If you have psoriasis -- a long-term skin condition that creates thick patches of itchy, red, white, or silvery skin -- you could get psoriatic arthritis. With psoriasis, your body's immune system goes into overdrive, causing inflammation of your skin. With psoriatic arthritis, it also attacks your joints, making them inflamed and stiff. Getting diagnosed early can help you prevent or limit joint damage.
Who Gets Psoriatic Arthritis?
Most people who get psoriatic arthritis -- about 85% -- have psoriasis first, usually for about 10 years before joint pains start. But not everyone with psoriasis gets psoriatic arthritis. About 15% have psoriatic arthritis without having any history of psoriasis. If you have psoriasis and you notice joint pain, see a doctor who specializes in arthritis for a diagnosis.
What Causes Psoriatic Arthritis?
The causes of psoriatic arthritis aren't exactly known. It's most likely passed on in families. About 40% of people who have psoriatic arthritis have a close relative with psoriasis or arthritis. Infections like strep throat also have been linked to psoriasis.
Psoriatic Arthritis Warning Signs
Most likely, you'll have stiff, painful joints with redness or swelling. Puffy, sausage-like fingers or toes are common. Your symptoms may be sudden and severe or mild and come on slowly. You could feel pain and tenderness in the same or different joints on each side of your body.
You may also have:
Little pits in your nails or a nail that separates from the nail bed
Eye redness and pain
Other Signs: Heel and Back Pain
One form of psoriatic arthritis can inflame the joints in your spine. It's called spondylitis and it causes back or neck pain. Another form causes pain, tenderness, or swelling where tendons attach to your bones, like in your heel. It can also affect your hands, knees, hips, or chest.
Get Diagnosed Early
An arthritis specialist (rheumatologist) can diagnose psoriatic arthritis and treat it early to slow the disease and limit damage to your joints. She will examine your joints and skin, looking for swelling, pain, and nail changes. Your doctor may also order X-rays, MRIs, ultrasounds, or CT scans to check for joint damage. Blood, joint fluid, or skin samples can rule out other forms of arthritis.
How Psoriatic Arthritis Is Treated
Getting treated for psoriatic arthritis can relieve your pain and keep you moving. If it's mild, you may need only an anti-inflammatory medication like ibuprofen or naproxen when your joints are sore. Corticosteroid injections can also ease joint inflammation and swelling.
Disease-modifying antirheumatic drugs (DMARDs) relieve more severe symptoms. They also slow or stop psoriatic arthritis from getting worse or damaging your joints.
Treatment With Biologic Therapy
Biologics are some of the newer drugs used to treat psoriatic arthritis. Your doctor may prescribe one for you if other drugs aren't working well enough. Biologics target immune cells that cause psoriasis and psoriatic arthritis. They can slow down damage to your joints as well as ease symptoms of psoriatic arthritis.
Living Well: Exercise
Exercise reduces psoriatic arthritis pain. Moving and stretching keep your joints and tendons loose and limber. Resistance exercise builds strong muscles to help support your joints. Swimming and walking in a pool are good no-impact cardio workouts that also build strength and flexibility. If you're not sure how to get moving, a physical therapist can help.
Living Well: Fatigue
You may get tired if you have psoriatic arthritis. Pain medication helps. Other ways to beat fatigue:
Try getting up later in the morning or taking an afternoon nap.
Save your energy for activities that are most important or that you enjoy most.
Ask family or friends to help.
Exercise regularly to boost your energy and sleep better at night.
Living Well: Pain
Try heat and cold therapy to relieve pain. Soak in a bath, take a shower, or use a hot pack to relax your aching muscles and relieve soreness. Apply a bag of ice or frozen vegetables wrapped in a towel to numb a joint and reduce swelling.
About one-third of people with psoriatic arthritis have a mild form of the disease that stays stable over time. Others need long-term treatment for more severe symptoms. Treatment has come a long way, and even severe psoriatic arthritis doesn't have to be disabling. Pro golfer Phil Mickelson (a spokesman for the drug Enbrel) credits an early diagnosis and good treatment to helping him overcome near-crippling pain and stay in the game.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.