Psoriatic arthritis (often shortened to PsA) is a chronic condition that affects your joints and skin. It is linked to psoriasis, a skin disease that causes red, scaly patches. While not everyone with psoriasis gets psoriatic arthritis, about one in three people with psoriasis will eventually develop it. PsA can cause swelling, stiffness, and joint pain that can affect everyday life, especially if left untreated.
This article explains in simple terms what PsA is, what causes it, the different types, symptoms to look out for, how it’s diagnosed, and what treatments are available to help manage the condition.
What Psoriatic Arthritis Is
Psoriatic arthritis is an autoimmune disease. This means your immune system, which normally protects your body, mistakenly attacks healthy tissue—in this case, your joints and sometimes the skin. PsA can affect any joint in the body and usually appears between the ages of 30 and 50, but it can develop at any age. Some people develop psoriasis first, and joint symptoms follow years later. Others may have joint pain before skin problems show up.
It’s a long-term condition that may come and go in flare-ups. Some people have mild symptoms, while others have more severe joint damage over time. Early diagnosis and treatment are important to reduce long-term problems and keep symptoms under control.
Causes and Types of Psoriatic Arthritis
Doctors aren’t completely sure what causes psoriatic arthritis, but it likely develops from a mix of genetic, immune, and environmental factors. If you have a close family member with psoriasis or PsA, your chances of developing it are higher. Certain infections, stress, or injuries may also trigger the disease in people who are already at risk.
There are several types of PsA, based on which joints are affected:
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Symmetric PsA: Affects joints on both sides of the body, similar to rheumatoid arthritis.
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Asymmetric PsA: Affects joints on one side of the body or a few joints at a time.
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Distal interphalangeal predominant PsA: Mainly affects the small joints in the fingers and toes.
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Spondylitis: Affects the spine and causes stiffness in the neck, back, and hips.
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Arthritis mutilans: A rare but severe form that causes joint damage and deformity, especially in the hands and feet.
Each type can vary in how it affects people. Some have mostly joint pain, while others deal more with swelling or stiffness.
Symptoms to Watch For
Psoriatic arthritis can look different from person to person, but there are some common symptoms to keep an eye on:
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Joint pain, swelling, or stiffness (especially in the morning or after rest)
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Swollen fingers or toes (sometimes called “sausage digits”)
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Pain in the heel or sole of the foot
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Lower back pain or stiffness
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Fatigue or feeling tired all the time
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Changes in nails, such as pitting, crumbling, or separation from the nail bed
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Red, scaly skin patches, usually on the elbows, knees, or scalp
Symptoms can come and go, with times of flare-ups and periods where things feel more normal. If you already have psoriasis and begin to notice joint pain or stiffness, it’s important to talk to a doctor.
How Doctors Diagnose Psoriatic Arthritis
There’s no single test to confirm psoriatic arthritis, so diagnosis usually involves several steps. Your doctor will ask about your symptoms, medical history, and any family history of psoriasis or arthritis. They’ll also examine your joints for swelling, tenderness, or stiffness.
Tests that may be used include:
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Blood tests to rule out other types of arthritis and check for signs of inflammation
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X-rays or MRI scans to look for joint damage or swelling
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Ultrasound to help detect inflammation in the joints and tendons
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Skin or nail exams to look for signs of psoriasis
Because PsA can be confused with other joint conditions like rheumatoid arthritis or gout, seeing a specialist (called a rheumatologist) is often helpful.
Treatment Options for Psoriatic Arthritis
While there’s no cure for PsA, many treatments can help control symptoms and stop the disease from getting worse. The goal is to reduce inflammation, relieve pain, and protect your joints.
Here are some of the most common treatments:
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Nonsteroidal anti-inflammatory drugs (NSAIDs): Help reduce pain and swelling. These are often the first medicines used.
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Disease-modifying antirheumatic drugs (DMARDs): These drugs, like methotrexate, can slow the disease and help prevent joint damage.
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Biologics: These are advanced medications that target specific parts of the immune system. They are often used when other treatments aren’t enough.
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Corticosteroids: These are powerful anti-inflammatory drugs used short-term for flares.
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Topical treatments: For people with active psoriasis, creams or shampoos may be used to ease skin symptoms.
In addition to medication, physical therapy can help you stay active and protect your joints. Exercise, especially low-impact activities like swimming or walking, can improve mobility and reduce stiffness. A healthy diet, good sleep habits, and stress management can also help with overall well-being.
Living With Psoriatic Arthritis
Living with PsA can be challenging, but many people manage it well with the right treatment and support. Catching it early and starting treatment can make a big difference in long-term health and comfort.
It’s important to stay in regular contact with your doctor and track your symptoms. Keeping a journal or using a phone app to monitor pain levels, fatigue, or flare-ups can help guide your care.
Building a support system—whether it’s family, friends, or others living with PsA—can also make life with this condition easier to manage. You’re not alone, and with good care, many people with psoriatic arthritis continue to live full, active lives.
