Psoriatic arthritis
Psoriatic arthritis
Psoriatic arthritis is a type of arthritis that can develop in people who have the skin condition psoriasis. It affects the joints, which may become swollen, stiff and painful.
Around 1 in 4 people with psoriasis go on to develop psoriatic arthritis.
For most people, the skin symptoms appear first, and joint problems follow later. In a smaller number of cases, the skin and joint symptoms start around the same time, or the joint problems come first.
Psoriatic arthritis happens when the immune system mistakenly attacks healthy tissue in the body. Doctors don't yet fully understand why some people with psoriasis go on to develop it while others don't.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
When to See a Doctor
Speak to your GP practice if you have:
- constant pain in your joints
- swelling in your joints
- stiffness in your joints
Do this even if you have not been diagnosed with psoriasis.
If you have already been diagnosed with psoriatic arthritis, make sure you have a check-up at least once a year. Also let your doctor know without delay if you notice any new problems with your joints.
Diagnosis
If your doctor thinks you might have psoriatic arthritis, they should refer you to a rheumatologist a specialist in joint conditions for a proper assessment.
If you already have psoriasis and are now noticing joint problems, a rheumatologist will usually be able to diagnose psoriatic arthritis. Before confirming it, they will first need to rule out other types of arthritis, such as rheumatoid arthritis and osteoarthritis.
To help confirm the diagnosis, you may be given a few tests, including:
- blood tests to check for signs of inflammation and other types of arthritis
- X-rays of your joints
- scans of your joints
Treatment
Treatment for psoriatic arthritis is built around three goals. Your doctors will want to:
- ease your symptoms
- slow down how the condition progresses
- help you keep a good quality of life
You may be given medicines to help manage psoriatic arthritis, such as:
- non-steroidal anti-inflammatory drugs (NSAIDs)
- steroid medications
- disease-modifying anti-rheumatic drugs (DMARDs)
Some people are also given other medicines that block the chemicals which switch on the immune system. These are called biological medications. In most cases, though, you will be started on DMARDs first. Many people end up trying several different medications before finding what suits them best, and some of these medicines can treat psoriasis as well.
Managing conditions linked to psoriatic arthritis
If you have psoriatic arthritis, you, like people with psoriasis or other forms of inflammatory arthritis, may be somewhat more likely to develop other health conditions, including cardiovascular disease (CVD). CVD refers to conditions affecting the heart or blood vessels, such as heart disease and stroke.
Because of this, your GP should check on you every year, testing things like your blood pressure and cholesterol, so that CVD can be picked up early. If needed, they can offer you further treatment.
Psoriatic arthritis can also lead to inflammation in the eyes, such as conjunctivitis and iritis. And if it is affecting both your skin and your joints, you might notice changes in your nails, including:
- small dents
- pits
- discolouration
- the nail loosening from the nail bed
These nail changes are less common when only the skin is affected.
Your care team
Alongside your GP and a rheumatologist, your care may involve several other specialists working together for you:
- a specialist nurse, who is often the first person you will turn to in your specialist care team
- a dermatologist, a skin specialist who treats your psoriasis symptoms
- a physiotherapist, who can put together an exercise plan to keep your joints moving well
- an occupational therapist, who can help you manage everyday tasks that have become difficult
- a psychologist, who can offer emotional and psychological support if you feel you need it
- a podiatrist, who can assess and advise you on any foot problems
Complications
Psoriatic arthritis tends to stay with you over the long term. If it has spread to many joints, you will likely need ongoing treatment to keep it under control.
Getting diagnosed early and starting the right treatment can slow the condition down. Treatment can also help reduce or prevent lasting damage to your joints.
In some people with severe disease, the joints can become permanently damaged or deformed, and surgery may be needed to treat this.
There is also a lot you can do to help yourself, such as:
- balancing rest with regular physical activity
- losing weight, if you are overweight
- avoiding smoking
- keeping alcohol to moderate amounts
Losing weight
Losing weight supports your overall health and eases the strain on your joints. Evidence also suggests that losing weight can help bring psoriatic arthritis under better control and improve how well you respond to treatment.
Read more about how to lose weight safely.
Stopping smoking
Several studies have found that people with psoriatic arthritis who do not smoke tend to have milder disease and respond much better to treatment than those who do smoke.
Read more about stopping smoking.