Psoriatic Arthritis FAQs

Answers to common questions about psoriatic arthritis

Psoriatic arthritis

Psoriatic arthritis is a common cause of joint pain in patients with psoriasis on their skin. Psoriasis creates red, scaly plaques that are typically found on the scalp, elbows, knees, and lower back. Both psoriasis and psoriatic arthritis are chronic and life-long conditions, and there is currently no cure. If you have psoriatic arthritis, it is important to get a correct diagnosis from a medical professional.

There are now good treatments available, and leaving psoriatic arthritis untreated can do permanent damage to the joints.

How common is psoriatic arthritis?

About 30% of people living with psoriasis will develop psoriatic arthritis at some point. While it’s possible to experience the joint pain first, most of the time (about 85%) the skin rash precedes joint problems. It occurs equally in men and women, and while it most commonly is found between the ages of 30 and 50 years old, it has been discovered in children as young as 11.

What type of joint pain occurs in psoriatic arthritis?

Pain in many different joints is possible, but the most common joints affected are the small joints in the hands, fingers, toes, and feet. Lower back pain is also quite common. The pain typically begins as morning stiffness lasting for an hour or more, or stiffness after sitting for long periods. Joints can be swollen and tender, and pain in specific joints may come and go.

Fingers and toes may swell and lock up, making them look like sausages (called dactylitis), or tendons and ligaments may hurt where they attach to the bone (enthesitis). Sometimes the joint inflammation can spill over into the body in general, which leads to fatigue.

Is the amount of pain related to how much psoriasis I have?

No. There is generally little relationship between the amount of psoriasis on the skin and the severity of arthritis. Some people have severe and disabling joint pain but only small patches on their skin, while others have terrible and widespread skin disease but no arthritis.

Are there tests for psoriatic arthritis?

There are currently no blood tests specifically for identifying psoriatic arthritis. A rheumatologist ( a doctor who specializes in joint problems) is often helpful in confirming the diagnosis and making a treatment plan. Your rheumatologist may perform X-rays to see how damaged the joint is or blood tests to exclude other forms of arthritis (like rheumatoid arthritis or gout, which can have similar symptoms).

What are the risks to not treating psoriatic arthritis?

Psoriatic arthritis can progress over years and decades to destroy the inner workings of the joints, especially in the hands. This can lead to permanent disability as the fingers become locked into certain positions and cannot be moved well or at all. It is very important to treat this type of arthritis in its early stages, as there is generally no good treatment to repair a joint once it has been destroyed.

Are there treatments for psoriatic arthritis?

Yes! Although not all treatments for psoriasis work also on the joints, good treatments are available for psoriatic arthritis. Methotrexate is a prescription drug that has been used to treat psoriasis for decades and can reduce joint pain, although may not stop the destruction of the joints. Newer medications, like Remicade (infliximab), Enbrel (etanercept), and Humira (adalimumab) have been shown to not only decrease pain, but also stop the destruction of the joints, and are therefore often the first choice for treatment. Also, a number of new medications are being tested in experimental trials.

They show promise for helping both psoriasis and psoriatic arthritis, and will hopefully be available in the next few years.

Does psoriatic arthritis affect my overall health?

Psoriatic arthritis is associated with certain broader symptoms like fatigue and sometimes low red blood cell counts (anemia). Scientists are beginning to understand that having psoriasis increases your risk of certain potentially more dangerous health conditions, like diabetes, heart disease, and stroke. It is important to get regular checkups with your primary care provider to monitor your blood pressure, blood sugar, and cholesterol. 

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