Psoriatic arthritis is arthritis that affects an estimated 10% to 30% of people with psoriasis. Psoriasis is an autoimmune condition that affects the skin. It causes skin cells to build upon one another to form scaly, itchy patches.
Pain, swelling, and tenderness in the joints are some of the many symptoms of psoriatic arthritis. Being familiar with its signs, symptoms, and risk factors could help you determine whether it’s time to see your doctor for an evaluation and treatment.
Causes of Psoriatic Arthritis
Psoriatic arthritis occurs when your immune system attacks healthy cells and tissues. This response can trigger inflammation in your joints to cause arthritis. The exact cause of psoriatic arthritis is unknown. However, many cases are linked to viral or bacterial infections and a family history of psoriatic arthritis, psoriasis, or both conditions.
Psoriasis is the number one risk factor for psoriatic arthritis. People with severe psoriasis are at the highest risk of developing arthritis.
Other potential risk factors for psoriatic arthritis include:
- Nail disease
- Obesity
- Smoking
- Alcohol use
- Trauma
- Stress
All of the above risk factors are linked to inflammation, which can cause inflammatory conditions like arthritis and psoriasis.
Signs and Symptoms of Psoriatic Arthritis
Symptoms of psoriatic arthritis are different for everyone. They may come and go, and they range from mild to severe. Many symptoms of psoriatic arthritis are similar to those of rheumatoid arthritis—another autoimmune condition.
Common symptoms of psoriatic arthritis include:
- Swelling in the toes and fingers (this can cause the toes and fingers to resemble thick sausages)
- Pain in the foot (this is more likely to occur at the back of your heel and/or in the sole of your foot)
- Joint stiffness (stiffness may be worse in the morning)
- Joint tenderness and swelling
- Muscle and tendon pain
- Nail problems (pitting, crumbling, and looseness are common characteristics of nail changes when you have psoriatic arthritis)
- Eye problems (redness, pain, blurred vision, and inflammation are common eye problems associated with this type of arthritis)
- Lower back pain (this may occur due to inflammation of the joints between your spine and pelvis or of the joints between your spine and vertebrae)
- Fatigue
- Scaly skin patches, or psoriasis (this symptom may become worse during joint pain flares)
- Flaking scalp
Diagnosing Psoriatic Arthritis
Psoriatic arthritis can usually be diagnosed with a physical exam, imaging tests, and lab tests.
During a physical exam, your healthcare provider will check your joints for signs of swelling and tenderness and examine your nails for signs of pitting, looseness, and other changes. Your provider may also examine your feet and eyes and look for signs of psoriasis.
X-ray, MRI, ultrasound, and CT scan are common imaging tests used to diagnose psoriatic arthritis. These tests can help your provider identify joint and tissue damage being caused by inflammation and also determine the severity of the disease.
Lab tests for psoriatic arthritis examine your blood and joint fluid for signs of inflammation, along with certain proteins and substances produced by your body when you have this type of arthritis. For instance, a blood test can detect the presence of a substance called rheumatoid factor, which can help your doctor determine whether you have rheumatoid arthritis or psoriatic arthritis.
Treatments for Psoriatic Arthritis
There is no cure for psoriatic arthritis. The goal of treatment is to reduce and control your symptoms so you feel more comfortable in your day-to-day life. Medications and surgery are common medical treatments for psoriatic arthritis.
Medications
Biologic agents and disease-modifying antirheumatic drugs (DMARDs) are the most common medications used to treat psoriatic arthritis. Biologic agents can target certain proteins and pathways in the body to reduce inflammation caused by arthritis. DMARDs work in a similar way to slow disease progression, prevent additional joint damage, and reduce inflammation.
Steroid injections may be used to reduce inflammation, though these medications are typically only used short-term due to the risk of serious side effects when used long-term, like nerve damage and joint infection.
Your doctor may also suggest using over-the-counter medicines like ibuprofen to reduce joint pain.
Surgery
In severe cases of psoriatic arthritis, you may need surgery to replace damaged joints with artificial joints. Hip and knee replacements are the most common surgeries performed in people with this form of arthritis.
All medical treatments come with their lists of pros and cons—including those for psoriatic arthritis. If you need treatment for this condition, your doctor can talk to you in more detail about your available options.
Lifestyle Changes
Certain lifestyle changes can help reduce your symptoms and the frequency of symptom flares. Smoking and alcohol use are risk factors for psoriatic arthritis that drive inflammation. Therefore, stopping these behaviors may help improve your condition.
Other lifestyle changes you can make to treat psoriatic arthritis include:
- Exercising regularly. Exercise can help reduce joint pain and stiffness and help you maintain a healthy weight.
- Losing excess weight. Obesity is a risk factor for psoriatic arthritis due to the way it puts extra pressure on joints in the hips and knees.
- Managing stress. Chronic stress causes your body to produce higher amounts of cortisol—a stress hormone that increases inflammation.
- Eating healthy foods. Foods that are high in sugar and unhealthy fats can drive inflammation, while healthy whole foods like fruits, vegetables, and fish have properties that reduce inflammation.
Make an appointment with your healthcare provider if you think you may have psoriatic arthritis. Your doctor can perform an evaluation, talk to you about your symptoms, and work with you to find the right treatments.