Psoriatic arthritis causes inflammation in the joints, leading to pain and swelling. People with severe psoriatic arthritis may feel these symptoms more intensely.

Psoriatic arthritis occurs in individuals with psoriasis. Psoriasis is an autoimmune condition causing scaly, itchy, dry, and red patches on areas of the skin.

People with severe psoriatic arthritis may experience more frequent flare-ups than those with a milder form of the condition. They may also need more aggressive treatment protocols and stronger medications to manage their symptoms.

Read on to learn about the condition, symptoms, treatment options, flare-ups, and more.

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Psoriatic arthritis is a chronic autoimmune form of arthritis causing joint inflammation. It can affect any of the joints and affects up to 30% of people with psoriasis.

The condition varies in severity between individuals. Some may have mild symptoms that develop slowly, whereas others may experience symptoms suddenly and severely.

People with severe psoriatic arthritis may feel the symptoms of typical psoriatic arthritis more intensely. They may also sometimes experience damage to the joints.

The main difference between typical and severe psoriatic arthritis is symptom severity. In “normal” cases, symptoms are mild to moderate. In severe cases, the symptoms are more intense and debilitating.

People with severe psoriatic arthritis may also experience more frequent flare-ups.

However, “severe” psoriatic arthritis is not an official diagnosis. If a person has intense symptoms and recurring flare-ups, their healthcare professional may refer to the condition as severe. They will recommend more aggressive treatment methods to manage the person’s symptoms.

Psoriatic arthritis has similar symptoms to other types of arthritis. Common symptoms of psoriatic arthritis include:

  • joint pain
  • stiffness, which may worsen in the morning
  • swelling
  • joints that are tender to the touch
  • fatigue
  • difficulty with movement
  • nail changes, including pitting or separation from the nail bed
  • redness or pain in the eye, known as uveitis

People with severe psoriatic arthritis may have particularly intense symptoms.

In addition to arthritis symptoms, people with psoriatic arthritis will also have symptoms of psoriasis. These may include:

  • patches of discolored, thick, scaly skin
  • itching or burning
  • dry and cracked skin that may bleed
  • thick, pitted nails

However, there is little connection between the severity of a person’s psoriasis and psoriatic arthritis. A person can have severe psoriatic arthritis but only mild psoriasis.

A person should contact a healthcare professional — ideally a rheumatologist — as soon as they notice psoriatic arthritis symptoms.

Treatment for psoriatic arthritis depends on the severity of the condition. For those with a mild form of the disease, over-the-counter (OTC) nonsteroidal anti-inflammatories (NSAIDs) may be enough to manage the pain and inflammation. In severe cases, a person may need stronger medication.

There is no cure for psoriatic arthritis, so treatment focuses on:

  • pain management
  • reducing inflammation
  • slowing down the progression of the condition
  • improving joint flexibility
  • reducing skin symptoms

Many people will take medication as a first-line treatment method. Some commonly recommended medications include:

  • NSAIDs: Examples include OTC options ibuprofen and naproxen sodium. Some doctors prescribe stronger NSAIDs to reduce inflammation and pain.
  • Corticosteroids: A person may have corticosteroids either as an injection into the affected joint or as an oral tablet. However, people can only have limited doses of both forms of corticosteroids as they can cause more significant side effects.
  • Disease-modifying antirheumatic drugs (DMARDs): These are very strong drugs that can help reduce inflammation. A person may take DMARDs orally, as a self-injection, or with an infusion. However, they may suppress the immune system, so doctors reserve these for severe cases.

People with psoriatic arthritis may also receive physical or occupational therapy. In these sessions, a therapist can help provide movement exercises and advise a person on managing their condition. A 2021 review concluded that physical exercise can also improve symptoms of psoriatic arthritis.

Additionally, psoriatic arthritis can cause damage to the joints, which would mean a person may have to undergo surgery. This would only be essential in the case of severe joint damage or if other treatments do not reduce pain.

Surgeons can remove problematic, painful joints and replace them with artificial joints. This can reduce pain and improve mobility.

Sometimes, psoriatic arthritis symptoms can significantly worsen for a short time. These periods are known as flare-ups and can last days or months.

Individuals will have different triggers, but some common ones include:

  • stress
  • not taking medications as prescribed
  • injury
  • skin infection
  • sunburn
  • sleep difficulties
  • lack of physical activity
  • inadequate diet
  • having COVID-19

People with severe psoriatic arthritis may feel symptoms more intensely and experience frequent flare-ups. Common symptoms include joint pain, swelling, stiffness, and fatigue.

Various treatment options are available, including different medications, physical and occupational therapy, and, in severe cases, surgery to replace damaged joints.

A person should contact a doctor as soon as they notice symptoms of psoriatic arthritis.