Psoriatic arthritis affects many people who have psoriasis, causing joint pain, stiffness, and swelling. Recognizing early warning signs of psoriatic arthritis and getting treated early can lead to better outcomes. Up to 30% of those with the skin condition may develop psoriatic arthritis. The disease can affect any joint in the body and varies from person to person in severity and progression.
Psoriatic arthritis is an inflammatory condition that occurs when the immune system attacks healthy joints and skin. It often appears in people who have the skin condition psoriasis. Symptoms include mild to severe joint pain, stiffness, and swelling that can affect any part of the body and may come and go in flares.
Psoriatic arthritis primarily affects people with psoriasis, with about 30% developing the condition. People with a family history are at higher risk due to genetics.. Most cases appear between ages 30 and 50, affecting men and women equally.
Other risk factors include:
Psoriatic arthritis differs from other kinds of arthritis affecting joints asymmetrically. Sausage digits, also known as Dactylitis, characterized by swollen fingers or toes, are common. Nail changes like pitting, ridging, and separation from the nail bed frequently occur. Unlike osteoarthritis, which results from wear and tear, psoriatic arthritis is linked to immune system dysfunction and occurs along with skin psoriasis.
Symptoms may come and go at first and be dismissed. The first sign of psoriatic arthritis might be foot pain in the heel or sole, while others experience lower back pain worsening with rest. Fatigue is another common early sign that can occur even before joint symptoms become obvious.
Joint Pain and Stiffness
Joint pain and stiffness in psoriatic arthritis vary from mild to severe affecting joints near the nails in fingers and toes. Pain develops gradually, accompanied by tenderness, warmth, or throbbing sensations. Many patients experience worsened stiffness after inactivity, especially in the morning or following prolonged sitting.
Swelling in Fingers and Toes
Swelling in the fingers and toes is a distinct symptom. Inflammation impacts the entire digit, causing swelling, redness, and warmth. This may make bending or straightening difficult. Dactylitis can be painful and might limit hand or foot function.
Morning Joint Stiffness
Morning stiffness in psoriatic arthritis can last 30 minutes or more, causing resistance in movement and affecting multiple joints. It may affect multiple joints at once, including the back, knees, hands, and feet.
Reduced Range of Motion
Over time, inflammation can restrict joining movement, which can make daily activities challenging. Without treatment, this limitation in movement can worsen and potentially lead to permanent joint damage.
Skin and Nail Changes Linked to Early Psoriatic Arthritis
Skin and nail changes are often the first visible signs of psoriatic arthritis. Psoriatic arthritis skin symptoms can appear before joint symptoms develop and are important warning signals.
Psoriasis Flare-Ups
Psoriasis flare-ups often precede joint symptoms in psoriatic arthritis patients, showing as silver or gray scaly patches on the scalp, elbows, knees, and lower back. Severity varies, with some experiencing only mild skin irritation mistaken for dry skin. Flare-ups can be triggered by stress, illness, or skin injury, and worsening psoriasis may indicate joint inflammation, even if skin symptoms remain mild.
Nail Pitting, Discoloration, and Separation of the Nail From the Nail Bed
Nail changes are common in psoriatic arthritis, often appearing early. Pitting, discoloration, and brittleness affect multiple fingernails more than toenails, signaling inflammation near joints. Nails can develop a yellow-brown color or white spots. In severe cases, onycholysis causes nail separation, increasing infection risk. This condition often affects frequently used fingers and can be painful. In some cases, the nail falls off. Bacteria and fungi can enter, potentially causing infection.
Psoriatic arthritis can develop gradually or suddenly, with joint symptoms appearing about 10 years after psoriasis in 85% of cases, although 15% experience joint issues first. The disease progresses with flare-ups, steady worsening, or temporary remission. While joint pain and skin rashes are commonly recognized signs of psoriatic arthritis, less obvious symptoms can appear early in the disease process, including:
If you experience joint pain, stiffness, or swelling—especially if you have psoriasis—see a doctor promptly. Psoriatic arthritis often develops 5-12 years after psoriasis appears, making early detection important. A dermatologist can assess skin and nail changes, while a rheumatologist specializes in joint symptoms. Psoriatic arthritis can run in families. Regular check-ups help catch the condition early, preventing joint damage and disability.
Psoriatic arthritis develops from a combination of genetic, environmental, and lifestyle factors that trigger the immune system to attack healthy joints and skin. Understanding these can help people recognize their risk level and reduce flare-ups.
During a physical examination, doctors assess joint inflammation, swelling, and tenderness, particularly in fingers and toes, looking for dactylitis. They examine the skin for psoriasis patches, even behind the ears or on the scalp, and check nails for pitting, ridging, or onycholysis, which can indicate underlying joint issues. Range of motion tests help evaluate joint flexibility, while the spine and lower back are checked for stiffness and discomfort. Since no single test confirms psoriatic arthritis, laboratory and imaging tests are used together to establish a diagnosis, including:
Blood tests:
Imaging tests:
Joint fluid analysis may be performed by removing a small sample of fluid from affected joints to rule out other conditions like gout.
Psoriatic arthritis mimics some other conditions, making diagnosis complex. Rheumatoid arthritis lacks skin involvement, osteoarthritis affects weight-bearing joints, and gout causes sudden pain, including in the big toe. Reactive arthritis follows infections, while ankylosing spondylitis has distinct genetic markers and spine-related progression.
Medications are the cornerstone of psoriatic arthritis treatment. Options include:
Physical therapy preserves joint function, while hot and cold therapy eases stiffness and inflammation. Steroid injections may help during severe flares, and regular rheumatology check-ups ensure effective treatment adjustments.
If you’re experiencing unexplained joint pain, swelling, morning stiffness, or nail changes—and especially if you have psoriasis—these are early signs of psoriatic arthritis, and early treatment can make a difference. Portland Wellness Care offers expert guidance for symptom evaluation and early detection. Whether it’s a first flare-up or ongoing discomfort, their medical team provides compassionate care and timely support. Don’t ignore the warning signs. Call Portland Wellness Care or walk in today for an evaluation and peace of mind.
An adjustment from a chiropractor is a non-invasive and affordable way to get a lot of relief from back and neck pain. Find out all the benefits and how chiropractic care improves lower back pain. Learn what not to do, too, for a fully informed decision.
Most people have experienced back pain at some point in their lives. It’s actually the leading cause of disability worldwide and the most common reason people call out of work. Back pain can come in many different forms, ranging from a dull ache that lasts only a few days to severe pain that lasts for weeks. Get the answers and the help you need here to find comfort in life again.
Not only can physiotherapy help neck pain, but it’s also often the most effective treatment. Physiotherapy for neck pain is beneficial since it relieves pain while also identifying and treating the underlying cause of the problem to prevent it from recurring.
Sprains and strains are among the most common ankle injuries, both of which offer discomfort, pain, and the need for crutches or other treatment measures. When the ligaments move too far on an ankle, a sprain injury occurs, and professional attention reduces complications. Treating these conditions is necessary to avoid arthritis, among other issues. Take a look at all the factors you need to consider with a sprained or strained ankle.
Portland Wellness Care
