Table of ContentsView AllTable of ContentsSymptomsTypesCausesFlare-UpsDiagnosisStagesTreatmentDietComplicationsOutlookNext in Psoriatic Arthritis GuideWhat Does Psoriatic Arthritis Look Like?
Table of ContentsView All
View All
Table of Contents
Symptoms
Types
Causes
Flare-Ups
Diagnosis
Stages
Treatment
Diet
Complications
Outlook
Next in Psoriatic Arthritis Guide
Psoriatic arthritis(PsA) is a progressive inflammatory disease that affects the joints andentheses, the areas where tendons and ligaments attach to bones. PsA occurs because the immune system malfunctions and starts affecting healthy tissues. Many people with PsA also havepsoriasis, an autoimmune skin condition that causes skin cell overgrowth.
There is no cure for PsA, but the condition is treatable, and treatments can slow disease progression, improve pain and other symptoms, and prevent joint damage.
This article covers psoriatic arthritis symptoms, types, causes, flares, treatment, and more.
Jacques Hugo / Getty Images
Psoriatic Arthritis Symptoms
The symptoms of PsA range from mild to severe. PsA primarily affects the peripheral joints (the joints located in the arms and legs), but it can also affect theaxial skeleton, which includes the spine, hips, and shoulders.
Symptoms of PsA can affect the joints, entheses, nails, and skin and may include the following:
Different Types of Arthritis and Pain Characteristics
Psoriatic Arthritis Pictures
Reproduced with permission from ©DermNet NZ www.dermnetnz.org 2022
Reproduced with permission from ©DermNet NZ www.dermnetnz.org 2023
Types of Psoriatic Arthritis
There arefive types of psoriatic arthritis. It is possible to have more than one of the following types:
What Causes Psoriatic Arthritis?
PsA prevalence in the United States ranges from 0.06% to 0.25% of the population.While it has a low prevalence in the general population, it is common among people with psoriasis.
PsA occurs when the immune system malfunctions and attacks healthy tissues. The overactive immune responses cause inflammation of the joints and entheses. It might also cause the overproduction of skin cells.
Genetic and environmental factors in PsA are believed to trigger the immune system’s overactive response.Many people with PsA have a family history of psoriasis or PsA or a personal history of psoriasis.
PsA is also associated with specific genetic markers that, with environmental factors, can cause the disease to develop. Such factors include smoking, certain medications, physical trauma, illness, or infection.
Risk Factors for PsA
Risk factorsthat might increase your risk of developing PsA include:
What Triggers PsA Flare-Ups?
PsA triggerscan vary from person to person. Common triggers include:
How Is Psoriatic Arthritis Diagnosed?
An accurate and timely diagnosis of PsA can help you to avoid joint damage and other disease complications.
No single test can confirm PsA, but your healthcare provider can make a diagnosis based on the following:
Psoriatic Arthritis Differential Diagnosis: Diseases That Mimic PsA
Stages of Psoriatic Arthritis
PsA is a disease that progresses over time. Progression varies from person to person.
Early Stages
Signs and symptoms may differ from what you would see with long-established PsA and will change over time.
In its early stages, PsA causes pain and swelling in a few joints, often on one side of the body. It will cause inflammation of the smaller joints of the hands and feet, usually the fingers and toes. Most people with early PsA will experience nail and skin symptoms, while around 10% will not.
As the disease progresses, you will notice symptoms in larger joints, including the knees. Over time, you may experience dactylitis and enthesitis.
Later Stages
As PsA progresses, it may affect your daily life. You might experience severe fatigue and frequent and painful flares.
Severe PsA can cause permanent damage to bones and joints. Ongoing inflammation, which might be the case for people with severe PsA, can causebone erosion and narrowing joint space.
Living with more severe symptoms of PsA can make working or maintaining a social life harder. These symptoms can also lead to depression, and research shows the prevalence of depression is significantly higher for people with PsA than for the general population.
Psoriatic Arthritis Treatment
PsA is treatedwith a combination of medication, therapies, lifestyle changes, and, as a last result, surgery.
Medication
Different classes of drugs used to treat PsA include:
Therapies
Many people with PsA can benefit from physical and occupational therapies to manage joint symptoms.Your healthcare provider might prescribelight therapyif you experience skin symptoms of the disease.
If you are experiencing depression or anxiety, your healthcare provider might recommendmental health therapyoptions to help you better cope with the effects of PsA.
Surgery
Surgery is a last resort for people with PsA. It is often recommended for people who experience severe pain due to a damaged joint.Surgery aims to improve joint function, reduce pain, and prevent additional joint damage.
Everything You Need to Know About Psoriatic Arthritis Surgery
Lifestyle Changes
As part of your treatment plan, your healthcare provider might recommend lifestyle changes to help you better manage PsA.
Lifestyle changes that might better help manage PsA include:
What to Know About Nicotine Withdrawal
Diet for Psoriatic Arthritis
There is no specific diet for PsA, buteating a healthy and nutritious dietcan help to control inflammation and relieve PsA symptoms.
Some foods might increase inflammation, while others might help reduce it. Foods that cause inflammation might include sugars, fried foods, refined carbs, red meats, and alcohol. Foods that mightreduce inflammationinclude fatty fish, nuts, olive oil, leafy green vegetables, and some fruits.
Complications of Psoriatic Arthritis
If PsA is not adequately treated, it can lead to complications.
Complications and comorbidities linked to PsA include:
Outlook for Psoriatic Arthritis
The outlook for PsA varies from person to person. For some people, PsA causes mild disease and a few flare-ups a year. PsA can be painful for others, leading to disability and severe joint damage.
Fortunately, PsA can be managed with appropriate treatment, and most people with the condition can manage pain and will not experience significant joint damage or disease complications.
Let your healthcare provider know if you have questions or concerns about your outlook. They can advise on ways to improve your outlook and the best ways to manage your disease.
19 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 Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis.Grinnell-MerrickLL, Lydon EJ, Mixon AM, Saalfeld W.Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature.Rheumatol Ther. 2020;7(4):667-684.doi:10.1007/s40744-020-00234-3Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P.The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial.Arthritis Res Ther. 2022;24(1):124. doi:10.1186/s13075-022-02808-8Lai TL, Au CK, Chung HY, Leung MC, Ng WL, Lau CS.Fatigue in psoriatic arthritis: Is it related to disease activity?.Int J Rheum Dis. 2021;24(3):418-425. doi:10.1111/1756-185X.14069Marchesoni A.Oligoarticular psoriatic arthritis: addressing clinical challenges in an intriguing phenotype.Rheumatol Ther. 2018;5(2):311-316. doi:10.1007/s40744-018-0115-5Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J.Psoriatic arthritis.Pol J Radiol. 2013;78(1):7-17. doi:10.12659/PJR.883763Dhir V, Aggarwal A.Psoriatic arthritis: a critical review.Clin Rev Allergy Immunol. 2013 Apr;44(2):141-8. doi:10.1007/s12016-012-8302-6Ogdie A, Weiss P.The epidemiology of psoriatic arthritis.Rheum Dis Clin North Am. 2015;41(4):545-568. doi:10.1016/j.rdc.2015.07.001Meer E, Thrastardottir T, Wang X, et al.Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies.J Rheumatol. 2022;49(1):53-59. doi:10.3899/jrheum.210006National Psoriasis Foundation.About psoriatic arthritis.Belasco J, Wei N.Psoriatic arthritis: what is happening at the joint?Rheumatol Ther.2019;6(3):305-315. doi:10.1007/s40744-019-0159-1Kingston Hospital NHS Foundation Trust.Psoriatic arthritis (PSA) flare self-management.Pennington SR, FitzGerald O.Early origins of psoriatic arthritis: clinical, genetic and molecular biomarkers of progression from psoriasis to psoriatic arthritis.Front Med (Lausanne). 2021;8:723944. doi:10.3389/fmed.2021.723944Mathew AJ, Chandran V.Depression in psoriatic arthritis: dimensional aspects and link with systemic inflammation.Rheumatol Ther. 2020;7(2):287-300. doi:10.1007/s40744-020-00207-6National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis: diagnosis, treatment, and steps to take.NYU Langone Health.Surgery for psoriatic arthritis.Arthritis Foundation.The ultimate arthritis diet.Haddad A and Zisman D.Comorbidities in patients with psoriatic arthritis.Rambam Maimonides Med J. 2017;8(1):e0004. doi:10.5041/RMMJ.10279
19 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 Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis.Grinnell-MerrickLL, Lydon EJ, Mixon AM, Saalfeld W.Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature.Rheumatol Ther. 2020;7(4):667-684.doi:10.1007/s40744-020-00234-3Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P.The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial.Arthritis Res Ther. 2022;24(1):124. doi:10.1186/s13075-022-02808-8Lai TL, Au CK, Chung HY, Leung MC, Ng WL, Lau CS.Fatigue in psoriatic arthritis: Is it related to disease activity?.Int J Rheum Dis. 2021;24(3):418-425. doi:10.1111/1756-185X.14069Marchesoni A.Oligoarticular psoriatic arthritis: addressing clinical challenges in an intriguing phenotype.Rheumatol Ther. 2018;5(2):311-316. doi:10.1007/s40744-018-0115-5Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J.Psoriatic arthritis.Pol J Radiol. 2013;78(1):7-17. doi:10.12659/PJR.883763Dhir V, Aggarwal A.Psoriatic arthritis: a critical review.Clin Rev Allergy Immunol. 2013 Apr;44(2):141-8. doi:10.1007/s12016-012-8302-6Ogdie A, Weiss P.The epidemiology of psoriatic arthritis.Rheum Dis Clin North Am. 2015;41(4):545-568. doi:10.1016/j.rdc.2015.07.001Meer E, Thrastardottir T, Wang X, et al.Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies.J Rheumatol. 2022;49(1):53-59. doi:10.3899/jrheum.210006National Psoriasis Foundation.About psoriatic arthritis.Belasco J, Wei N.Psoriatic arthritis: what is happening at the joint?Rheumatol Ther.2019;6(3):305-315. doi:10.1007/s40744-019-0159-1Kingston Hospital NHS Foundation Trust.Psoriatic arthritis (PSA) flare self-management.Pennington SR, FitzGerald O.Early origins of psoriatic arthritis: clinical, genetic and molecular biomarkers of progression from psoriasis to psoriatic arthritis.Front Med (Lausanne). 2021;8:723944. doi:10.3389/fmed.2021.723944Mathew AJ, Chandran V.Depression in psoriatic arthritis: dimensional aspects and link with systemic inflammation.Rheumatol Ther. 2020;7(2):287-300. doi:10.1007/s40744-020-00207-6National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis: diagnosis, treatment, and steps to take.NYU Langone Health.Surgery for psoriatic arthritis.Arthritis Foundation.The ultimate arthritis diet.Haddad A and Zisman D.Comorbidities in patients with psoriatic arthritis.Rambam Maimonides Med J. 2017;8(1):e0004. doi:10.5041/RMMJ.10279
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 Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis.Grinnell-MerrickLL, Lydon EJ, Mixon AM, Saalfeld W.Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature.Rheumatol Ther. 2020;7(4):667-684.doi:10.1007/s40744-020-00234-3Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P.The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial.Arthritis Res Ther. 2022;24(1):124. doi:10.1186/s13075-022-02808-8Lai TL, Au CK, Chung HY, Leung MC, Ng WL, Lau CS.Fatigue in psoriatic arthritis: Is it related to disease activity?.Int J Rheum Dis. 2021;24(3):418-425. doi:10.1111/1756-185X.14069Marchesoni A.Oligoarticular psoriatic arthritis: addressing clinical challenges in an intriguing phenotype.Rheumatol Ther. 2018;5(2):311-316. doi:10.1007/s40744-018-0115-5Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J.Psoriatic arthritis.Pol J Radiol. 2013;78(1):7-17. doi:10.12659/PJR.883763Dhir V, Aggarwal A.Psoriatic arthritis: a critical review.Clin Rev Allergy Immunol. 2013 Apr;44(2):141-8. doi:10.1007/s12016-012-8302-6Ogdie A, Weiss P.The epidemiology of psoriatic arthritis.Rheum Dis Clin North Am. 2015;41(4):545-568. doi:10.1016/j.rdc.2015.07.001Meer E, Thrastardottir T, Wang X, et al.Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies.J Rheumatol. 2022;49(1):53-59. doi:10.3899/jrheum.210006National Psoriasis Foundation.About psoriatic arthritis.Belasco J, Wei N.Psoriatic arthritis: what is happening at the joint?Rheumatol Ther.2019;6(3):305-315. doi:10.1007/s40744-019-0159-1Kingston Hospital NHS Foundation Trust.Psoriatic arthritis (PSA) flare self-management.Pennington SR, FitzGerald O.Early origins of psoriatic arthritis: clinical, genetic and molecular biomarkers of progression from psoriasis to psoriatic arthritis.Front Med (Lausanne). 2021;8:723944. doi:10.3389/fmed.2021.723944Mathew AJ, Chandran V.Depression in psoriatic arthritis: dimensional aspects and link with systemic inflammation.Rheumatol Ther. 2020;7(2):287-300. doi:10.1007/s40744-020-00207-6National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis: diagnosis, treatment, and steps to take.NYU Langone Health.Surgery for psoriatic arthritis.Arthritis Foundation.The ultimate arthritis diet.Haddad A and Zisman D.Comorbidities in patients with psoriatic arthritis.Rambam Maimonides Med J. 2017;8(1):e0004. doi:10.5041/RMMJ.10279
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis.
Grinnell-MerrickLL, Lydon EJ, Mixon AM, Saalfeld W.Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature.Rheumatol Ther. 2020;7(4):667-684.doi:10.1007/s40744-020-00234-3
Sobolewski P, Walecka I, Dopytalska K.Nail involvement in psoriatic arthritis.Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912
Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P.The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial.Arthritis Res Ther. 2022;24(1):124. doi:10.1186/s13075-022-02808-8
Lai TL, Au CK, Chung HY, Leung MC, Ng WL, Lau CS.Fatigue in psoriatic arthritis: Is it related to disease activity?.Int J Rheum Dis. 2021;24(3):418-425. doi:10.1111/1756-185X.14069
Marchesoni A.Oligoarticular psoriatic arthritis: addressing clinical challenges in an intriguing phenotype.Rheumatol Ther. 2018;5(2):311-316. doi:10.1007/s40744-018-0115-5
Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J.Psoriatic arthritis.Pol J Radiol. 2013;78(1):7-17. doi:10.12659/PJR.883763
Dhir V, Aggarwal A.Psoriatic arthritis: a critical review.Clin Rev Allergy Immunol. 2013 Apr;44(2):141-8. doi:10.1007/s12016-012-8302-6
Ogdie A, Weiss P.The epidemiology of psoriatic arthritis.Rheum Dis Clin North Am. 2015;41(4):545-568. doi:10.1016/j.rdc.2015.07.001
Meer E, Thrastardottir T, Wang X, et al.Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies.J Rheumatol. 2022;49(1):53-59. doi:10.3899/jrheum.210006
National Psoriasis Foundation.About psoriatic arthritis.
Belasco J, Wei N.Psoriatic arthritis: what is happening at the joint?Rheumatol Ther.2019;6(3):305-315. doi:10.1007/s40744-019-0159-1
Kingston Hospital NHS Foundation Trust.Psoriatic arthritis (PSA) flare self-management.
Pennington SR, FitzGerald O.Early origins of psoriatic arthritis: clinical, genetic and molecular biomarkers of progression from psoriasis to psoriatic arthritis.Front Med (Lausanne). 2021;8:723944. doi:10.3389/fmed.2021.723944
Mathew AJ, Chandran V.Depression in psoriatic arthritis: dimensional aspects and link with systemic inflammation.Rheumatol Ther. 2020;7(2):287-300. doi:10.1007/s40744-020-00207-6
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Psoriatic arthritis: diagnosis, treatment, and steps to take.
NYU Langone Health.Surgery for psoriatic arthritis.
Arthritis Foundation.The ultimate arthritis diet.
Haddad A and Zisman D.Comorbidities in patients with psoriatic arthritis.Rambam Maimonides Med J. 2017;8(1):e0004. doi:10.5041/RMMJ.10279
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