Psoriatic arthritis: symptoms, causes, treatment and more

About 30% of people with psoriasis—a common autoimmune disorder that causes itchy or sore patches of thick, red, white or silver-colored skin—also develop psoriatic arthritis (PsA). PsA causes pain, stiffness and swelling around the joints, most often in the fingers and toes. If you start to notice these symptoms, getting medical care early is a must. Over time, PsA can lead to permanent joint damage.

Researchers aren’t exactly sure what causes psoriatic arthritis. One theory is that an infection sets the immune system into overdrive. Another theory is that certain genes may make you more susceptible, since about 40% of people who have psoriatic arthritis have a family member with either psoriasis or arthritis. 

Some people experience mild symptoms with occasional flare-ups, while others have more severe symptoms and continuous pain. Here are some of the most common PsA symptoms:

• Pain, swelling, stiffness or tenderness in one or more joints
• Joints that are red or warm to the touch
• Sausage-like swelling in one or more fingers and toes
• Pain in and around the feet and ankles
• Lower-back pain
• Pitting/separation of nails from nail bed
• Fatigue

About 85% of people who develop PsA already have psoriasis, but the other 15% have no skin symptoms before their joint pain starts.

It’s hard for doctors to diagnose PsA because the condition shares many of the same symptoms as rheumatoid arthritis and gout. In order to know if you have psoriatic arthritis, your doctor has to eliminate other possible causes. He or she can do this by looking at your medical history, completing a physical exam, running blood tests and looking at MRIs or X-rays of your joints.

There are a few doctors you can see to help diagnose and treat PsA. You can schedule an appointment with your primary care physician, your dermatologist or—perhaps the best option—a rheumatologist. Rheumatologists specialize in arthritis and joint disorders.

If you have PsA, treatment is pivotal. Leaving psoriatic arthritis untreated can make your joints deformed or cause long-term discomfort. That being said, there are a number of treatment options depending on the severity of your symptoms. If you have mild pain, you may be able to get relief with over-the-counter pain medication like aspirin, acetaminophen, ibuprofen or naproxen. If you have more severe symptoms, your doctor may prescribe corticosteroids, disease modifying antirheumatic drugs (DMARDs), or biologics. Newer biologic drugs target certain immune cells more specifically and are becoming increasingly popular.

There’s no reason why you can’t live a full, active life with PsA. In fact, exercising is one of the best things you can do if you have this condition. Activities like walking, biking, swimming or yoga can help your joints move more freely, reduce the amount of pain and stiffness you have and help you maintain a healthy weight. You could also work with a physical therapist to help create an exercise plan that’s right for you. Discover more everyday tips for dealing with PsA.