Psoriatic arthritis (PsA) typically develops after the onset of psoriasis and can cause a range of symptoms. Some people develop joint pain before they notice any skin-related symptoms.
Below are 11 symptoms to watch if you think you might have PsA.
PsA affects roughly 20% of people with psoriasis,
1. Joint pain or stiffness
PsA causes inflammation in the joints, which can cause pain, tenderness, and stiffness. You might feel this in just one joint or several.
PsA usually affects:
- lower back
Symptoms of pain and stiffness may disappear at times and then return and worsen at other times. When symptoms subside for a time, it’s known as remission. When they worsen, it’s called a flare-up.
2. Joint swelling or warmth
The joints connect bones within the body, including the feet, ankles, knees, hips, wrists, and more. They’re surrounded by soft tissues that cushion the bones on either side. When fluid accumulates in the tissues, swelling can occur.
Joint swelling may be accompanied by:
- an irregular shape of digits in chronic cases
Swelling in the joints due to inflammation is a common sign of PsA. Inflamed tissue produces heat, so your joints may also feel warm to the touch.
3. Pitted nails
Changes to your nails, such as pitting, may be an early sign of PsA. Pitted nails appear bumpy or dented.
Symptoms of pitted nails include:
- depressions in the fingernails or toenails
- changes in nail color (discoloration)
- changes to nail shape (deformation)
- thickening of the nails
Learn more about treatment for nail pitting.
4. Nail separation
Onycholysis can happen with or without pitting, though the presence of transverse grooves, or grooves that run horizontally across the nail, appears strongly correlated with PsA.
If you experience onycholysis, your nail will begin to peel off the nail bed. Depending on the cause, it may also become yellow, greenish, purple, white, or gray. Onycholysis is not usually painful.
5. Lower back pain
PsA can lead to a condition called spondylitis. This causes swelling in the joints, especially in the spine.
According to the Spondylitis Association of America, 20% of people with PsA will develop psoriatic spondylitis.
Learn more about the symptoms of and treatment for psoriatic spondylitis
6. Swollen fingers or toes
PsA may begin in smaller joints, such as fingers or toes, and progress from there.
Spondylitis may be accompanied by dactylitis or swelling of the toe or finger joints. This is sometimes called “sausage fingers.”
When caused by PsA, dactylitis may affect individual digits differently. For example, your left hand may be swollen while your right is not.
Unlike other types of arthritis, PsA tends to make your entire finger or toe appear swollen rather than just the joint.
Learn more about the treatment for dactylitis.
7. Eye inflammation
People with PsA may experience eye problems, such as inflammation and redness.
If you develop new or large floaters and flashing lights in your field of vision, it may be a sign of a medical emergency. Seek immediate treatment from a qualified medical professional.
If you notice these symptoms, seeking medical care right away is important. Early diagnosis is essential in preventing complications like:
Learn more about how PsA can affect your eyes.
8. Foot pain
Pain in the feet or ankles may be an indication of PsA.
People with PsA often develop enthesitis, or pain in the places where tendons attach to bones. This tends to appear as pain, swelling, and tenderness. The most common locations for enthesitis include the:
- Achilles tendon
Enthesitis affects about
Learn more about the treatment for PsA enthesitis.
9. Reduced range of motion
One possible sign of PsA is a reduced range of motion in your joints. You might find it harder to extend your arms, bend your knees, or bend forward.
You may also have problems using your fingers effectively. This can lead to problems for people who work with their hands in any way, including typing and drawing.
When the joint becomes permanently fixed or unable to move beyond a certain point, it’s known as a contracture deformity. This can lead to complications such as Dupuytren’s contracture and Volkmann’s contracture, which is the lack of blood flow to the forearm that causes muscle shortening
Prevention involves a range of motion exercises prescribed by a doctor or done with a physical therapist.
In the case of PsA, fatigue may be due to symptoms or complications like:
- chronic pain
- reduced physical fitness
- increased weight or obesity
- underlying sleeping issues
- anxiety and depression
Learn about treatment for PsA fatigue.
11. Skin problems
Among people living with PsA, 85% will experience a rash before they experience any joint symptoms.
It will look similar to a psoriasis rash, meaning there will be plaques that look like silver or white scales on top of red patches.
Learn more about identifying and treating PsA rash.
At what age does psoriatic arthritis start?
PsA often begins between the ages of 30 and 50.
Where does psoriatic arthritis usually start?
In 60-80% of cases, the disease will affect the skin for about 10 years before it starts to affect the joints.
How is early psoriatic arthritis diagnosed?
PsA is usually diagnosed when patients present with psoriasis skin lesions and rheumatoid factor (RF)-negative inflammatory arthritis. Those who have a history of psoriasis may be diagnosed sooner.