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Psoriatic arthritis is an inflammatory condition that causes stiffness, pain, and swelling in your joints. Methods of managing the symptoms include medication, exercise, and heat therapy.
Psoriatic arthritis (PsA) is a type of arthritis thatâs usually associated with the autoimmune skin condition psoriasis. Itâs estimated that up to 30% of people with psoriasis will develop PsA within 10 years of their psoriasis diagnosis.
When youâre living with psoriasis, itâs important to watch for changes in your joints. Early diagnosis and treatment of PsA can help you better manage the symptoms and prevent joint damage.
Keep reading to learn more about the symptoms of PsA and how to manage them.
PsA could affect one or more of your joints, leading to symptoms such as pain, swelling, and stiffness. You may also experience warmth, redness, or tenderness in those joints.
PsA can affect any joint in your body but commonly affects smaller joints in the hands, feet, wrists, and elbows.
Treatment for PsA aims to help reduce pain and swelling. Your treatment plan will depend on the severity of your symptoms and the number of joints affected.
According to the Arthritis Foundation, treatment may include the following medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs): These may help reduce pain by lowering inflammation.
Disease-modifying antirheumatic drugs (DMARDs): These may target the underlying cause of your joint swelling and pain. They may also help prevent permanent joint damage.
Biologics: These are a type of DMARDs that can help reduce inflammation by targeting specific parts of your immune system. They work outside the cells.
Janus kinase (JAK) inhibitors: These medications help reduce inflammation and provide symptom relief by working inside the cells.
Immunosuppressants: These target your immune system to help slow it down.
Steroids: These medications, also known as corticosteroids, may help reduce pain and inflammation. A healthcare professional may inject them into a specific area.
PsA may cause joint stiffness, which could affect your range of motion and mobility. Stiffness is most common first thing in the morning or after sitting for long periods.
The Arthritis Foundation suggests that using heat therapy for up to 20 minutes at a time may help relieve stiffness. This may involve:
applying heat packs to the affected areas
taking a warm shower in the morning
bathing in a warm bath or pool
Other strategies that may help you manage PsA stiffness include:
PsA may cause enthesitis, which is inflammation, tenderness, or swelling in the entheses (the areas in your body where ligaments join a bone). Examples of these areas include:
your heels
your elbows
the bottoms of your feet
About 1 in 3 people with PsA experience enthesitis, according to the Arthritis Foundation.
Treatment aims to reduce inflammation and help you manage your symptoms. Treatments may include:
PsA can cause inflammation, stiffness, and pain in your spinal joints and ligaments. This condition is called spondylitis and most commonly affects the lower back.
Symptoms of spondylitis are often worse when you first get up in the morning or after you spend a lot of time in the same position during the day. Some people also experience decreased flexibility and mobility.
Spondylitis treatment and management options include:
medications such as biologics, JAK inhibitors, and NSAIDs
Up to 80% of people with PsA experience symptoms that affect their fingernails and toenails, such as:
pitting, lesions, or grooves
discoloration
thickening
separation from the nail bed
pain
Treatment will depend on how the condition affects your nails.
Topical creams are the first-line treatment for PsA nail symptoms. These may specifically target your nails without affecting the rest of your body. Examples of these medications include:
corticosteroids
calcipotriol to help treat the buildup under your nails
tazarotene to help treat discoloration, separation, and pitting
If these treatments donât work, a healthcare professional may suggest other treatment methods, including:
systemic therapies such as methotrexate, cyclosporine, and biologics
According to the National Psoriasis Foundation, about 7% of people living with PsA will develop an inflammatory eye condition called uveitis. This happens when your immune system attacks the uvea, which is the area between the white of your eye and your retina.
If youâre experiencing these symptoms, itâs important to speak with a healthcare professional as soon as possible. Theyâll develop a treatment plan to help prevent complications such as vision loss.
Treatment may involve steroid medications to help reduce inflammation. These are available in the form of eye drops, oral tablets, or injections. Your doctor might also prescribe mydriatic eye drops for pain relief.
Some natural remedies and lifestyle strategies may help you manage your PsA symptoms and avoid flare-ups. Flare-ups are periods when your symptoms worsen, typically in response to a trigger. Flare-ups are usually followed by periods of mild symptoms, known as remission.
The following lifestyle strategies may be helpful:
Can you live a normal life with psoriatic arthritis?
Early detection and treatment may help reduce PsAâs impact on your day-to-day activities. However, flare-ups may affect your range of motion and mobility. PsA also causes your immune system to become hyperactive, increasing inflammation. This may increase your risk of developing some health conditions, such as:
cardiovascular disease
obesity
high blood pressure
metabolic syndrome
diabetes
anxiety
depression
Does psoriatic arthritis affect quality of life?
PsA could have a significant impact on your mobility, mental health, and immune system activity. Talk with a healthcare professional if you experience any symptoms of PsA. Early diagnosis and treatment are key to improving quality of life and avoiding complications such as permanent joint damage.
If you live with psoriasis, you have an increased risk of developing PsA. Look out for symptoms such as joint pain, stiffness, swelling, and changes to your eyes and nails.
If left untreated, PsA can lead to permanent joint damage. Itâs important to get treatment early to preserve joint structure and function.
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Palominos PE, et al. (2023). Management of dactylitis in patients with psoriatic arthritis: An updated literature review informing the 2021 GRAPPA treatment recommendations. https://www.jrheum.org/content/50/2/265