Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
Psoriatic spondylitis (also called axial disease) is a type ofpsoriatic arthritis(PsA) in which inflammation affects the spine and causes movement problems in the neck, low back, pelvis, andsacroiliac (SI) joints. Psoriatic spondylitis may also cause joint pain in the arms, legs, hands, and feet.
Research published inClinical and Experimental Rheumatologyfound that up to 40% of people with PsA have spine involvement.
Psoriatic spondylitis is often asymmetrical, meaning it affects only one side of the body. Spine involvement causes inflammatory low back pain and the inflammation can be seen on imaging studies, includingmagnetic resonance imaging (MRI)and X-ray.
Symptoms of psoriatic spondylitis may include:
The Signs and Symptoms of Psoriatic Arthritis
There are other genes associated with PsA, but HLA-B27 is the highest predictor of this condition, according to a 2016 study in theAnnals of Rheumatic Diseases.But not everyone with this gene will develop PsA.
Other risk factors include:
A diagnosis of psoriatic spondylitis starts with a physical examination and a review of your medical history. The doctor may request X-rays or an MRI of the spine. X-rays generally look for abnormalities of the spine and sacroiliac joints. An MRI (magnetic resonance imaging) can offer a closer look at the joints.
Bloodwork can determine if someone carries the HLA-B27 gene. The presence of this gene, along with imaging and symptoms, generally confirms a diagnosis.
It is important to note that no blood or imaging tests can definitivelydiagnose psoriatic arthritis. The diagnosis requires clinical expertise and the exclusion of all other possible causes of the symptoms.
Other medical conditions that mimic psoriatic arthritis includeosteoarthritis,gout,rheumatoid arthritis, andreactive arthritis.It is vital that a differential diagnosis is conducted to ensure that the correct treatment is used.
Minor pain, stiffness, and other symptoms of psoriatic spondylitis can be managed withnonsteroidal anti-inflammatory drugs (NSAIDs). These include over-the-counter NSAIDs like Advil (ibuprofen) and Aleve (naproxen), and prescription NSAIDs like Celebrex (celecoxib).
For moderate to severe disease, treatment is aimed at alleviating inflammation and pain, preventing joint deformity, and halting disease progression. This includes using disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate or biologic drugs like Cosentyx (secukinumab).
Other biologics include tumor necrosis factor (TNF) inhibitors like Humira (adalimumab) and Enbrel (etanercept), which block the substance that instigates the inflammatory response.
Physical and occupational therapy are also recommended to protect joints and maintain the optimal range of motion. Lifestyle changes can also help, including:
DIP Psoriatic Arthritis (DIP PsA) Symptoms and Treatment
A Word From Verywell
Living with psoriatic spondylitis can be stressful, so it is important to take the steps needed to manage your symptoms and maintain a good quality of life. By being proactive, you may be able to slow disease progression and avoid treatments that are typically more difficult to manage.
Frequently Asked QuestionsPsA can affect the skin, eyes, heart, lungs, digestive system, liver, and kidneys. Not everyone with PsA will see multiple organs affected.Yes, it is possible to have both. Many people with autoimmune disease have more than one type.What’s more, as recently as 2018, researchers have questioned whether ankylosing spondylitis and psoriatic arthritis are the same disease with different appearances in different people.
PsA can affect the skin, eyes, heart, lungs, digestive system, liver, and kidneys. Not everyone with PsA will see multiple organs affected.
Yes, it is possible to have both. Many people with autoimmune disease have more than one type.What’s more, as recently as 2018, researchers have questioned whether ankylosing spondylitis and psoriatic arthritis are the same disease with different appearances in different people.
Yes, it is possible to have both. Many people with autoimmune disease have more than one type.
What’s more, as recently as 2018, researchers have questioned whether ankylosing spondylitis and psoriatic arthritis are the same disease with different appearances in different people.
12 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.Baraliakos X, Coates L, Braun J.The involvement of the spine in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S31-5.The Arthritis Foundation.Psoriatic arthritis.Rheumatology Network.Psoriatic spondyloarthritis burden is similar to ankylosing spondylitis.Jadon D, Sengupta R, Nightingale A, et al.Axial disease in psoriatic arthritis study: Defining the clinical and radiographic phenotype of psoriatic spondyloarthritis.Ann Rheum Dis. 2016;76(4):701-707. doi:10.1136/annrheumdis-2016-209853Ogdie A, Gelfand JM.Clinical risk factors for the development of psoriatic arthritis among patients with psoriasis: A review of available evidence.Curr Rheumatol Rep. 2015;17(10):64. doi:10.1007/s11926-015-0540-1Queiro R, Morante I, Cabezas I, Acasuso B.HLA-B27 and psoriatic disease: A modern view of an old relationship.Rheumatology. 2016;55(2):221-229. doi:10.1093/rheumatology/kev296Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “Psout”.Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Saalfeld W, Mixon AM, Zelie J, Lydon EJ.Differentiating psoriatic arthritis from osteoarthritis and rheumatoid arthritis: A narrative review and guide for advanced practice providers.Rheumatol Ther. 2021;8(4):1493-1517. doi:10.1007/s40744-021-00365-1Arthritis Foundation.Treatment options for psoriatic arthritis.New York University Langone Health.Lifestyle changes for psoriatic arthritis.Arthritis Foundation.Beyond joints: How psoriatic arthritis affects the body.Feld J, Chandran V, Haroon N, Inman R, Gladman D.Axial disease in psoriatic arthritis and ankylosing spondylitis: A critical comparison.Nat Rev Rheumatol. 2018;14(6):363-371. doi:10.1038/s41584-018-0006-8Additional ReadingLaiho K, Kauppi M.The cervical spine in patients with psoriatic arthritis.Ann Rheum Dis. 2002;61(7):650-652. doi:10.1136/ard.61.7.650Mortezavi M, Thiele R, Ritchlin C.The joint in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S20-S25.Proft F, Poddubnyy D.Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria.Ther Adv Musculoskelet Dis. 2018;10(5-6):129-139. doi:10.1177/1759720X18773726Snekvik I, Smith CH, Nilsen TIL, et al.Obesity, waist circumference, weight change, and risk of incident psoriasis: Prospective data from the HUNT Study.J Invest Dermatol. 2017;137(12):2484-2490. doi:10.1016/j.jid.2017.07.822
12 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.Baraliakos X, Coates L, Braun J.The involvement of the spine in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S31-5.The Arthritis Foundation.Psoriatic arthritis.Rheumatology Network.Psoriatic spondyloarthritis burden is similar to ankylosing spondylitis.Jadon D, Sengupta R, Nightingale A, et al.Axial disease in psoriatic arthritis study: Defining the clinical and radiographic phenotype of psoriatic spondyloarthritis.Ann Rheum Dis. 2016;76(4):701-707. doi:10.1136/annrheumdis-2016-209853Ogdie A, Gelfand JM.Clinical risk factors for the development of psoriatic arthritis among patients with psoriasis: A review of available evidence.Curr Rheumatol Rep. 2015;17(10):64. doi:10.1007/s11926-015-0540-1Queiro R, Morante I, Cabezas I, Acasuso B.HLA-B27 and psoriatic disease: A modern view of an old relationship.Rheumatology. 2016;55(2):221-229. doi:10.1093/rheumatology/kev296Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “Psout”.Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Saalfeld W, Mixon AM, Zelie J, Lydon EJ.Differentiating psoriatic arthritis from osteoarthritis and rheumatoid arthritis: A narrative review and guide for advanced practice providers.Rheumatol Ther. 2021;8(4):1493-1517. doi:10.1007/s40744-021-00365-1Arthritis Foundation.Treatment options for psoriatic arthritis.New York University Langone Health.Lifestyle changes for psoriatic arthritis.Arthritis Foundation.Beyond joints: How psoriatic arthritis affects the body.Feld J, Chandran V, Haroon N, Inman R, Gladman D.Axial disease in psoriatic arthritis and ankylosing spondylitis: A critical comparison.Nat Rev Rheumatol. 2018;14(6):363-371. doi:10.1038/s41584-018-0006-8Additional ReadingLaiho K, Kauppi M.The cervical spine in patients with psoriatic arthritis.Ann Rheum Dis. 2002;61(7):650-652. doi:10.1136/ard.61.7.650Mortezavi M, Thiele R, Ritchlin C.The joint in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S20-S25.Proft F, Poddubnyy D.Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria.Ther Adv Musculoskelet Dis. 2018;10(5-6):129-139. doi:10.1177/1759720X18773726Snekvik I, Smith CH, Nilsen TIL, et al.Obesity, waist circumference, weight change, and risk of incident psoriasis: Prospective data from the HUNT Study.J Invest Dermatol. 2017;137(12):2484-2490. doi:10.1016/j.jid.2017.07.822
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.
Baraliakos X, Coates L, Braun J.The involvement of the spine in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S31-5.The Arthritis Foundation.Psoriatic arthritis.Rheumatology Network.Psoriatic spondyloarthritis burden is similar to ankylosing spondylitis.Jadon D, Sengupta R, Nightingale A, et al.Axial disease in psoriatic arthritis study: Defining the clinical and radiographic phenotype of psoriatic spondyloarthritis.Ann Rheum Dis. 2016;76(4):701-707. doi:10.1136/annrheumdis-2016-209853Ogdie A, Gelfand JM.Clinical risk factors for the development of psoriatic arthritis among patients with psoriasis: A review of available evidence.Curr Rheumatol Rep. 2015;17(10):64. doi:10.1007/s11926-015-0540-1Queiro R, Morante I, Cabezas I, Acasuso B.HLA-B27 and psoriatic disease: A modern view of an old relationship.Rheumatology. 2016;55(2):221-229. doi:10.1093/rheumatology/kev296Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “Psout”.Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0Saalfeld W, Mixon AM, Zelie J, Lydon EJ.Differentiating psoriatic arthritis from osteoarthritis and rheumatoid arthritis: A narrative review and guide for advanced practice providers.Rheumatol Ther. 2021;8(4):1493-1517. doi:10.1007/s40744-021-00365-1Arthritis Foundation.Treatment options for psoriatic arthritis.New York University Langone Health.Lifestyle changes for psoriatic arthritis.Arthritis Foundation.Beyond joints: How psoriatic arthritis affects the body.Feld J, Chandran V, Haroon N, Inman R, Gladman D.Axial disease in psoriatic arthritis and ankylosing spondylitis: A critical comparison.Nat Rev Rheumatol. 2018;14(6):363-371. doi:10.1038/s41584-018-0006-8
Baraliakos X, Coates L, Braun J.The involvement of the spine in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S31-5.
The Arthritis Foundation.Psoriatic arthritis.
Rheumatology Network.Psoriatic spondyloarthritis burden is similar to ankylosing spondylitis.
Jadon D, Sengupta R, Nightingale A, et al.Axial disease in psoriatic arthritis study: Defining the clinical and radiographic phenotype of psoriatic spondyloarthritis.Ann Rheum Dis. 2016;76(4):701-707. doi:10.1136/annrheumdis-2016-209853
Ogdie A, Gelfand JM.Clinical risk factors for the development of psoriatic arthritis among patients with psoriasis: A review of available evidence.Curr Rheumatol Rep. 2015;17(10):64. doi:10.1007/s11926-015-0540-1
Queiro R, Morante I, Cabezas I, Acasuso B.HLA-B27 and psoriatic disease: A modern view of an old relationship.Rheumatology. 2016;55(2):221-229. doi:10.1093/rheumatology/kev296
Felten R, Duret PM, Gottenberg JE, Spielmann L, Messer L.At the crossroads of gout and psoriatic arthritis: “Psout”.Clin Rheumatol. 2020;39(5):1405-1413. doi:10.1007/s10067-020-04981-0
Saalfeld W, Mixon AM, Zelie J, Lydon EJ.Differentiating psoriatic arthritis from osteoarthritis and rheumatoid arthritis: A narrative review and guide for advanced practice providers.Rheumatol Ther. 2021;8(4):1493-1517. doi:10.1007/s40744-021-00365-1
Arthritis Foundation.Treatment options for psoriatic arthritis.
New York University Langone Health.Lifestyle changes for psoriatic arthritis.
Arthritis Foundation.Beyond joints: How psoriatic arthritis affects the body.
Feld J, Chandran V, Haroon N, Inman R, Gladman D.Axial disease in psoriatic arthritis and ankylosing spondylitis: A critical comparison.Nat Rev Rheumatol. 2018;14(6):363-371. doi:10.1038/s41584-018-0006-8
Laiho K, Kauppi M.The cervical spine in patients with psoriatic arthritis.Ann Rheum Dis. 2002;61(7):650-652. doi:10.1136/ard.61.7.650Mortezavi M, Thiele R, Ritchlin C.The joint in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S20-S25.Proft F, Poddubnyy D.Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria.Ther Adv Musculoskelet Dis. 2018;10(5-6):129-139. doi:10.1177/1759720X18773726Snekvik I, Smith CH, Nilsen TIL, et al.Obesity, waist circumference, weight change, and risk of incident psoriasis: Prospective data from the HUNT Study.J Invest Dermatol. 2017;137(12):2484-2490. doi:10.1016/j.jid.2017.07.822
Laiho K, Kauppi M.The cervical spine in patients with psoriatic arthritis.Ann Rheum Dis. 2002;61(7):650-652. doi:10.1136/ard.61.7.650
Mortezavi M, Thiele R, Ritchlin C.The joint in psoriatic arthritis.Clin Exp Rheumatol. 2015;33(5 Suppl 93):S20-S25.
Proft F, Poddubnyy D.Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new classification criteria.Ther Adv Musculoskelet Dis. 2018;10(5-6):129-139. doi:10.1177/1759720X18773726
Snekvik I, Smith CH, Nilsen TIL, et al.Obesity, waist circumference, weight change, and risk of incident psoriasis: Prospective data from the HUNT Study.J Invest Dermatol. 2017;137(12):2484-2490. doi:10.1016/j.jid.2017.07.822
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