Psoriatic arthritis (PsA) is a chronic autoimmune disorder. It may affect any part of your body, such as your skin, your eyes, your larger joints, and the distal joints of your fingers and toes.
PsA combines the thick, scaly, and sometimes painful skin plaques of psoriasis with the joint inflammation and stiffness of arthritis.
People typically start to show signs of PsA at ages 30–50 years, and PsA affects 1 in 3 people with psoriasis within 10 years of their psoriasis diagnosis.
However, in 13–17% of cases, people receive an arthritis diagnosis before psoriasis symptoms appear.
Keep reading to learn more about how PsA affects your body.
Sometimes, these patches may develop into skin lesions or blisters.
Patches may form anywhere on your body, but they typically form on your scalp, lower back, elbows, and knees.
Patches on your scalp may sometimes look like dandruff, but dandruff and psoriasis are not the same. Scalp psoriasis causes large, discolored scales that can sometimes be extremely itchy and cause severe shedding.
Additionally, your fingernails and toenails might become thick, ridged, or discolored. They may also grow abnormally, develop pits, or separate from the nail bed.
Note: Some of these symptoms overlap with those of 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, developing a sausage-like appearance. This is called dactylitis. They may also become painful, stiff, and difficult to bend.
Inflammation and swelling in your knees can cause pain and limit your range of motion. This can make it hard for you to move freely.
People sometimes describe this as a sensation of the knee being “stuck” or unable to bend.
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 your spine is called axial PsA. It may cause inflammation and bone growth in various parts of your spine that affect your back, shoulders, and hips.
Axial PsA may affect up to 70% of people with PsA.
Axial PsA manifests in two ways:
- Spondylitis occurs when spinal inflammation affects the joints between your vertebrae, which are the small bones in your spine.
- Sacroiliitis occurs when PsA affects the sacroiliac joints between your spine and pelvis. You’ll typically feel it at the bottom of your back near your hip, as well as further into your lower back, hips, or buttocks.
Back pain from axial PsA will usually get better with exercise and worsen when you’re inactive. The pain may wake you up in the middle of the night and may be worse in the first 30 minutes after you wake up.
Over time, you may experience chronic joint pain and stiffness and decreased range of motion.
Spinal involvement usually comes later in the progression of PsA, but not always. Early treatment can often help prevent the condition from affecting your spine.
PsA may cause 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 your Achilles tendon, which is the band of tissue connecting your calf to your heel. This is a frequent area of inflammation for people with PsA.
PsA can also cause muscle pain and stiffness. It
Talk with a doctor if you experience muscle pain with PsA. To ensure proper treatment, they will want to determine whether you have both conditions or only PsA.
Regular low impact exercise is important to keep your muscles strong and your joints flexible.
Psoriatic arthritis mutilans is a rare but severe form of PsA that can destroy the joints of your hands and feet, leading to permanent physical changes and disability.
Chronic inflammation can damage the cartilage that covers the ends of your bones. As the condition progresses, damaged cartilage causes the bones to rub against each other. This process also weakens the surrounding ligaments, tendons, and muscles, leading to inadequate joint support.
This can make you lose the desire to stay active, which can inadvertently worsen your symptoms.
Treatment of psoriatic arthritis mutilans focuses on symptom relief and slowing the condition’s progression to prevent bone and joint damage.
As psoriasis and PsA develop, they may cause vision problems.
The authors of a 2017 review found that nearly 70% of people with psoriasis had eye-related symptoms.
Inflammatory lesions such as conjunctivitis affect nearly 65% of people with psoriasis.
PsA may also cause a group of inflammatory eye diseases known as uveitis. Anterior uveitis may affect up to 20% of people with psoriasis. Symptoms of uveitis may include:
- blurred vision
- eye redness
- light sensitivity
- discomfort in the affected eye
It’s important to get prompt treatment for uveitis. If left untreated, it may lead to eye conditions such as:
- retinal detachment
- vision loss
PsA is an autoimmune condition. This means your immune system mistakenly attacks healthy tissue, such as your joints, tendons, and ligaments.
Over time, PsA weakens your immune system and may increase your risk of developing comorbidities such as:
- lung diseases, including asthma, chronic obstructive pulmonary disease, obstructive sleep apnea, and pulmonary hypertension
irritable bowel disease (IBD), including Crohn’s disease and ulcerative colitis cardiovascular conditions, including stroke and heart attack
Infections may also weaken your immune system and trigger PsA flare-ups.
The authors of a 2020 study in 137 people with PsA also found that the condition caused sleep disturbances in
It’s important to know that you’re not alone in living with PsA.
Talk with a healthcare professional if you notice symptoms of depression or anxiety. They’ll be able to provide you with a treatment plan and may be able to suggest support groups in your area.
What is the life expectancy of someone with psoriatic arthritis?
Although there’s no cure for PsA, the condition itself doesn’t affect life expectancy. But it may increase your chances of developing other conditions that could affect your life outlook, such as cardiovascular and lung diseases.
What organs does psoriatic arthritis affect?
According to the Arthritis Foundation, PsA may affect the following organs:
Will psoriatic arthritis cripple me?
Severe inflammation in your legs, knees, and spine can reduce your mobility over time. But early treatment, regular low impact exercise, and frequent monitoring can help you maintain an active lifestyle and increase your quality of life.
What is the most serious complication of psoriatic arthritis?
PsA causes inflammation that may lead to life threatening complications if left untreated. Possible complications include:
- metabolic syndrome
- chronic obstructive pulmonary disease
- pulmonary hypertension
- heart attack
PsA is a chronic condition that may affect any part of your body, including your skin and joints. It can also affect your mental health.
There’s currently no cure for PsA, but treatment can help stop the progression of the disease and provide symptom relief. A treatment plan usually involves a combination of:
- lifestyle strategies such as regular exercise
- dietary changes
- physical or occupational therapy
Talk with a doctor if you’re experiencing symptoms of PsA. They’ll be able to develop a treatment plan that’s right for you.