The signs of psoriatic arthritis (PsA) can sneak up on you — maybe hand stiffness is suddenly making it difficult to open jars. Or maybe your feet seem to have become more tender than usual. Maybe it takes you a long time to get out of bed in the morning, because you feel stiff and sore.
Affecting almost one in three people with psoriasis, PsA can cause joint pain ranging from mild to severe. As it turns out, the same miscommunication between cells that can cause skin to form plaques can also affect your joint cells.
It’s important to be alert to the signs of PsA, since the earlier you get treatment, the better you can protect your joints from permanent damage.
When does it strike?
“Psoriatic arthritis can be more difficult to diagnose than psoriasis,” says M. Elaine Husni, MD, vice chair of rheumatology at the Cleveland Clinic. “It usually occurs years after the diagnosis of psoriasis — up to 10 years — sometimes with subtle findings of only one or two joints affected.” And, in some cases, the joint problems begin before skin lesions appear.
What to watch for
Symptoms of PsA typically include joint pain, as well as:
- Sausage-like swelling of fingers and toes. Only one finger or toe may be swollen. If you have pitted or thickened fingernails, the joints at the fingertips are often affected.
- Foot pain at the points where tendons and ligaments attach to bones — especially at the back of your heel or in the sole.
- Back pain. Some people develop spondylitis, a condition that causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis.
- Morning stiffness. Pain that is worse after waking up and lessens after walking and using your joints for a bit.
Know your treatment options
Current medications can treat the pain. Some can also help slow or prevent joint damage.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can lessen pain, swelling and stiffness, but cannot slow joint destruction.
- Disease-modifying antirheumatic drugs (DMARDs) include nonbiologics and biologics. They can relieve pain and stiffness and also stop RA progression by interrupting immune system signals that trigger inflammation and joint damage. These medications can be used alone or in combination therapy, especially with biologics. “These therapies help reset the immune system. In fact, they’ve helped many people achieve remission,” says Dr. Husni.