What Does Psoriatic Arthritis Feel Like?

PsA is an inflammatory autoimmune condition that affects about 20% of people with psoriasis. Sometimes, PsA develops without a prior diagnosis of psoriasis, but there are almost always associated skin symptoms.

According to the Arthritis Foundation, PsA affects males and females equally, runs in families, and usually starts after age 30 (though people of any age can experience the condition).

In autoimmune diseases like PsA, your immune system mistakenly targets healthy tissue, causing inflammation and tissue damage. The key signs of inflammation are pain, swelling, redness or discoloration, and heat.

Doctors can diagnose PsA based on:

• a thorough evaluation of your symptoms and medical history
• lab tests to rule out rheumatoid arthritis
• X-rays to look for joint damage

Like most diseases, PsA affects different people differently.

Your symptoms may be mild to severe. Because PSA comes in phases of flares and remission, the symptoms will not always be the same.

Here’s a guide to PsA symptoms and what they might feel like.

Pain

PsA pain most often affects large joints, like your knees, and peripheral joints in your fingers and toes.

Pain in your spine is less likely but not impossible. If you have spine pain, it will likely be in your lower back (just above the tailbone) or your neck. You may also feel pain in your heel or the bottom of your foot because of inflammation where ligaments attach to bones.

Swelling

Notice if you have swelling around the painful joint. Entire fingers and toes may sometimes swell and look “sausage-like.” Affected joints may look red or discolored or feel warm, which are other clues that inflammation is present.

Tenderness

While pain is a hallmark of PsA, it may go beyond constant ache or pain associated with moving the joint. Inflamed joints may feel tender to the touch, meaning you’ll experience more pain if you bump or press on the body part.

Stiffness

Swelling and pain can lead to stiffness or reduced joint mobility. Stiffness is often worse first thing in the morning or after rest.

Fatigue

With PsA, fatigue is a severe and persistent tiredness that doesn’t get better with rest.

You may also have a low grade fever that contributes to fatigue. If, after a full night’s sleep, you still don’t have the energy for your usual activities, consider speaking with a doctor.

Skin symptoms

According to a 2020 survey, 80% of people with PsA reported skin and nail symptoms. Usually, skin symptoms are red or discolored patches that are itchy, painful, and scaly.

Psoriasis is most common on knees, elbows, and the scalp, but it can occur anywhere on the body.

Research from 2021 suggests that itchiness and skin pain significantly affect the quality of life among people with PsA.

Nail symptoms

A 2017 research review found psoriasis and PsA can cause nail changes, such as pitting and separation from the nail bed. Pitted nails appear to have tiny divots across the surface of the nail. They may feel tender or uncomfortable.

PsA can also cause nails to detach from your finger partially. Nails that aren’t attached well may result in painful snags and tears. Once the skin is torn, you’re at risk of infection, which can cause painful swelling and redness.

Mood changes

Living with PsA can cause difficulty concentrating, anxiety, and depression. Social stigma associated with the appearance of psoriasis may lead to low self-esteem and isolation.

Fatigue and inflammation may also affect your moods. In a 2020 study, 69% of people with PsA said the condition had a moderate or major influence on their emotional well-being.

Typically, a person will experience skin symptoms associated with psoriasis before joint symptoms occur and before a diagnosis of PsA. Though experts don’t fully understand what causes PsA, potential triggers include:

• infection
• stress
• injury
• other environmental factors

Evidence shows that males and females have different experiences with PsA.

According to a 2021 study of more than 1,000 people with peripheral PsA, females have lower rates of remission, more pain and fatigue, and lower quality of life. Males were more likely to have symptoms affecting the spine.

Here are some frequently asked questions about symptoms of PsA.

What are the first signs of psoriatic arthritis?

The first signs usually include joint pain, tenderness, stiffness, and swelling.

What test confirms psoriatic arthritis?

Test confirming PsA include blood tests such as C-reactive protein (CRP) and imaging tests like X-rays, ultrasounds, or MRI scans.

How do you describe the pain of psoriatic arthritis?

The pain may feel like tenderness in the joints, meaning touching them may hurt. It’s also usually accompanied by painful swelling.

What is the red flag for psoriatic arthritis?

Symptoms to look out for include swollen, tender joints, stiffness, and swelling, especially with psoriasis.

Symptoms of PsA vary from person to person. The main signs to look for are joint pain, swelling, stiffness, skin and nail changes, and fatigue. Symptoms could be mild to severe, and their severity will increase during flare-ups.

Based on the history of your symptoms and lab tests, a doctor can diagnose PsA. Early treatment means better management of symptoms and lower risk of joint damage.