Nail pitting and separation of the nail from the nail bed. This can occur with discoloration of the nails that may be hard to distinguish from fungal infections of the nail.
Psoriatic arthritis affects people differently.
- joint pain
- joint stiffness
- joint swelling
- swollen, sausage-shaped fingers
- skin lesions
- nail changes
- pain and swelling where the tendons meet the bone, known as enthesitis
- inflammatory bowel disease (IBD) in some cases
Where can psoriatic arthritis affect the body?
Psoriatic arthritis can affect many parts of the body, including:
- Joints: Psoriatic can cause inflammation, stiffness, pain, and tenderness in any joint.
- Feet: Toe joints on one or both feet may be swollen and tender to touch. There may be pain on the bottom or back of the feet due to ligament and tendon inflammation.
- Skin: Itchy, flaky, and painful psoriatic rashes may develop on the knees, scalp, and elbows.
- Hands: The same swelling in the toes can also occur in the fingers, with inflammation affecting the distal finger joints more than the proximal joints.
- Ribs: Ligament and tendon inflammation may lead to rib pain.
- Elbows: Inflammation and swelling can affect the elbows. It may feel like tennis elbow, with pain from the elbows to the forearms and wrists.
- Pelvis: Some people may experience inflammation and stiffness in the pelvis.
- Nails: Changes may occur in the finger or toenails. They can look like a fungal infection.
- Eyes: Psoriatic arthritis may also cause eye pain, itching, dryness, blurred vision, and an inflammatory condition known as uveitis.
- Back: Psoriatic arthritis can affect the spine, and this inflammation is known as spondylitis. It can cause neck stiffness and lower back pain. Spondylitis affects around 20% of people with psoriatic arthritis.
There is no specific known cause of psoriatic arthritis, but it is a type of autoimmune condition. It happens when the immune system mistakenly attacks healthy tissue in the joints, leading to inflammation.
Psoriatic arthritis may also have links to environmental triggers, such as:
- acute injury
Some of the risk factors for developing psoriatic arthritis include:
- Age: The condition is more likely in people aged 30–50 years.
- Family history: Genes may play a role in the development of psoriatic arthritis.
- History of psoriasis: Around one-third of people with psoriasis develop psoriatic arthritis.
According to the American College of Rheumatology, 40% of people with the condition have a relative who has either arthritis or psoriasis. This suggests that there is a genetic component.
There is no specific test for psoriatic arthritis as a doctor will need to make a clinical diagnosis. A rheumatologist is an ideal specialist for this purpose.
A rheumatologist will ask the person about their medical history, including whether or not they have previously had psoriasis.
As well as carrying out a physical examination, they may order tests to help verify a diagnosis of psoriatic arthritis and rule out other causes.
The symptoms of psoriatic arthritis can resemble those of other forms of arthritis, which can make confirming a diagnosis challenging. Having skin or nail changes, in addition to other symptoms, may indicate the presence of psoriatic arthritis.
A unique symptom of psoriatic arthritis is enthesitis, which refers to tenderness in the areas where tendons and ligaments connect to bones.
There is currently no cure for psoriatic arthritis. However,
Medications cannot cure psoriatic arthritis but can help slow down disease progression and reduce symptoms.
A person should seek medical treatment as early as possible. Typically, the most appropriate treatment should develop as part of a consultation between the primary care physician, dermatologist, and rheumatologist.
Treatment will also depend on the severity of the symptoms, the degree of physical damage, and whether the disease has only impacted peripheral parts of the body or has reached the spine.
People with mild psoriatic arthritis may find relief with nonsteroidal anti-inflammatory drugs (NSAIDs).
If the condition does not respond to NSAIDs, a doctor may suggest:
- conventional disease-modifying antirheumatic drugs (DMARDs)
- tumor necrosis factor inhibitors
- corticosteroid injections
- other biologic medications or JAK inhibitors
A doctor may recommend surgery in cases where there is severe damage.
When psoriasis is also present, a doctor may suggest:
- topical creams and lotions
- exposure to sunlight or UV light
Exercise and movement play an essential part in psoriatic arthritis treatment. Exercising can help maintain mobility and flexibility and reduce stiffness in the joints. People can try activities such as walking, swimming, or cycling to strengthen and protect their joints.
A person can manage symptoms at home by:
- performing strengthening and flexibility exercises
- using hot and cold therapy to help with inflammation and swelling
- using braces and splints to support the joints
- resting during flare-ups
- finding and avoiding arthritis triggers
- maintaining a moderate weight
Over-the-counter ointments may help to reduce swelling and the appearance of psoriatic arthritis lesions.
No specific diet can cure psoriatic arthritis. However, some people may find that dietary changes can help with symptoms.
Consuming foods that have anti-inflammatory properties may help decrease symptoms of psoriatic arthritis. For example, eating a diet rich in fiber may help reduce swelling associated with the condition.
Foods rich in antioxidants may also help
Additionally, reaching or maintaining a moderate weight may help reduce symptoms. People with psoriatic arthritis may find it beneficial to prioritize a balanced diet rich in whole grains, carbohydrates, fruits, and vegetables.
People with psoriatic arthritis have a higher chance of developing other serious conditions, such as:
- heart disease
- Crohn’s disease
- metabolic syndrome
- liver disease
Untreated psoriatic arthritis could lead to permanent joint damage and a loss of joint function.
To discover more evidence-based information and resources for arthritis, visit our dedicated hub.
Psoriatic arthritis can
- many inflamed joints
- loss of function in the joints
- increased disability
- elevated erythrocyte sedimentation rate (ESR) in the blood.
There is currently no cure for the condition, but people can manage their symptoms with a specialist’s help. Early treatment may prevent severe damage to the joints by slowing disease progression.
When to see a doctor
Psoriatic arthritis can look a lot like other types of arthritis. Therefore, it is important to see a doctor for a correct diagnosis and begin the appropriate treatment.
A person should see a doctor if they have psoriasis with arthritis-like symptoms, such as joint pain and swelling. Early treatment can help limit complications of the condition, such as joint damage.
Below are some common questions regarding psoriatic arthritis.
What is the main cause of psoriatic arthritis?
Psoriatic arthritis is a type of psoriatic disease. Like psoriasis, it is an autoimmune condition. This means that the immune system mistakenly attacks the body’s own cells. In psoriatic arthritis, this leads to joint inflammation. Genetic and environmental factors may play a role.
What are the early warning signs of psoriatic arthritis?
Psoriatic arthritis presents with asymmetric swelling of the joints. It can cause sausage-like swelling of the fingers and toes, and there may be psoriasis-like skin and nail symptoms, too.
What is the difference between psoriatic arthritis and arthritis?
Psoriatic arthritis is a type of arthritis. Like other types of arthritis, it can cause joint pain. Like rheumatoid arthritis (RA), it is an autoimmune disease. However, specific features of psoriatic arthritis include swollen fingers, pain where tendons meet the bones, and psoriasis-like changes such as nail and skin symptoms.
Can psoriatic arthritis be prevented?
Since there is currently
Psoriatic arthritis is an autoimmune condition that can affect the joints and spine. Symptoms can be mild, moderate, or severe. It often occurs in conjunction with psoriasis.
Psoriatic arthritis can also affect other parts of the body, such as the skin, nails, and eyes. Without treatment, it can cause joint damage and dysfunction and lead to other serious health complications.
However, early treatment can slow its progression and help a person manage the symptoms.