Psoriatic arthritis is a type of arthritis that can affect people who have psoriasis, a skin condition that causes red, scaly patches on the skin. However, not everyone who has psoriasis will develop psoriatic arthritis, and in some cases, psoriatic arthritis can occur even in those who don’t have any visible signs of psoriasis. Psoriatic arthritis occurs when the body’s immune system mistakenly attacks healthy cells in the joints, causing inflammation, pain and other uncomfortable symptoms.

There are five main types of psoriatic arthritis, each with slightly different signs and symptoms:

• Symmetric psoriatic arthritis — This is the most common type, affecting joints on both sides of the body symmetrically.
• Asymmetric psoriatic arthritis — This type affects joints on one side of the body more than the other. 
• Polyarticular psoriatic arthritis — This type affects many joints throughout the body, including the small joints of the hands and feet. 
• Spondylitis — This type of psoriatic arthritis primarily affects the spine, causing inflammation and stiffness. 
• Distal interphalangeal joint arthritis — This type primarily affects the joints at the tips of the fingers and toes. 

Psoriatic arthritis is fairly common among people with psoriasis — up to 30% of people are affected. Like other autoimmune diseases, psoriatic arthritis can appear at any age, although it most commonly affects people after the age of 30.

8 symptoms of psoriatic arthritis 

When asking, “what are the symptoms of psoriatic arthritis?” the answer depends on the type of psoriatic arthritis a person has. However, there are also many common signs and symptoms across all types of psoriatic arthritis:

• Joint pain and stiffness — One of the most common signs of psoriatic arthritis is joint pain, which can vary in intensity. The pain often affects fingers, toes, knees and ankles. In more severe cases, the pain may impact the spine or hips. Joint stiffness, especially in the morning, can make it hard to get going. You may also experience joint stiffness after sitting for a long period of time. 
• Dactylitis — Dactylitis causes the fingers and toes to swell, giving them a puffy, sausage-like appearance. This swelling happens because the tendons, joints and other tissue in the fingers and toes become inflamed. Dactylitis can make everyday tasks, like opening a bottle or typing, challenging and even painful. 
• Skin patches — Many people with psoriatic arthritis also experience psoriasis. The skin symptoms may include red patches with a silver or white buildup of skin cells on top. These patches, called plaques, can be itchy and uncomfortable and are commonly found on the scalp, elbows, knees and lower back. 
• Nail changes — Psoriatic arthritis often affects the nails, which may become pitted, discolored or thickened. In some cases, the nails may begin to separate from the nail bed. Nail changes can be a key indicator of psoriatic arthritis and may help doctors diagnose the condition. 
• Fatigue — Chronic inflammation caused by psoriatic arthritis may make you feel fatigued or very tired, even with plenty of rest. This constant fatigue can be frustrating and make it hard to stay active, go to work or do daily activities. 
• Eye problems — Some people with psoriatic arthritis may experience eye inflammation. Uveitis is a condition where the middle layer of the eye becomes inflamed, causing redness, pain, sensitivity to light and blurred vision. If uveitis isn’t treated, it could lead to complications and even vision loss. 
• Back pain — In cases of spondylitis, you may experience pain and stiffness in the spine or lower back. This form of psoriatic arthritis can limit flexibility and make movement painful; it often gets worse with inactivity. 
• Enthesitis — Enthesitis is the inflammation of the entheses, the places where tendons or ligaments attach to the bone. Areas that can be affected by enthesitis frequently include the bottom of the feet, the back of the heel and other areas where tendons attach to bones. It can make movement painful and is a unique symptom that can help distinguish psoriatic arthritis from other types of arthritis. 

Causes and risk factors of psoriatic arthritis 

The exact cause of psoriatic arthritis isn’t completely understood, but scientists believe it may be due to a mix of:

• Genetics — Having a family history of psoriasis or psoriatic arthritis can increase your likelihood of developing psoriatic arthritis. Certain genes are believed to play a role, as researchers have found specific gene markers in people with psoriatic arthritis. 
• Immune system — Psoriatic arthritis is an autoimmune disease, that is, the immune system mistakenly attacks healthy cells in the body. For psoriatic arthritis, the immune system targets joint tissue, causing inflammation and pain. It’s not clear why the immune system acts this way, but it’s believed to be a combination of factors. 
• Environmental factors — Sometimes, external triggers can activate psoriatic arthritis in people who are genetically prone to it. Infections, severe stress or even an injury to a joint or skin area can trigger the condition in those who are more susceptible. 
• Psoriasis — People with psoriasis can have a higher risk of developing psoriatic arthritis. Those with severe psoriasis symptoms, including extensive plaques, can be even more likely to develop this condition. 

Diagnosis of psoriatic arthritis 

It can be challenging to diagnose psoriatic arthritis, especially because it shares many symptoms with other forms of arthritis, like rheumatoid arthritis. To diagnose psoriatic arthritis, your health care provider will likely conduct the following:

• Medical history and physical exam — Your doctor will ask about your symptoms, family history of arthritis and any history of psoriasis. They may also examine your skin, nails and joints for typical psoriatic arthritis symptoms.
• Blood tests — While there isn’t a specific blood test for psoriatic arthritis, blood tests can help rule out other types of arthritis. 
• Imaging tests — X-rays, MRI or ultrasound may be used to look for joint or tissue damage. These images can help doctors spot changes associated with psoriatic arthritis, such as joint erosion or enthesitis, which can help in diagnosing. 

Complications of psoriatic arthritis 

If left untreated, psoriatic arthritis can lead to complications that impact your quality of life. Possible complications may include:

• Joint damage
• Heart disease
• Diabetes
• Depression and anxiety
• Eye inflammation

Treatment options for psoriatic arthritis 

While there currently isn’t a cure for psoriatic arthritis, there are several treatments that can help manage symptoms and improve your quality of life, including:

• Medications — Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs and biologic therapies can help reduce inflammation and slow disease progression. 
• Physical therapy — Physical therapy can help improve joint function, reduce pain and increase range of motion. 
• Lifestyle changes — Staying active and managing your weight can help reduce the stress on your joints and improve your mobility. Regular exercises, especially low-impact activities such as walking or swimming, can help.
• Surgery — In severe cases, when joint damage becomes too advanced, surgery may be needed to repair or replace joints. This option is generally considered a last resort if other treatments aren’t effective. 

Physical therapy techniques that may be beneficial for psoriatic arthritis 

Physical therapy can play a key role in managing psoriatic arthritis symptoms and can help improve mobility, flexibility and overall function. Some techniques that your physical therapist may incorporate into your treatment plan include:

• Therapeutic exercises — Therapeutic exercises involve stretches and movements that help maintain or improve your joint flexibility and strength. Your physical therapist may guide you through specific exercises targeting the affected joints, making adjustments based on your pain level and mobility. 
• Manual therapy — Manual therapy includes the following hands-on techniques:
• Soft tissue manipulation — Your physical therapist may use soft tissue manipulation to target muscles and tendons surrounding the joints to relieve tension and reduce inflammation. 
• Joint mobilization — Joint mobilization involves gentle, controlled movements to increase joint flexibility. Your physical therapist will carefully guide your joints through their full range of motion, which can help reduce stiffness and improve function over time. 
• Aquatic therapy — Exercising in water is ideal for people with psoriatic arthritis since water provides gentle resistance without putting pressure on joints. Aquatic therapy can improve your strength and flexibility while being easy on inflamed joints. 
• Electrical stimulation — Electrical stimulation uses mild electric currents to reduce pain and improve muscle strength. It’s a noninvasive treatment that can help relieve some of the discomfort associated with psoriatic arthritis. 

Take control of your psoriatic arthritis with Lattimore Physical Therapy

At Lattimore Physical Therapy, we’re committed to helping you manage psoriatic arthritis with personalized and compassionate care. Our expert team of physical therapists understands the unique challenges of psoriatic arthritis, and we’ll work closely with you to develop an individualized treatment plan that targets your specific symptoms and needs. We’re here to support your journey to improved mobility, reduced pain and a higher quality of life. Don’t let psoriatic arthritis hold you back — trust us as you start on your path to relief and reclaim your everyday comfort. 

Contact our team today for more information or to schedule an initial appointment.