Psoriatic arthritis (PsA) is a type of arthritis that affects 30% of people with psoriasis, according to the National Psoriasis Foundation. With PsA, your immune system attacks your own body, especially the skin and joints. “PsA can mimic other forms of arthritis, such as gout, rheumatoid arthritis and osteoarthritis,” says Dr. H. Kevin Jones, FAAOS,, a board-certified orthopedic surgeon at Beaufort Memorial Orthopaedic Specialists. “Blood tests can point to other similar conditions and check for signs of inflammation. We can also order X-rays to look for bone and joint changes.”
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10 Early Symptoms of Psoriatic Arthritis
Here are some common first signs of PsA. If you experience any of these, talk to your primary care provider. Early detection and treatment of the disease can help prevent future joint damage.
- Sausage fingers. People with PsA often have painful swelling in the fingers and toes. Dactylitis is the proper medical term, but some people call this swelling “sausage fingers” or “sausage digits.” About 40% of people with PsA have dactylitis.
- Nail changes. You may notice nail pitting, or holes developing in your nails. Other nail changes include deformity, discoloration, thickening and separation of the nail bed.
- Scaly patches on elbows and knees. PsA causes itchy, painful, red patches or buildup of dead skin cells on the body. This occurs most commonly on the knees, elbows and scalp.
- Eye pain and redness. You may have eye inflammation, especially in the middle layer of the eye, a condition known as uveitis. PsA causes additional vision symptoms, including eye pain, redness and blurry vision. Vision loss can occur if eye inflammation isn't treated quickly.
- Joint pain and stiffness. PsA causes mild to severe joint pain and stiffness in the joints. This can get worse if the disease goes unchecked.
- Fatigue. Fatigue is common for people with psoriasis and PsA.
- Stomach issues. PsA can cause inflammation in the digestive tract. Many people with PsA also have inflammatory bowel disease.
- Tenderness. People with PsA have tenderness in areas where tendons or ligaments attach to bones. Pain and swelling in the toes, ankles, heels and soles are also common.
- Difficulty moving. If you have PsA, you may have reduced range of motion. With time, it can be more difficult to move, and the disease may cause disability.
- Back pain. People with PsA can develop pain in the lower back. Back pain with PsA may cause you to wake up in the middle of the night or feel stiff for 30 minutes or longer in the morning. Pain can also travel down into your hips and buttocks.
Diagnosing and Treating Psoriatic Arthritis
Having a physical exam is the first step to diagnosing and treating PsA. Your physician will talk with you about ongoing symptoms. Let your physician know if you have a family history of PsA, psoriasis or other autoimmune diseases. Your health care provider will also check for tenderness, swelling, limited movement, and skin or nail changes.
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There is no cure for PsA. But that doesn't mean you can’t manage the disease and have a healthy, active life. You can work with your health care team to find the best treatment for you.
“Treatment varies based on how the disease affects your life,” Dr. Jones says. “If you have mild symptoms, you may only need treatment during flare-ups. People with severe psoriatic arthritis may need a more aggressive treatment plan to reduce inflammation and improve quality of life.”
Medications
Your physician may prescribe a nonsteroidal anti-inflammatory medication, such as aspirin or ibuprofen, for initial treatment. If this doesn’t help, your physician may try injections of strong inflammation-fighting drugs.
Lifestyle Changes
Don’t underestimate the positive impact of a healthy lifestyle if you have a chronic disease. Commit to lifestyle habits that reduce pain and improve your quality of life. These include:
- Avoiding ingredients in clothing, skincare products and laundry detergents that could irritate your skin
- Eating a healthy, balanced diet with plenty of anti-inflammatory foods
- Getting enough exercise to keep joints healthy
- Managing stress with fun activities or support groups
- Soothing skin with gentle moisturizers
- Using hot and cold packs to reduce swelling and stiffness
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Surgery
Most cases of PsA don’t require surgery. But if joints are severely damaged by the disease, your physician may refer you to an orthopedic specialist for joint replacement surgery. During surgery, surgeons insert a plastic, metal or ceramic prosthesis to replace damaged joints.
Learn which treatment for psoriatic arthritis works best for you. Schedule an appointment with your primary care provider. Find a provider accepting new patients.
