You may have been wondering if your itchy skin and achy joints add up to psoriatic arthritis (PsA). But lists of tongue-twister symptoms like “dactylitis,” “enthesitis,” and “spondylitis” may make you feel like you need a Latin dictionary before you can even think about finding a rheumatologist.
While understanding the proper medical terms is helpful, you first need a clear picture of what PsA symptoms really feel like. Having this information will help you gauge whether what you’re experiencing warrants a Q&A with your doctor and what steps to take for treatment.
PsA is an inflammatory autoimmune condition that affects about 20 percent of people who have the skin disease psoriasis. Sometimes PsA develops without a prior diagnosis of psoriasis, but there are almost always associated skin symptoms.
PsA affects men and women equally, runs in families, and usually starts after age 30 (though people of any age can be affected).
In autoimmune diseases like PsA, your immune system mistakenly targets healthy tissue. The result? Inflammation and tissue damage.
The key signs of inflammation are pain, swelling, redness, and heat — but how can you tell if your symptoms point to PsA or another condition?
According to the Arthritis Foundation, doctors can diagnose PsA based on:
- a thorough evaluation of your symptoms and medical history
- lab tests to rule out rheumatoid arthritis
- X-rays to look for joint damage
Like most diseases, PsA affects different people differently.
Your symptoms may be mild to severe. And because PsA comes in phases of flares and remission, the symptoms will not always be the same.
Here’s a guide to PsA symptoms and what they might feel like.
PsA pain most often affects large joints, like your knees, and peripheral joints in your fingers and toes.
Pain in your spine is less likely but not impossible. If you do have spine pain, it will likely be in your lower back (just above the tailbone) or in your neck. You may also feel pain in your heel or the bottom of your foot because of inflammation where ligaments attach to bones.
Notice if you have swelling around the painful joint. Entire fingers and toes may sometimes swell and look “sausage-like.” Affected joints may look red or feel warm, other clues that inflammation is present.
While pain is a hallmark of PsA, it may go beyond an ever-present ache or pain associated with moving the joint. Inflamed joints could be tender to the touch, meaning you’ll experience more pain if you bump or press on the body part.
Swelling and pain can contribute to stiffness, or decreased mobility of the joint. Do you feel like you just don’t have the same range of motion you used to? Stiffness is often worse first thing in the morning or after a period of rest.
We’re all tired for one reason or another, but how is PsA fatigue different? With PsA, fatigue is a severe and persistent tiredness that doesn’t get better with rest.
You may also have a low-grade fever that contributes to fatigue. If after a full night’s sleep, you still don’t have the energy for your normal activities, check in with a doctor.
According to a 2020 survey,
Psoriasis is most common on knees, elbows, and the scalp, but it can occur anywhere on the body.
Not to be taken lightly, itchiness and skin pain have a big impact on the quality of life among people with PsA, according to 2021 research.
Psoriasis and PsA can cause nail changes like pitting and separation from the nail bed, per a
PsA can also cause nails to partially detach from your finger. Nails that aren’t attached well may result in painful snags and tears. Once the skin is torn, you’re at risk of infection, which can cause painful swelling and redness.
Living with PsA can cause difficulty concentrating, anxiety, and depression. Social stigma associated with the appearance of psoriasis may lead to low self-esteem and isolation.
Fatigue and inflammation may also affect your moods. In a recent study,
Typically, a person will experience skin symptoms associated with psoriasis before joint symptoms occur and prior to a diagnosis of PsA. Though experts don’t fully understand what causes PsA, it may be triggered by:
- an infection
- other environmental factors
Evidence indicates that men and women have different experiences with PsA.
According to a 2021 study of more than 1,000 people with peripheral PsA, women have lower remission rates, more pain and fatigue, and lower quality of life. Men were more likely to have symptoms affecting the spine.
Symptoms of PsA vary from person to person, but the main signs to look for are joint pain, swelling, stiffness, skin and nail changes, and fatigue. Symptoms could be mild to severe, and their severity will increase during flare-ups.
Based on the history of your symptoms and lab tests, a doctor can diagnose PsA. Early treatment means better management of symptoms and lower risk of joint damage.