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Understanding Psoriatic Arthritis: Symptoms, Causes, and Treatment Options

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on July 11th, 2023.

Key Takeaways

  • This inflammatory condition develops in approximately 30% of psoriasis patients, typically appearing 5-10 years after skin symptoms first emerge, though it can occur simultaneously or even before skin involvement.
  • Distinctive "sausage-like" swelling of entire fingers or toes (dactylitis) occurs in 40% of cases, while spinal involvement affects the lower back and can lead to permanent stiffness if untreated.
  • The HLA-B27 genetic marker is present in 60-70% of patients with spinal involvement, and having a first-degree relative with the condition increases risk by 40 times compared to the general population.
  • Biologic medications like TNF inhibitors can achieve 20% improvement in joint symptoms (ACR20 response) in 60-80% of patients within 12-16 weeks, significantly outperforming traditional DMARDs alone.
  • Untreated disease causes irreversible joint erosion in 47% of patients within 2 years, making early aggressive treatment crucial to prevent permanent disability and maintain joint function.

Psoriatic arthritis (PsA) is a chronic autoimmune condition that causes inflammation in the joints and skin. It affects about 1.5 million people in the United States, or 30% of those who have psoriasis, a skin disease characterized by red, scaly patches. While there is no cure for psoriatic arthritis, various treatment options can help manage the symptoms and slow the progression of the disease.

Symptoms of Psoriatic Arthritis

The most common symptoms of psoriatic arthritis include:

  • Swollen, stiff, and painful joints, particularly in the fingers and toes

  • Foot pain and lower back pain

  • Fatigue and morning stiffness

  • Swelling and pain around tendons

  • Reduced range of motion

  • Nail changes, such as pitting or separation from the nail bed

  • Eye redness and pain (uveitis)

  • Scaly skin patches, especially on the knees, elbows, and scalp

Understanding Psoriatic Arthritis: Symptoms, Causes, and Treatment Options

Causes and Risk Factors

The exact cause of psoriatic arthritis is unknown, but several factors may play a role, including:

  • Genetics: Having a family history of psoriasis or psoriatic arthritis increases the risk

  • Infections: Certain infections, such as strep throat, may trigger the immune system

  • Physical trauma: Injury to a joint or bone may increase the likelihood of developing PsA

  • Obesity: Being overweight or obese is a risk factor for both psoriasis and psoriatic arthritis

Diagnosis and Treatment

To diagnose psoriatic arthritis, your doctor will review your medical history, perform a physical examination, and may order imaging tests (X-rays, MRIs, or ultrasounds) and blood tests. Treatment options for psoriatic arthritis include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation

  • Disease-modifying antirheumatic drugs (DMARDs) to slow disease progression

  • Biologics, which target specific proteins in the immune system to reduce inflammation

  • Physical and occupational therapy to improve joint function and mobility

  • Surgery, in severe cases, to replace damaged joints

In addition to medical treatment, lifestyle changes such as maintaining a healthy weight, exercising regularly, and following an anti-inflammatory diet can help manage psoriatic arthritis symptoms. It's also essential to practice stress-reduction techniques and get enough rest to minimize flare-ups.

Living with Psoriatic Arthritis

Psoriatic arthritis is a chronic condition that can significantly impact a person's quality of life. However, with proper treatment and self-care, many people with PsA can manage their symptoms and lead active, fulfilling lives. If you suspect you may have psoriatic arthritis, consult your healthcare provider for an accurate diagnosis and personalized treatment plan. For more information and support, visit the National Psoriasis Foundation and the Arthritis Foundation websites.

The Bottom Line

Early recognition and treatment within the first 6 months of symptom onset provides the best chance of preventing permanent joint damage and maintaining normal function. Combining medication with weight management and regular low-impact exercise maximizes treatment effectiveness. If you're experiencing joint swelling, back stiffness, or nail changes alongside skin symptoms, Doctronic can help you get prompt evaluation and answers.

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