How Psoriatic Arthritis Affects Hands and Feet

Symptoms of psoriatic arthritis in hands and feet

In this section, we describe what psoriatic arthritis symptoms look like in various parts of the body.

PsA in hands and fingers

PsA of the hands or fingers primarily causes stiffness and swelling.

In some cases, your fingers may swell enough to take on a sausage-like appearance (known as dactylitis). It’s estimated that 33–55% of people with PsA experience dactylitis in at least one finger.

Stiff, swollen fingers can make performing ordinary tasks like zipping a jacket or unscrewing a jar hard. If you’re experiencing these difficulties for the first time, consider talking with a doctor.

PsA in nails

Up to 80% of people affected by PsA experience nail psoriasis.

Symptoms include:

• discoloration, typically yellowing or browning
• thickening
• pitting
• separation of the nail from the nail bed (known as onycholysis)
• chalky buildup under the nail
• nail tenderness or pain

Nail psoriasis can resemble a fungal infection. Treatment for a fungal infection is different, so finding the underlying cause of your symptoms is essential. Your doctor can check for fungal infection by taking a nail skin cell sample and testing it.

In some cases, you may be experiencing both conditions. People with nail psoriasis are more likely to develop a fungal infection.

PsA in feet

If you have PsA, your feet may feel swollen, sore, and stiff. Walking or standing for a long time can be painful, and your shoes may feel uncomfortable.

Other symptoms can include:

• ankle swelling
• toe swelling, especially swelling of the big toe (dactylitis)
• pain in the bottom of your heel (plantar fasciitis)
• pain in your Achilles tendon (enthesitis or enthesopathy)

These symptoms may come and go, so paying attention is important when they occur. Left untreated, these can create long-term problems like an elongated big toe and stiff toe joints.

Your doctor may recommend that you see a physical or occupational therapist. A therapist can develop a set of exercises and stretches to help you avoid stress on your feet, protect your joints, and keep your joints flexible.

Other symptoms of psoriatic arthritis

PsA symptoms vary from person to person. Overall, the most common symptoms include:

• joints that are painful, swollen, and warm
• stiffness, especially in the morning
• back pain
• pain or tenderness
• reduced range of motion
• swollen fingers and toes
• eye problems, including redness, irritation, and sensitivity to light
• nail changes, such as pitting and cracking
• fatigue

Home remedies for psoriatic arthritis

The following are home remedies for managing PsA.

For hands and fingers

You can do several procedures at home that can help relieve your symptoms. Once you meet with a doctor, they can make a diagnosis and help you develop a treatment plan suited to your needs.

You may also find relief by:

• massaging the affected areas
• applying a hot or cold compress to reduce swelling
• wearing hand splints to help stabilize and protect your wrist and fingers
• taking regular breaks when typing or writing
• performing hand and wrist exercises to help stretch and strengthen the muscles

For nails

In addition to your doctor-approved treatment plan, being proactive with your nail care is beneficial. Nail injury can worsen psoriasis and trigger another flare-up, so protecting your nails and hands is vital.

You should:

• keep your nails short
• moisturize nails after soaking
• wear gloves when doing dishes, housework, or gardening
• use clear polish because colored polish could mask signs of disease

You should not:

• soak your hands for too long
• push your cuticles too aggressively because it might promote tiny tears
• wear nail polish if you have a nail infection

For feet

In addition to your doctor-approved treatment plan, you can wear shoe inserts to help relieve pressure on your feet. You can also use a walking aid for added stability.

Wearing the right footwear is also crucial. When selecting a pair of shoes, consider:

• choosing roomy footwear to accommodate potential swelling
• opting for open-toed shoes if closed-toed shoes feel too tight
• selecting breathable materials for footwear, such as leather or canvas
• ensuring that shoe options offer proper arch support

Diagnosing psoriatic arthritis

There’s no single test to diagnose psoriatic arthritis. Instead, a healthcare professional will review your medical history and perform a physical exam.

A doctor can rule out other conditions and confirm a diagnosis of PsA by using:

• blood tests
• imaging tests
• joint fluid tests

Treatment options for psoriatic arthritis

If a PsA diagnosis is reached, your doctor will work with you to determine how to relieve pain, swelling, or stiffness.

Your treatment plan may include one or more of the following:

• Over-the-counter (OTC) or prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs)
• corticosteroid injections
• immunomodulator disease-modifying anti-rheumatic drugs (DMARDs)
• immunosuppressant medications
• TNF-alpha inhibitors (biologic)
• interleukin inhibitors (biologic)

Everyone with PsA experiences the condition differently. You may need to experiment to find a combination of treatments that works for you.

In more severe cases, your doctor may recommend joint replacement or other corrective surgery.

Why you should see a doctor

If you’re experiencing symptoms, make an appointment to see a doctor right away. The sooner you begin treatment, the better.

Joint damage can happen quickly. Early diagnosis and treatment are critical.

The bottom line

Psoriatic arthritis (PsA) is a chronic and progressive disease that can cause stiffness, soreness, and swelling in your hands and feet.

There is currently no cure, but treatments such as physical and occupational therapy can help relieve symptoms.