Topic Overview

What is psoriatic arthritis?

Psoriatic arthritis (say “sor-ee-AT-ik ar-THRY-tus”) is a type of arthritis that sometimes occurs in people who have a skin problem called psoriasis. The arthritis causes joints to become swollen, tender, and painful.

Psoriatic arthritis is an autoimmune disease. That means the body’s own defense (immune) system attacks the joints. An infection or a serious joint injury may trigger the arthritis in people who have psoriasis.

There is no specific test to diagnose psoriatic arthritis. Your doctor may do a physical exam to look for swelling in your joints and changes in your skin and nails. You may also have imaging tests, such as X-rays, and blood tests.

What are the symptoms?

Psoriatic arthritis causes swelling, stiffness, and pain in your joints, such as in the fingers and toes. Other joints can also be affected. Some people may have pain in the back of the heel.

Some people may have problems with their fingernails and toenails. The nails may form pits, change color, and separate from the nail bed.

Symptoms may be mild or severe. Severe arthritis can affect many joints and make it hard to do daily tasks.

Joint symptoms may occur before, at the same time, or after you get skin symptoms from psoriasis. Joint and skin symptoms may come and go over time. The joint symptoms usually improve after skin symptoms improve.

How is it treated?

Treatment can help relieve symptoms and prevent damage to your joints. Treatment includes medicines and physical and occupational therapy.

Take an over-the-counter pain medicine, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), for mild pain. If psoriasis symptoms get worse after you take these medicines, call your doctor right away. For severe arthritis, stronger drugs may be used to help reduce pain and prevent joint damage. These include disease-modifying antirheumatic drugs (called DMARDs), biologics, and a drug known as a PDE4 inhibitor. Steroid injections or pills may also be given to relieve joint pain.

A physical therapist may help you move and stay active, build your strength, learn to manage daily tasks, and reduce pain.

Some people with severe arthritis may need surgery to replace or repair damaged joints.

What can you do at home?

You can do things at home to help protect your joints and ease pain. Try these tips:

• Rest your joints when they are sore or overworked. Ask your doctor or therapist about using braces, splints, or shoe supports to help protect your joints.
• Try to limit or avoid activities that may cause joint pain or swelling. Writing down these triggers may help you keep track of them.
• Try ice or a cold pack on the joint area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. Or try using heat to ease pain.
• Try to reach and stay at a healthy weight. Regular exercise and a healthy diet will help you do this. Extra weight can strain the joints. Losing even a few pounds may help.

Stay active

Keeping an active lifestyle can also help you manage arthritis. Talk to your doctor about exercises that may be safe and helpful for you. These may include:

• Walking.
• Swimming or doing other water exercise.
• Riding a stationary bike.
• Doing yoga or tai chi.

Take care of your skin

Psoriatic arthritis often improves when the skin symptoms of psoriasis get better. So make sure to follow your treatment plan for psoriasis.