Psoriatic arthritis is a type of arthritis that causes joint pain and swelling. It is also known as arthropathic psoriasis or psoriatic arthropathy.
Psoriatic arthritis 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, people can develop psoriatic arthritis at any age. However, it is most likely to occur at age 30–50 years.
People with psoriasis have a higher chance of developing psoriatic arthritis than people without the condition. Around 30% of people with psoriasis develop psoriatic arthritis.
However, having severe psoriasis does not necessarily mean that someone will also have severe psoriatic arthritis.
Psoriatic arthritis can affect many parts of the body, including:
Toe joints may be noticeably swollen and tender to touch. This can involve the distal joints, proximal joints, or both. The involvement can be symmetrical or asymmetrical.
People with psoriatic arthritis may experience pain on the bottoms of their feet or in their Achilles tendons due to ligament and tendon inflammation.
Psoriatic rashes may develop on the knees, scalp, and elbows. The rashes tend to be:
The same swelling that happens in the toes can also occur in the fingers, with inflammation affecting the distal finger joints more than the proximal joints. This involvement can also be symmetrical or asymmetrical.
Because psoriatic arthritis causes ligament and tendon inflammation, people may experience rib pain with this condition.
Inflammation and swelling can occur in the elbows. The pain may feel like tennis elbow, with pain from the elbows to the forearms and wrists.
Some people may experience inflammation and stiffness in the pelvis.
People with psoriatic arthritis might experience changes in the appearance of their nails. The changes could mimic the look of a fungal infection. Changes may appear in the fingernails or toenails.
Psoriatic arthritis may also cause eye symptoms, such as:
- blurred vision
- sensitivity to bright light
- uveitis, which is a serious inflammatory condition occurring in a small percentage of people
Psoriatic arthritis can affect the spine, and this inflammation is known as spondylitis. It can cause neck stiffness and lower back pain.
According to the Spondylitis Association of America, around 20% of people with psoriatic arthritis could develop spondylitis.
In addition to the involvement of the hands and feet, various joints in the body may also become swollen and inflamed due to psoriatic arthritis, resulting in stiffness, pain, and tenderness.
It is important to note that this type of arthritis can be very destructive, and a healthcare professional should periodically perform imaging of the joints to assess possible damage.
There is not a specific known cause of psoriatic arthritis.
However, 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 to it.
Psoriatic arthritis may also have links to environmental triggers, such as:
- acute injury
There is currently no cure for psoriatic arthritis. However, medications can help stop disease progression and reduce the symptoms.
Treatment depends on the severity of the symptoms. For example, a person with mild psoriatic arthritis might only require treatment during flare-ups. 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:
- disease-modifying antirheumatic drugs
- tumor necrosis factor inhibitors
- corticosteroid injections
A doctor may recommend surgery in cases where there is severe damage.
Exercise and movement play an essential part in psoriatic arthritis treatment. Exercising can help a person maintain mobility and flexibility and reduce stiffness in their joints. People can try activities such as walking, swimming, or cycling to strengthen and protect their joints.
When psoriasis is also present, a doctor may suggest:
- topical creams and lotions
- exposure to sunlight or UV light
People 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
There is no specific test for psoriatic arthritis. However, a rheumatologist is an ideal specialist to confirm the diagnosis.
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.
These tests may include:
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.
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.
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.
Psoriatic arthritis can look a lot like other types of arthritis. Therefore, it is important to see a doctor for a correct diagnosis and to 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.
Psoriatic arthritis can severely affect a person’s quality of life.
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.
Making certain lifestyle changes can help reduce pain and swelling and make it easier to live with the condition. These changes include:
- incorporating low impact exercises
- resting during flare-ups
- finding and avoiding arthritis triggers
- maintaining a moderate weight
Early diagnosis is vital to help slow disease progression and prevent permanent joint damage.
Since there is currently little understanding of the specific causes of psoriatic arthritis, healthcare professionals can do very little to prevent it.
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, the condition 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.