Psoriatic arthritis is a type of inflammatory arthritis that affects some people with psoriasis, a chronic skin condition that causes red, scaly patches. As well as causing joint pain, stiffness, swelling, and damage, psoriatic arthritis can affect the skin and nails. Despite the fact that psoriatic arthritis can affect any joint in the body, it is most common in the fingers, toes, wrists, ankles, knees, and lower back. Eyes, tendons, ligaments, and the spine can also be affected by psoriatic arthritis.
As far as the cause of psoriatic arthritis is known, it is believed to be caused by a combination of genetic and environmental factors. An autoimmune disease, psoriatic arthritis is caused by the immune system mistakenly attacking healthy cells and tissues in the body. The following factors may trigger or worsen psoriatic arthritis:
Having psoriasis, especially if it is severe or involves the nails
Having a family history of psoriasis or psoriatic arthritis
Having certain genes that are associated with psoriatic arthritis
Having a history of physical trauma or infection that may activate the immune system
Being overweight or obese, which can put extra stress on the joints
Smoking, drinking alcohol, or having a poor diet, which can affect the immune system and inflammation
The symptoms of psoriatic arthritis can vary from person to person, and they may change over time. Some of the common symptoms of psoriatic arthritis include:
Painful, swollen, and stiff joints, especially in the morning or after rest
Reduced range of motion and function in the affected joints
Red, scaly, and itchy skin patches, usually on the elbows, knees, scalp, and lower back
Nail changes, such as pitting, thickening, lifting, or crumbling of the nails
Fatigue, low energy, and poor sleep quality
Eye problems, such as redness, pain, dryness, or blurred vision
Tendon or ligament problems, such as inflammation of the Achilles tendon or the plantar fascia
Enthesitis, which is inflammation of the places where tendons or ligaments attach to the bones, such as the heel, elbow, or ribs
Dactylitis, which is swelling of the entire finger or toe, giving it a sausage-like appearance
There is no specific test that can diagnose psoriatic arthritis, but a doctor can use a combination of methods to rule out other conditions and confirm the diagnosis. Some of the methods that a doctor may use include:
Medical history and physical examination, to check for signs and symptoms of psoriatic arthritis, such as joint swelling, skin lesions, and nail changes
Blood tests, to measure the levels of inflammation, antibodies, and other markers that may indicate psoriatic arthritis or other types of arthritis, such as rheumatoid arthritis or gout
Joint fluid analysis, to collect and examine a sample of fluid from an affected joint, to look for signs of infection or crystals that may cause gout
X-rays, to look for changes in the bones and joints, such as erosion, narrowing, or fusion
MRI, to obtain detailed images of the soft tissues, such as the tendons, ligaments, and cartilage, and to detect early signs of joint damage
Ultrasound, to visualize the inflammation and blood flow in the joints and tendons
There is no cure for psoriatic arthritis, but treatment can help control the symptoms, prevent joint damage, and improve the quality of life. Treatment options for psoriatic arthritis include:
Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic drugs, corticosteroids, and pain relievers, to reduce inflammation, pain, and swelling, and to slow down the progression of the disease
Physical therapy, to improve the strength, flexibility, and function of the affected joints, and to prevent stiffness and deformity
Occupational therapy, to help with daily activities, such as dressing, bathing, and working, and to provide adaptive devices, such as splints, braces, or shoe inserts, to protect and support the joints
Surgery, to repair or replace severely damaged joints, such as the hip, knee, or elbow, or to correct deformities, such as clawed toes or hammer fingers
Alternative therapies, such as acupuncture, massage, yoga, or tai chi, to relieve stress, pain, and inflammation, and to promote relaxation and well-being
There is no way to prevent psoriatic arthritis, but there are some steps that can help reduce the risk of developing or worsening the condition, such as:
Treating psoriasis promptly and effectively, to prevent or delay the onset of psoriatic arthritis
Maintaining a healthy weight, to reduce the pressure and stress on the joints
Eating a balanced diet, rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, to provide the nutrients and antioxidants that can support the immune system and fight inflammation
Avoiding or limiting alcohol, tobacco, and caffeine, which can trigger or aggravate psoriasis and psoriatic arthritis
Exercising regularly, to improve the blood circulation, muscle strength, joint mobility, and mood, and to prevent stiffness and pain
Protecting the skin and joints from injury, infection, or irritation, by wearing sunscreen, moisturizing the skin, avoiding harsh chemicals, and using gloves or pads when needed
Getting enough sleep, to allow the body to rest and heal, and to prevent fatigue and depression
Seeing a doctor regularly, to monitor the condition, adjust the treatment, and prevent complications