Symptoms of Psoriatic Arthritis

Medically Reviewed by David Zelman, MD on May 26, 2023
Written by WebMD Editorial Contributors
4 min read

Up to a third of people with psoriasis also get psoriatic arthritis (PsA). Most people are diagnosed between 30 and 50, but you can get it at any age. It causes inflammation, mainly in your joints. And it can affect other body parts, too.

Some symptoms can be similar to rheumatoid arthritis, so your doctor may want to do tests to confirm the diagnosis.

Often you'll notice swelling in your knees, ankles, feet, and hands. Usually, a few joints are inflamed at a time. They get painful and puffy, and sometimes hot and red. When your fingers or toes are affected, they might take on a sausage shape. Psoriatic arthritis might affect pairs of joints on both sides of your body, like both of your knees, ankles, hips, and elbows.

Stiff joints are common. They're typically worse early in the morning.

Pain and stiffness in your neck, upper back, low back, and buttocks could be from inflammation in the joints of your spine and hip bones.

You could also get inflammation where a muscle connects to a bone, such as the Achilles tendon behind your heel. It might hurt to walk and climb stairs.

Many people with psoriatic arthritis see tiny dents, called pitting, and ridges in their nails.

Sometimes the entire nail pulls away from the nail bed. The separated part might be opaque with a white, yellow, or green tint. Your doctor might call this condition onycholysis.

It doesn’t happen often, but chest pain and shortness of breath can be symptoms of psoriatic arthritis. These might happen when the chest wall and the cartilage that links your ribs to your breastbone get inflamed. It’s also rare, but your lungs or your aorta (the large blood vessel that leaves your heart) could be affected.

Both the inflammation process and medications you take for PsA can leave you feeling tired and mentally drained. Eat well, try to rest, and get some exercise. And talk to your doctor about possible other causes.

Having PsA can make you more likely to develop other conditions over time, some of the most common are:

  • Cancer. People with PSA may be more likely to get lymphoma and nonmelanoma skin cancer. Your treatment plan should include regular cancer screenings.
  • Cardiovascular disease. Psoriatic arthritis can boost your risk for cardiovascular disease like a heart attack or stroke. Talk to your doctor about your risk and treatments that can help.
  • Crohn's disease. People with psoriatic arthritis and Crohn's share similar changes to their genes, called mutations. That’s why there’s a link between psoriasis, psoriatic arthritis, and inflammatory bowel disease like Crohn's disease or ulcerative colitis. If you have both psoriasis and psoriatic arthritis, your odds are even higher.
  • Depression. Psoriasis and psoriatic arthritis can make you more likely to have low self-esteem and mood disorders like depression. Depression is even more likely If you have both psoriatic arthritis and psoriasis. But treating the psoriasis can help with your depression.
  • Diabetes. Having psoriasis and psoriatic arthritis raises your risk of type 2 diabetes. Having severe psoriasis boosts it even higher. Tell your doctor if you have symptoms of type 2 diabetes, such as heavy thirst, hunger, blurry vision, or fatigue.
  • Eye inflammation and vision problems. Inflammation in the colored part of your eye, the iris, can cause pain that gets worse in bright light. This can cause vision problems. You'll probably need to see an eye doctor to treat this condition, which is known as uveitis.
  • Gout. You get this form of inflammatory arthritis when uric acid crystals form in your joints. Though you can get uric acid from food, doctors also think it’s a byproduct of psoriasis and psoriatic arthritis.
  • Joint damage. Arthritis, a rare but destructive condition that sometimes happens with psoriatic arthritis, rapidly damages joints at the ends of your fingers and toes. Severe damage can interfere with activities of daily living such as walking or dressing.
  • Metabolic syndrome. Researchers have found a link between psoriasis, psoriatic arthritis, and metabolic syndrome -- a cluster of conditions that include heart disease, obesity, and high blood pressure. Women with psoriasis and anyone with severe psoriatic arthritis may be almost twice as likely to get it as others.

If you have psoriasis and your joints hurt, let your doctor know.

People without psoriasis can get psoriatic arthritis, too. You should call your doctor if you have:

Show Sources

SOURCES:

Arthritis Foundation: "Psoriatic Arthritis," “Psoriasis and Psoriatic Arthritis Linked to Increased Gout Risk.”

MedlinePlus Medical Encyclopedia: "Psoriatic Arthritis."

National Institute of Arthritis and Musculoskeletal and Skin Disorders: "Roundtable Discussion on Psoriasis, Psoriatic Arthritis, and Rheumatoid Arthritis."

Current Rheumatology Reports: “Arthritis mutilans.”

The Journal of Rheumatology: “Acute Presentation of Arthritis Mutilans.”

Mayo Clinic: “Fingernails: Possible problems.”

The Psoriasis and Psoriatic Arthritis Alliance: “Why do I feel so tired?

National Psoriasis Foundation: “Comorbidities Associated with Psoriatic Disease,” “Fatigue and psoriatic arthritis,” “Uveitis: A Threat to Eyesight.”

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