Psoriatic arthritis (PsA) is an autoimmune disease where the body’s immune system attacks its healthy skin cells and joints.
Psoriasis and arthritis are two separate conditions, but they sometimes occur together. If you’re diagnosed with psoriasis, you could develop joint problems later on. In fact, as many as 30 percent of people living with psoriasis eventually develop PsA, says the National Psoriasis Foundation (NPF).
Some people develop psoriasis and then arthritis. Other people experience joint pain first and then red skin patches. There’s no cure for PsA, but it is possible to control symptoms and enjoy periods of remission.
Here is what you can expect when living with PsA.
1. Joint pain
Because PsA attacks the joints, chronic pain can become your new norm. Joint pain can be widespread, affecting both sides of your body, or it may only affect the joints on one side of your body. Sometimes, the condition also affects the nails.
You might feel pain and tenderness in your fingers, toes, knees, lower back, upper back, as well as your neck. Joint inflammation and pain can also limit your range of motion, which can make activity and exercise a challenge.
PsA pain can be mild, moderate, or severe. When pain is severe, this condition can be disabling and affect your quality of life.
2. Itchy skin
PsA causes a distinct red skin rash with silvery scales called plaque. These lesions are usually raised and may become dry and crack at times, leading to skin bleeding.
As if it isn’t enough to deal with the skin patches, you may also develop psoriatic itch along with joint pain. This can become a constant itch, and the more you scratch, the worse your skin may look. Scratching can cause cracking and bleeding, which can also trigger an inflammatory response and worsen psoriasis.
Apply topical anti-itch cream and keep your skin moisturized to relieve symptoms.
3. Sleepy time
PsA doesn’t only affect the skin and joints; it can also affect your energy level. Some days you may feel energetic and ready to take on the world, while other days it may be hard to drag yourself out of bed.
This type of general fatigue is due to the inflammatory response of the disease. When your body is inflamed, it releases proteins called cytokines. These are cell-signaling molecules that help regulate the body’s response to diseases and infections. These proteins can also cause lack of energy and fatigue, although it’s unclear why.
Get regular physical activity (at least 30 minutes most days of the week) to lessen fatigue and strengthen your joints. It doesn’t have to be strenuous — a walk around the neighborhood is good. Also, pace yourself and get plenty of sleep to avoid becoming overly tired.
4. Sausage-like swelling
If you have PsA, you might not expect your fingers, toes, hands, or feet to swell to nearly twice their original size.
Excessive swelling can lead to deformities and affect the appearance of different parts of your body. Swelling can be painful, and it could become difficult to use your hands, wear shoes, or stand for long periods.
Inflammation prompts your body to release white blood cells, which protect your tissues from damage. This response can cause fluid to leak into your tissue, resulting in excess swelling.
PsA is plaque, not the plague. Although you’re not contagious and can’t pass the rash to others, those who don’t know much about the condition may assume it’s an infection and avoid physical contact with you. You might spend a great deal of time explaining your condition to relatives and friends.
It’s unclear why some people develop this form of arthritis, but genetics and environment may be contributing factors. Many people diagnosed with PsA have a parent or sibling with the disease.
6. Eye inflammation
If you’re living with PsA, you can get an eye condition called uveitis.
Symptoms can occur suddenly, so talk with your doctor if you notice any eye changes, like pain, redness, itching, or loss of vision. Treatment usually involves steroid eye drops. If left untreated, this condition can cause permanent eye damage, including vision loss or blindness.
7. It can get better
PsA is unpredictable, but remission is possible. Relief comes once you’re able to stop your overactive immune response and reduce inflammation throughout your body. Different medications are available to help control symptoms. These include antirheumatic drugs to prevent permanent joint damage, immunosuppressants to reduce the strength of your immune system, biologics that target specific cells in the immune system, and steroids to reduce chronic inflammation. There’s no cure for this type of arthritis. Symptoms could return later.
Being diagnosed with psoriasis doesn’t mean that you’ll develop PsA, and vice versa. Even so, a percentage of people with psoriasis go on to have symptoms of PsA.
Talk to your doctor if you start to have joint pain, swelling, or stiffness.
Experiencing pain doesn’t automatically indicate that your condition has progressed to PsA, but you should be examined by a doctor to rule out the possibility.
Diagnosing the condition may involve an X-ray, MRI, or ultrasound of your joints, as well as blood tests. An early diagnosis and treatment can help relieve your symptoms, and prevent permanent joint damage and disability.