Psoriasis and Joint Pain

If you have psoriasis and have experienced pain, stiffness, or swelling in and around your joints, you may be experiencing symptoms of a psoriasis-related disease called psoriatic arthritis, or PsA. PsA is a chronic inflammatory disease that affects both your skin and your joints.

How Are PsA and Psoriasis Related?

You may be wondering how a disease on your skin can affect your joints, too. But, as you may have learned in Underneath the Skin, what you see as psoriasis on the outside starts as inflammation on the inside. This same inflammation can affect your joints as psoriatic arthritis.

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PsA Symptoms

PsA can affect any joint in the body. The most common symptoms can include:

  • Swollen fingers and toes

  • Tender, painful, or swollen joints

  • Red scaly skin patches known as plaques

  • Reduced range of motion of the joints

  • Morning stiffness

  • Lower back, upper back, and neck pain

  • General fatigue

  • Changes to nails, such as pitting or separation from the nail bed

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Psoriatic Arthritis Types and Pictures

If you show symptoms of PsA, your doctor will want to know which parts of the body are affected and the severity of your symptoms. This information helps identify which of the 5 types of PsA you may have.

Symmetric Arthritis

Affects the same joints on both sides of the body, for instance, the right and left knees, right and left wrists, etc. Can resemble rheumatoid arthritis (RA).

Asymmetric Arthritis

Can occur in any joint, but not necessarily the same joints on both sides of the body. Fingers and toes can become enlarged and "sausage-like."

Distal Interphalangeal Predominant (DIP)

Involves the joints of the fingers and toes closest to the nails. Changes in the nail are common. Is similar to, and sometimes confused with, osteoarthritis.


Refers to inflammation of the spinal column. Only about 5% of people with PsA have spondylitis as their main symptom. But a larger number of people with PsA will have similar symptoms—stiffness in the neck, lower back, pelvic area, or spinal vertebrae.

Arthritis Mutilans

A severe, deforming, and destructive type of PsA that usually affects the small joints of the hands and feet. Can also cause neck and lower-back pain. Fewer than 5% of PsA patients have this type.

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What Causes Psoriatic Arthritis?

The inflammation associated with PsA is caused by an abnormal response of your body's immune system, which may result in red flaky skin patches known as plaques, as well as joint pain and swelling.

Genetic and environmental factors also come into play. People with PsA often have a family member with psoriasis or arthritis. And among people who are susceptible, an infection may activate the immune system, triggering the development of psoriatic arthritis.

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Diagnosing Psoriatic Arthritis

The joint inflammation caused by psoriatic arthritis can result in joint damage that can get worse over time, so early diagnosis is important.

It’s important to work with a doctor who specializes in treating psoriatic arthritis—a rheumatologist. Rheumatologists specialize in diseases of the joints, tissue, and bones, and are experts on both the diagnosis and the management of PsA.

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Treating Psoriatic Arthritis

Diagnosing PsA early is extremely important. Left untreated, PsA can result in joint damage that leads to severe physical limitations and disability. Your doctor will most likely look for signs of PsA at every visit and will depend on you to share your symptoms.

What your doctor recommends for treating your PsA will depend on the severity of your condition, but could include:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Help to reduce inflammation and ease pain and stiffness in milder cases of PsA. Some require prescriptions; others are over-the-counter drugs.


Used most often when only a few joints are involved; given by injection.

Disease-modifying Antirheumatic Drugs (DMARDs)

Used to treat more severe symptoms and given by injection or mouth; can slow or limit the amount of joint damage, as well as reduce pain and inflammation.


Medications that work with the body's immune system to target specific causes of inflammation; may prevent further damage to bones and joints.

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