Table of ContentsView AllTable of ContentsAffectsCauses and Risk FactorsAppearanceSymptoms of Psoriatic Arthritis in the FeetStages of PSA in the FeetDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Affects
Causes and Risk Factors
Appearance
Symptoms of Psoriatic Arthritis in the Feet
Stages of PSA in the Feet
Diagnosis
Treatment
Coping
Psoriatic arthritis(PsA) can affect the joints of the feet and ankles, as well as the structures supporting the joint. According to the National Psoriasis Foundation, up to 50% of people living with PsA also experience inflammation where the tendons and ligaments meet the foot bones.
PsA in the feet can make it hard to walk and performactivities of daily living. And while PsA has no cure, there aretreatment optionsavailable to slow down the disease and relieve symptoms. With appropriate treatment, people with PsA can manage pain, stay active, and lead fulfilling lives.
This article will help you understand how psoriatic arthritis affects your feet and what it can look like. It explains why a diagnosis of early-stage psoriatic arthritis and effective treatment can help to prevent more severe and systemic complications.
What Is Psoriatic Arthritis?
PsA is a form of inflammatory arthritis that often affects people with the autoimmune skin conditionpsoriasis. It can affect any of the joints of the foot, plus the ankle joints and the ligaments and tendons of the foot. It causes parts of the feet to become inflamed, sore, and tender.
PsA affects people assigned male and female equally. According to the National Psoriasis Foundation, an estimated 30% of people with psoriasis also have PsA. Psoriasis affects 2% to 3% of the world’s population.
Foot involvement in PsA can cause significant pain and difficulty with walking, especially in the morning and after sitting for a long period. PsA is also associated with many different foot conditions, includingdactylitis, Achilles tendonitis,plantar fasciitis, andarthritis mutilans.
What Does It Look Like?
Psoriatic arthritis can affect the heels and ankles, the toes, and the middle or top of the foot.
Arthritis in the Heel and Ankle
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Inflammation at the heel can cause impacts where tendons or ligaments attach to bones.It can lead to conditions that cause heel pain that includeretrocalcaneal bursitis, a condition in which the bursa (the fluid-filled sac at the heel bone) becomes inflamed, causing pain and swelling.
Additional symptoms of PsA in the ankle include swelling and stiffness of the ankle and problems with mobility. The condition will eventually affect gait—the way a person walks.
PsA in the Toes
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PsA in the toes is often the result of wear and tear of the cartilage in the toe joints or inflammation of the toe joints.The big toe is most often affected, but other toes can also be involved.
Common symptoms of PsA of the toes may include pain that can take hours or days to resolve, and swelling and inflammation in and around the toe joints. PsA can cause significant pain and swelling. Sometimes, the toes become so swollen that they can resemble sausages (dactylitis).
Additional symptoms of PsA in the toes might include:
Claw Toes
PAUL CAMPBELL / Getty Images.
Claw toes are a condition in which the toes bend into a claw-like position. Claw toes are not a serious problem on their own, but they are generally a sign of an underlying condition like PsA.
You should call your doctor if your toes show signs of becoming clawed. Your toes may seem flexible early on, but they can become stuck in this position permanently over time.Treatment is important to keep this from happening.
PsA in the Middle/Top of the Foot
SDI Productions / Getty Images.
PsA might affect the middle or top of the foot. In the midfoot, symptoms include pain and swelling that becomes worse with standing and walking.
Other Changes in Appearance
PsA can cause changes in the appearance of feet. These include skin and nail changes, bunions, and bursae inflammation.
Skin and Nail Changes
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PsA can cause skin and nail changes. For example, rashes associated with PsA and psoriasis can occur anywhere on the body, including on the feet.
PsA is also associated with a condition calledpalmoplantar pustulosis, which can cause tiny, pus-filled blisters on the soles of the feet. Up to 80% of people with PsA will have nail involvement.
Nail changes include pitting (small indents in the nails), thickening,brittle nails, andonycholysis(nails separating from the nail bed).
Bunions
bgwalker / Getty Images
Bunionsare bony bumps that form at the joint at the base of the big toe. They occur when the bones at the front part of the foot move out of place. This will cause the tip of the big toe to be pulled toward the smaller toes, forcing the joint at the base of the big toe to stand out. The skin covering the bunion can become red and sore.
Bursae
Pornpak Khunatorn / Getty Images.
Bursae are thin, fluid-filled sacs that act as a cushion and reduce friction between bones and soft tissues like muscles, tendons, and skin. The foot and ankle have several bursae.
Conditions like PsA can cause the bursae to become inflamed, leading to a symptom calledbursitis. Bursitis can cause pain, swelling, and redness. Bursa pain can be disabling and affects the ability to walk.
Swelling or Heat
Swellingand warmth are common characteristics of inflammation. When inflammatory arthritis affects the feet or the ankles, you may experience swelling of one or more joints of the feet, ankles, or toes. Abnormal warmth in one or more areas of the foot often accompanies swelling in the joints of the feet, even while the rest of the body remains generally cool.
Swelling is noticeable after a person has been sitting for a long time, or after they get out of bed in the morning. Swelling can make it hard to put on your shoes, and shoes may feel tight when you first start walking around.
Pain and Stiffness
Pain is one of the most common symptoms of PsA in the feet. You may feel general foot pain with stepping, pain in the toes, and/or pain only in the big toe.
Foot pain can be sharp or stabbing depending on the amount of inflammation or the level of damage in the foot. Pain can make it harder to do normal daily activities.
Locked Joint
Locked jointsare typical when there is a lot of swelling and stiffness. Locking means that the joint is hard to bend. Rough edges on bones and bone spurs can also cause joints to lock up.
Wylius/iStock / Getty Images Plus
Early Stages
Most people diagnosed with psoriatic arthritis (about 85% to 92%) experience signs and symptoms of psoriasis that occur seven to 10 years before arthritis symptoms emerge.
It may be helpful to watch for certain symptoms of early-stage psoriatic arthritis in the feet, to help arrive at an early diagnosis and treatment. They include:
Nail psoriasis can be an important predictor. One study found between 15% and 50% of people with psoriasis had it, but the incidence of nail psoriasis increased to between 41% and 93% in people who were diagnosed with psoriatic arthritis.
Mid Stages
Liudmila Chernetska / Getty Images.
With progression of psoriatic arthritis, you may experience more joint pain and swelling in your feet. The pain and swelling also can occur in other parts of the body, including the neck and hips.
Other symptoms can include:
Late Stages
Catherine McQueen / Getty Images
In the late stages of psoriatic arthritis, you may experience considerable pain as joints become damaged. This can lead to permanent changes. Other serious consequences can occur with untreated PsA as it advances. These include:
PsA is associated with a higher risk ofmetabolic syndrome. This condition is really a pattern of several disorders that can includeobesity, hypertension (high blood pressure),insulin resistanceand diabetes, and high cholesterol.
9 Psoriatic Arthritis Complications
If you have symptoms of psoriatic arthritis, see your healthcare provider. It is important to get a diagnosis right away since untreated psoriatic arthritis can cause permanent damage to your joints.
Your healthcare provider will look for swollen joints and toes, skin and nail changes, and pain in your toes and feet. You may need an imaging test such as an X-ray, CT scan, or ultrasound. Blood tests can help rule out other types of arthritis such as gout and rheumatoid arthritis. A blood test can also tell your healthcare provider if you have inflammation.
If you haven’t already been diagnosed with psoriasis, your healthcare provider may do a skin test to confirm that you have the condition.
Your healthcare provider might recommend different therapies to treat PsA in your feet. These might include:
Your healthcare provider might also recommend surgery if other treatments don’t work to manage your condition. Surgical options might include:
There are many things you can do at home to help cope with the pain and discomfort of PsA in your feet. These include:
Making changes to your lifestyle can also help you feel better and keep the condition from getting worse. Lifestyle changes might include choosing low-impact exercises like swimming rather than high-impact ones (e.g., jogging), maintaining a healthy weight to keep stress off joints, and reducing or avoiding activities that trigger symptoms in the feet and ankles.
Summary
Psoriatic arthritis can cause pain, swelling, stiffness, and other foot symptoms. It may also cause your toes to become claw-shaped or sausage-like. The nails may develop thickening and pitting.
PsA foot and ankle pain can be debilitating, but it is treatable. Reach out to your healthcare provider if you experience symptoms or see a visible deformity in your foot. Your healthcare provider may prescribe medications like NSAIDs or steroid injections to help treat your psoriatic arthritis. If these treatments don’t work, you may need surgery.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Classification of psoriatic arthritis.National Psoriasis Foundation.Psoriasis statistics.University of Washington.Ankle arthritis.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic Arthritis Symptoms.Arthritis Foundation.When foot pain may mean arthritis.American Academy of Orthopaedic Surgeons.Claw toe.Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia.2017;55(3):131-135. doi:10.5114/reum.2017.68912Arthritis Foundation.BursitisLiu X, Zhao Y, Mu Z, Jia Y, Liu C, Zhang J,et al.The Combination of IL-6, PLR and Nail Psoriasis: Screen for the Early Diagnosis of Psoriatic Arthritis.Clin Cosmet Investig Dermatol.2023 Jun 28;16:1703-1713. doi:10.2147/CCID.S413853.Arthritis Foundation.Psoriatic Arthritis.Aljohani R.Metabolic Syndrome and Its Components in Psoriatic Arthritis.Open Access Rheumatol. 2022 Feb 17;14:7-16. doi:10.2147/OARRR.S347797.National Psoriasis Foundation.Why treat psoriatic arthritis?Weatherford BM.Rheumatoid arthritis of the foot and ankle. American Academy of Orthopaedic Surgeons.Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E.New insights in physical therapy and rehabilitation in psoriatic arthritis: a review.Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Psoriasis Foundation.Classification of psoriatic arthritis.National Psoriasis Foundation.Psoriasis statistics.University of Washington.Ankle arthritis.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic Arthritis Symptoms.Arthritis Foundation.When foot pain may mean arthritis.American Academy of Orthopaedic Surgeons.Claw toe.Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia.2017;55(3):131-135. doi:10.5114/reum.2017.68912Arthritis Foundation.BursitisLiu X, Zhao Y, Mu Z, Jia Y, Liu C, Zhang J,et al.The Combination of IL-6, PLR and Nail Psoriasis: Screen for the Early Diagnosis of Psoriatic Arthritis.Clin Cosmet Investig Dermatol.2023 Jun 28;16:1703-1713. doi:10.2147/CCID.S413853.Arthritis Foundation.Psoriatic Arthritis.Aljohani R.Metabolic Syndrome and Its Components in Psoriatic Arthritis.Open Access Rheumatol. 2022 Feb 17;14:7-16. doi:10.2147/OARRR.S347797.National Psoriasis Foundation.Why treat psoriatic arthritis?Weatherford BM.Rheumatoid arthritis of the foot and ankle. American Academy of Orthopaedic Surgeons.Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E.New insights in physical therapy and rehabilitation in psoriatic arthritis: a review.Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Psoriasis Foundation.Classification of psoriatic arthritis.National Psoriasis Foundation.Psoriasis statistics.University of Washington.Ankle arthritis.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic Arthritis Symptoms.Arthritis Foundation.When foot pain may mean arthritis.American Academy of Orthopaedic Surgeons.Claw toe.Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia.2017;55(3):131-135. doi:10.5114/reum.2017.68912Arthritis Foundation.BursitisLiu X, Zhao Y, Mu Z, Jia Y, Liu C, Zhang J,et al.The Combination of IL-6, PLR and Nail Psoriasis: Screen for the Early Diagnosis of Psoriatic Arthritis.Clin Cosmet Investig Dermatol.2023 Jun 28;16:1703-1713. doi:10.2147/CCID.S413853.Arthritis Foundation.Psoriatic Arthritis.Aljohani R.Metabolic Syndrome and Its Components in Psoriatic Arthritis.Open Access Rheumatol. 2022 Feb 17;14:7-16. doi:10.2147/OARRR.S347797.National Psoriasis Foundation.Why treat psoriatic arthritis?Weatherford BM.Rheumatoid arthritis of the foot and ankle. American Academy of Orthopaedic Surgeons.Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E.New insights in physical therapy and rehabilitation in psoriatic arthritis: a review.Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9
National Psoriasis Foundation.Classification of psoriatic arthritis.
National Psoriasis Foundation.Psoriasis statistics.
University of Washington.Ankle arthritis.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic Arthritis Symptoms.
Arthritis Foundation.When foot pain may mean arthritis.
American Academy of Orthopaedic Surgeons.Claw toe.
Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia.2017;55(3):131-135. doi:10.5114/reum.2017.68912
Arthritis Foundation.Bursitis
Liu X, Zhao Y, Mu Z, Jia Y, Liu C, Zhang J,et al.The Combination of IL-6, PLR and Nail Psoriasis: Screen for the Early Diagnosis of Psoriatic Arthritis.Clin Cosmet Investig Dermatol.2023 Jun 28;16:1703-1713. doi:10.2147/CCID.S413853.
Arthritis Foundation.Psoriatic Arthritis.
Aljohani R.Metabolic Syndrome and Its Components in Psoriatic Arthritis.Open Access Rheumatol. 2022 Feb 17;14:7-16. doi:10.2147/OARRR.S347797.
National Psoriasis Foundation.Why treat psoriatic arthritis?
Weatherford BM.Rheumatoid arthritis of the foot and ankle. American Academy of Orthopaedic Surgeons.
Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E.New insights in physical therapy and rehabilitation in psoriatic arthritis: a review.Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9
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