Psoriatic Arthritis: Understanding The Condition, Symptoms & Treatment
September 15, 2025
If you or someone you know has psoriasis, it's important to realize they could have a greater chance of developing psoriatic arthritis (PsA), an inflammatory joint condition. Psoriatic arthritis affects 1.5 million people in the U.S. and can cause joint discomfort, edema and stiffness.
"When a person has inflammation of the joints, it is commonly caused by arthritis," said Gina Saylor, ANP-BC, at Franciscan Physician Network Rheumatology and Osteoporosis Specialists in Franklin, Indiana.
Key Takeaways: Psoriatic Arthritis
- Psoriatic arthritis (PsA) is an inflammatory joint condition. It affects people with psoriasis and is caused by an overactive immune system that leads to inflammation in the joints.
- Symptoms vary but can include joint swelling. Signs of PsA include joint pain and stiffness, with a common symptom being "sausage digit," which is the swelling of an entire finger or toe.
- Psoriatic arthritis is manageable with treatment. While there is no cure, treatment options like medication, exercise, and a healthy lifestyle can help manage symptoms and slow the disease's progression.
What Is Psoriatic Arthritis?
Psoriatic arthritis is different from other types of arthritis. Psoriatic arthritis is associated with psoriasis, a skin condition that shows up as red, scaly areas on the skin. More than 8 million people in the U.S. have psoriasis, and of those about 30% also develop psoriatic arthritis, according to the National Psoriasis Foundation.
Psoriatic arthritis occurs when the immune system becomes overactive, causing inflammation in the joints.
"PsA is an autoimmune disease. The abnormal inflammation can lead to problems with bone erosion and joint inflammation," said Saylor. "While PsA affects the joints and connective tissue, psoriasis affects only the skin."
Who Is At Risk For Psoriatic Arthritis?
Psoriatic arthritis can affect anyone, but some factors can put a person at greater risk for psoriatic arthritis.
Age
"It can develop at any age, even in children," said Saylor. But the most common age PsA develops is between 30 and 50. "It doesn't always occur, but most times, about 30% of patients with psoriasis can develop psoriatic arthritis," said Saylor.
Genetics and family history
There is evidence that genetics can contribute to psoriatic arthritis development, too. According to studies, common genes are more prevalent in patients with psoriatic arthritis, making them more susceptible to the condition.
"If you have a first-degree family relative with the gene, there's a 40% chance you could develop psoriatic arthritis," said Saylor. However, not everyone with the genes will develop psoriatic arthritis.
Other risk factors
The American College of Rheumatology says other risk factors for psoriatic arthritis include:
- Strep throat: It is suspected that the strep infection may be a trigger.
- Obesity
- Severe psoriasis
- Stressful events
- Trauma to the joints or bones
- Infections
According to a study published in the journal JAMA Dermatology, there seems to be a causal effect between inflammatory bowel disease and psoriasis/PsA.
PsA can take several years between the actual psoriasis skin rash and developing arthritis, sometimes as long as seven or eight years.
What Are The Symptoms Of Psoriatic Arthritis?
Psoriatic arthritis symptoms might differ for each person but are associated with joint pain and swelling.
"A person can have something we call dactylitis or a sausage digit," said Saylor. Generally, one finger or toe becomes red, puffy or swollen, a sign of psoriatic arthritis.
Other psoriatic arthritis symptoms include:
- Fatigue is a common problem for people with psoriatic arthritis. According to the National Psoriasis Foundation, some studies show that half of all people with psoriatic arthritis have moderate-to-severe fatigue.
- Conjunctivitis, characterized by redness and pain in tissues surrounding the eyes
- Inflammation of tendons and ligaments, called enthesitis
- Joint pain, stiffness or swelling, frequently in the foot or ankle
- Morning stiffness that takes about 30 minutes to go away
- Nail changes such as pitting or nails separating from the nail bed
- Skin symptoms, such as red, scaly spots on the skin
- Tenderness where tendons or ligaments attach to bones, such as the back of the heel or the sole of the foot
- Painful, sausage-like swelling of a whole finger or toe
- Eye inflammation
- Inflammatory bowel disease
"A percentage of the PsA population also experiences spine pain, usually, the lower spine, the lumbar region or the sacroiliac joints (two joints that link the pelvis and lower spine)," Saylor said.
Types of psoriatic arthritis
Psoriatic arthritis comes in five forms:
- Affects small joints in fingers and/or toes
- Asymmetrical arthritis in the hands and feet of one side or the other
- Symmetrical polyarthritis: similar to rheumatoid arthritis and affects both sides equally in multiple joints
- Arthritis mutilans: rare, destroys and deforms joints
- Psoriatic spondylitis: arthritis of the lower back and the spine.
How Is Psoriatic Arthritis Diagnosed?
According to the American College of Rheumatology, diagnosing psoriatic arthritis starts with a physical exam to look for swollen or painful joints, and nail and skin changes. Doctors may review your medical and family history to identify risk factors and distinguish psoriatic arthritis from other conditions with similar symptoms.
Other tests to diagnose psoriatic arthritis may include:
- X-rays or scans like ultrasound, MRI or CT, which can show joint damage.
- Blood tests that may help rule out other diseases
- A skin biopsy can confirm psoriasis. Furthermore, Consequently, establishing an accurate diagnosis is essential for developing an effective treatment plan and preventing long-term joint damage.
How Is Psoriatic Arthritis Treated?
Because it affects both the skin and joints, psoriatic arthritis is a complex condition to treat, according to the Arthritis Foundation. Although there is no known cure for psoriatic arthritis, rheumatologists recommend several treatment options to help manage symptoms and slow the disease's progression.
Treatments include medications and non-drug therapies such as exercise, massage, heat and cold. Doctors often recommend non-steroid anti-inflammatory and disease-modifying antirheumatic medications to control the disease.
"It's wonderful to see how patients can control their symptoms with newer treatments, and it's so gratifying to be able to help them," Saylor said.
Medications for psoriatic arthritis
"Over the last 20 years, many advances in medication treatment have helped patients improve," said Saylor. Medicine often controls and relieves symptoms and treats skin problems and joint inflammation.
Psoriatic arthritis medications include the following:
- Non-steroidal anti-inflammatory meds such as ibuprofen or naproxen.
- Disease modifying anti-rheumatic drugs (DMARDs).
- Biologics, such as TNF inhibitors such as Humira (adalimumab), Cimzia (certolizumab pegol), Enbrel (etanercept), Simponi (golimumab) and Remicade (infliximab)
- Corticosteroids, which are injected into the joint for temporary relief during a flare-up.
Non-drug therapies for psoriatic arthritis
Non-medication therapies include:
- Exercise. As with other types of arthritis, staying active helps.
- Massage therapy. Stress can cause flare-ups and massage helps with stress.
- Heat and cold. Heat and cold may help decrease the inflammation.
- Physical therapy and occupational therapy. These treatments to strengthen muscles, protect joints from further damage and increase flexibility.
- Water therapy. Some people find it easier to move while in the water, which partly supports the body’s weight.
7 Lifestyle Changes To Help PsA Symptoms
Lifestyle changes and treatment options for PsA symptoms include:
- Get plenty of sleep.
- Get regular exercise to help ease pain and boost energy.
- Manage your weight.
- Eat a nutritious, well-balanced diet.
- Limit alcohol, use only in moderation.
- Prioritize your to-dos and pace yourself throughout the week.
- Quit smoking.
While psoriatic arthritis can be a life-altering diagnosis, with proper treatment and lifestyle adjustments, many people with this condition can continue to live an active, fulfilling life.
