You may know a bit about the skin symptoms associated with psoriasis, and you may also know about the joint pain of classic arthritis.
Psoriatic arthritis (PsA) is a combination of both skin and arthritic symptoms. The inflammation that drives the condition can make symptom management difficult.
Read on to learn more about the effects of psoriatic arthritis on the body and what symptoms to look out for.
PsA is an autoimmune disorder that causes the immune system to attack healthy parts of the body, mostly the skin and the joints.
This causes pain, stiffness, and swelling in the joints, either singly or throughout the body. Early treatment is essential to avoid long-term joint and tissue deterioration.
Psoriatic arthritis usually develops within 10 years of developing psoriasis. Skin psoriasis causes flare-ups of red, patchy skin that can occur anywhere on the body.
According to the National Psoriasis Foundation, about 30 percent of people with psoriasis eventually develop PsA.
In some cases, PsA is diagnosed before you have skin psoriasis because the arthritic symptoms might be more noticeable.
It’s also possible to develop PsA without having psoriasis, especially if you have a family history of psoriasis. Both skin psoriasis and inflammatory types of arthritis are considered autoimmune disorders.
PsA is a chronic, or long-term, condition. Anyone can get it, but it’s most common between ages 30 and 50 years. Since there’s no cure, treatment is aimed at managing symptoms and preventing permanent joint damage.
Research theorizes that genetics play a part in the development of psoriatic arthritis. Scientists are trying to find out which genes are involved. Identifying the genes may allow the development of gene therapy treatment.
PsA affects many parts of the body and targets larger joints, including those of your lower extremities and the distal joints of your fingers and toes. Symptom frequency ranges from mild flare-ups to chronic.
Psoriasis is a chronic skin condition that causes rough, red patches to form on your skin. These patches sometimes look like silvery scales. Symptoms include tenderness and itching.
Patches can form anywhere but tend to show up around your elbows, knees, hands, and feet. The skin around your joints can appear cracked. In some cases, skin lesions or blisters may form.
Patches on your scalp can range from what resembles a mild case of dandruff to severe shedding. But ordinary dandruff and PsA are not the same.
The big difference is that scalp psoriasis causes larger scales that are also red and extremely itchy. Scratching may cause flakes in your hair and on your shoulders.
Your fingernails and toenails may become thick, ridged, or discolored. They can grow abnormally, develop pits, or even separate from the nail bed.
PsA causes inflammation in your joints. It can affect a single joint or many. Stiff, swollen, and painful joints are classic symptoms.
Many people report back pain and stiffness, especially in the morning, or pain that wakes them up in the middle of the night. This usually occurs later in the progression of the disease, but not always.
As PsA progresses, it can affect your ability to move and do daily activities easily. Read on to learn the effects that PsA may have on your musculoskeletal system.
Note: Some of these symptoms overlap with other conditions. It’s important that your diagnosis pinpoints the correct cause of your pain to make sure you get the right treatment.
Fingers and toes
Your fingers and toes may swell, causing a sausage-like appearance, which is called dactylitis. They may also become painful and stiff, making them difficult to bend.
Inflammation in your knees can cause pain and limit your range of motion. This can make it hard for you to move freely.
Some people describe this sensation as the knee being “stuck” or unable to bend. You may also notice swelling in the area around your knee.
The pain may seem to get better at times, only to occur again later. This recurring pain is called a flare.
Spine, shoulders, and hips
PsA that affects the spine is called axial psoriatic arthritis. It can cause bony growths and inflammation in various parts of the spine that affect the back, shoulders, and hips.
Over time, spinal inflammation may affect the joints between the vertebrae, which are the small bones in the spine. This is caused spondylitis.
PsA that affects the sacroiliac joints between the spine and the pelvis is called sacroiliitis. This is often felt at the bottom outside of your back near your hip. It can also cause pain further into the lower back, hips, or buttocks.
The back pain caused by axial PsA is different from common back pain in that it gets better with exercise and worse when sedentary. The pain may wake you up in the middle of the night and be worse the first 30 minutes after you wake up.
Over time, you may experience chronic joint pain and stiffness, which may make it hard for you to bend your spine. You may also experience decreased range of motion.
Spinal involvement usually comes later in the progression of PsA, but not always. Early treatment can often help prevent your spine from becoming affected.
A common symptom of PsA is soreness where your tendons and ligaments connect to your bones. This can cause pain in your heel or the sole of your foot.
The pain in your heel results from inflammation of the band of tissue connecting your calf to your heel, which is called the Achilles’ heel. It is a frequent point of inflammation for people with PsA.
PsA can also cause muscle pain and stiffness. Fibromyalgia, another condition marked by muscle pain, sometimes occurs in tandem with PsA.
If you experience muscle pain with PsA, be sure to tell your doctor. They will want to diagnose whether you have both conditions or just PsA to be sure you get the most effective treatment.
It’s important to engage in regular moderate exercise to keep your muscles strong. Ask your doctor to recommend an exercise program or a physical therapist who can teach you how to exercise without stressing your joints.
Low impact exercise, especially water exercise, can help keep your joints flexible.
Physical and occupational therapy may be useful to help strengthen muscles and improve flexibility. Walking is one of the best exercises. Shoe inserts can help lessen the impact on your joints.
Chronic inflammation can damage the cartilage that covers the ends of your bones. As the condition progresses, damaged cartilage then causes the bones to rub against each other.
Besides weakening your bones, this process weakens surrounding ligaments, tendons, and muscles, which leads to inadequate joint support.
This can make you lose the desire to stay active, which can inadvertently make your symptoms worse.
Treatment of psoriatic arthritis mutilans focuses on slowing its progression to prevent bone and joint damage, and lessen symptoms.
Uveitis, a condition in which the middle layer of your eye swells, can be a result of PsA. About 7 percent of people with PsA develop uveitis. Other symptoms of uveitis may include:
- blurred vision
- redness in the eye
- light sensitivity
- discomfort in the affected eye
It is important to get prompt treatment for uveitis. Left untreated, it may lead to further eye disorders, such as:
- retinal detachment
- vision loss
Sometimes in autoimmune conditions, your body mistakenly attacks healthy tissues. With PsA, your immune system attacks your joints, tendons, and ligaments.
Certain conditions that affect the immune system may trigger a flare of PsA. You may find your PsA triggered by:
- a respiratory infection
- an ear infection
Physical pain and discomfort, along with the chronic nature of the disease, can have an impact on your emotional health. PsA may cause extreme fatigue and restlessness.
PsA may also increase your risk for anxiety and depression. You might feel embarrassment, low self-esteem, and sadness. You might also feel extremely worried and uncertain about the future of your condition.
Mental health risks are especially high in cases where PsA isn’t managed. If you start to notice symptoms of depression or anxiety, get in touch with a healthcare professional who can help you with treatment options.
Know that you’re not alone when it comes to living with PsA. There are treatments that can help and communities that can help you cope.
Psoriatic arthritis is a lifelong condition, but you may experience periodic attacks followed by remission.
PsA may bring a raised risk for developing other conditions, such as:
- high blood pressure
- high cholesterol
Treatment usually includes medication coupled with mild exercise and physical or occupational therapy. A variety of medications are available, including the newer biologics.
A healthy lifestyle can go a long way toward helping you manage your PsA. Your healthy choices might include:
- a nutrient-dense diet
- regular gentle exercise
- a good sleep schedule
Ask your doctor about complementary health techniques or medications that can help.