Psoriatic arthritis (PsA) is an inflammatory disorder that affects many people with psoriasis. It makes the person’s joints swell and can limit their range of movement. When it affects a person’s elbow, it can make bending or straightening the arm painful.
The American College of Rheumatology (ACR) states that PsA can affect any joint. When it is in the elbow, this part of the body may be tender and painful, making it difficult for the person to move their arm.
This article explains what psoriatic arthritis is and how it affects the elbow.
PsA is a type of inflammatory arthritis that causes swelling and pain in a person’s joints. It is an autoimmune disease, which means that it occurs because a person’s immune system malfunctions and attacks healthy tissue in their body.
Most people who develop PsA already have psoriasis, but very occasionally, people experience joint pain before seeing any sign of a skin rash.
The Arthritis Foundation (AF) estimates that one-third of people with psoriasis will develop PsA.
Psoriatic arthritis on the elbow
People with PsA on the elbow may experience painful swelling and stiffness around these joints. The National Psoriasis Foundation (NPF) explains that the pain and stiffness are often more noticeable in the mornings.
PsA can also affect a person’s tendons and ligaments. These can swell and cause pain, particularly at the point where they connect to the arm bones. Doctors call this enthesitis.
PsA can affect any of the joints, and many people have symptoms in more than one place. The AF says that it usually affects the ankles, knees, wrists, and fingers.
Sometimes, PsA affects a person’s spine or pelvis. This is called spondylitis, and it usually occurs in the neck, lower back, or hips.
However, as PsA is an inflammatory disease, it can affect other parts of the body, including the eyes, nails, lungs, and heart.
Most people with PsA on the elbow experience pain and swelling around the area, making it uncomfortable to move their arm. The whole area may also feel warm to the touch.
- inflamed tendons or ligaments, often at the back of the heel or on the sole of the feet
- changes to the nails, including pitting or the nail separating from the nail bed
- blurry vision, eye pain, and redness due to uveitis, which is swelling in the middle layer of the eye
Early warning signs
PsA can come on quickly or develop slowly over time. As the
People with psoriasis should talk with a doctor about joint pain as quickly as possible. It could be an early sign of PsA.
Other early warning signs include:
- swollen fingers, or dactylitis
- pain that goes around the outside of the elbow, down the forearm, and into the wrist
- difficulty moving the hands or fingers
- digestive issues, including inflammatory bowel disease (IBD)
This section provides images of PsA in the elbow.
PsA is an autoimmune disease in which the body’s immune system mistakenly attacks healthy tissue.
No one knows exactly what triggers this, but PsA tends to run in families, which suggests that genetic factors contribute. The ACR estimates that as many as 40% of people with PsA have a family member with psoriasis or arthritis.
Some people develop PsA after an injury to a joint, but it can affect anyone.
Researchers have identified several factors that may increase the risk of a person with psoriasis developing PsA. These
- Severe psoriasis in certain locations: People with psoriasis in multiple places — particularly those with lesions around the buttocks or on the scalp — may be at higher risk.
- Nail changes: Changes to the nails may include pitting, discoloration, or the nail separating from the nail bed.
- Obesity: Those who are overweight or have obesity may be more at risk of developing PsA.
- Smoking: Smoking may increase a person’s risk of developing the disease, but studies have shown conflicting results.
- Excessive alcohol use: This could be a risk factor, but the study results on this subject are mixed.
- Some infections: Infectious diarrhea or infections leading to hospitalization could be a risk factor for PsA.
- Injury or trauma: Research has associated trauma that leads to hospitalization and injuries resulting from heavy lifting with an increased risk of PsA.
- Stress: Psychological stress could be a risk factor for the condition.
They may recommend blood tests to rule out other conditions, including rheumatoid arthritis, and imaging tests such as ultrasound or MRI scans to look for changes in the person’s joints.
Doctors tailor a person’s treatment depending on the severity of the symptoms and how much these are affecting their quality of life.
The treatment may involve medication, physical therapy, surgery, or a combination of these.
Some people can manage their symptoms with over-the-counter anti-inflammatories and pain relievers.
According to the ACR, doctors may prescribe disease-modifying antirheumatic drugs (DMARDs). These include methotrexate and sulfasalazine.
Other options include corticosteroid injections into the affected elbow and biologics that target specific parts of the immune system.
Exercise is a great way to keep the joints flexible and improve a person’s range of movement. Strengthening the muscles around the elbow joint can give it more support.
The ACR says that aqua therapy may help, as some people find it easier to move their arms in the water. Yoga and Pilates may also be beneficial.
If other treatment options fail, doctors may consider surgery.
However, most doctors only recommend surgery if the elbow is severely damaged or if they can repair the person’s tendons.
Some people with PsA benefit from making certain
- maintaining a moderate weight
- stopping smoking, if applicable
- reducing or eliminating alcohol, if applicable
- practicing stress management techniques, such as regular exercise, meditation, and breathing exercises
The AF also recommends incorporating foods with anti-inflammatory properties into the diet. These include oily fish, nuts and seeds, colorful vegetables, and lean proteins.
Psoriatic arthritis can affect any joint in a person’s body, including the elbow. People with PsA on the elbow may find it painful to bend or straighten their arm, and the elbow area may be tender and swollen.
About one-third of people with psoriasis go on to develop PsA, but the exact causes remain unknown.
Doctors treat PsA with anti-inflammatory medications and may also recommend lifestyle changes.