Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects both the skin and joints, and for many people, it significantly impacts the feet. Between 50% and 70% of people with PsA develop foot-related problems, while around 65% experience toe swelling known as dactylitis.

Because the feet contain many small joints, tendons, and ligaments, inflammation in these areas can make walking, standing, or even wearing shoes painful. Understanding how PsA affects the feet can help you recognize symptoms early and take steps to protect mobility and comfort.

What Does PsA on the Feet Look Like?

visible changes in toes and structure
For many people, PsA symptoms first appear in the feet. Swollen, painful toes — often called “sausage digits” — are among the earliest signs. The toes or ankles may appear red, tender, and enlarged due to inflammation.

Other visible changes include:

  • Toes that look shortened or claw-like

  • A flattened foot arch or inward-rolling ankles, causing uneven pressure

  • Corns or thickened skin on the toe joints

  • Psoriasis patches on the feet, similar to those on the elbows, knees, or scalp

Nail changes are also common, such as thickening, crumbling, or discoloration, sometimes caused by onychomycosis (toenail fungus). These nail issues can be painful and make shoes uncomfortable to wear.

How Does PsA on the Feet Feel?

pain, swelling, and reduced movement
When PsA affects your feet, you may feel persistent aching, stiffness, and swelling that limits your movement. Pain often worsens after long periods of standing or walking.

Typical symptoms include:

  • Warm, swollen, sausage-like toes

  • Tender, inflamed ankles

  • Pitted or brittle toenails lifting from the nail bed

  • Heel or sole pain (similar to plantar fasciitis)

  • Painful red skin patches or white scaly buildup

  • Stiffness or “locking” in foot joints

  • Painful calluses or pressure sores on the toes or heels

Because the feet bear your body weight, even mild inflammation can lead to significant pain and difficulty walking.

Health Effects

how inflammation impacts your body
Each foot has 26 bones and 33 joints connected by muscles, ligaments, and tendons. In PsA, inflammation can occur in any of these areas. Swelling may make your shoes feel tight or cause misalignment in your gait.

If PsA is not managed properly, it can lead to:

  • Permanent joint damage and deformities

  • Achilles tendon pain or plantar fasciitis

  • Decreased mobility and difficulty with daily activities

Beyond foot pain, long-term inflammation from PsA increases the risk of heart disease, metabolic syndrome, and depression. Maintaining good health habits and consistent treatment can help protect both your joints and overall well-being.

Diagnosis

how doctors confirm PsA in the feet
There’s no single test for diagnosing psoriatic arthritis in the feet. Instead, healthcare providers rely on a combination of exams, imaging, and bloodwork.

During an exam, your doctor may check for:

  • Swelling, warmth, or tenderness in your joints

  • Skin or nail changes linked to psoriasis

  • Reduced flexibility or altered foot shape

They may also order:

  • X-rays or MRI scans to detect joint or bone changes

  • Blood tests such as CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) to measure inflammation

  • RF (rheumatoid factor) and anti-CCP tests to rule out rheumatoid arthritis

  • Additional tests to exclude gout or infection

By evaluating all these findings, your healthcare provider can confirm a PsA diagnosis and create a personalized treatment plan.

How To Treat PsA in the Feet

managing pain and protecting joints
Although PsA cannot be cured, proper treatment can significantly improve symptoms and slow disease progression.

Common approaches include:

take medications as prescribed: Doctors may recommend NSAIDs for pain relief, DMARDs to prevent joint damage, and biologic therapies that target immune system inflammation.

corticosteroid injections: Injecting steroids directly into inflamed joints can reduce swelling and improve flexibility.

manage your weight: Reducing excess weight helps take pressure off the feet and joints, easing pain and inflammation.

choose low-impact exercises: Activities like yoga, swimming, cycling, or tai chi strengthen muscles without straining the feet.

wear supportive footwear: A podiatrist can recommend shoes that support your arches and cushion your joints, helping reduce discomfort and prevent deformities.

try foot soaks: Some people find relief from Epsom salt soaks, though you should consult your doctor first.

avoid smoking: Smoking worsens inflammation and reduces treatment effectiveness. Seek help from your healthcare provider if quitting feels difficult.

seek emotional support: Managing PsA in your feet can be frustrating. Talking to a therapist or joining a PsA support group can help you handle emotional and physical challenges.

A Quick Review

More than half of all people with psoriatic arthritis will experience symptoms in their feet — from swelling and stiffness to red patches and joint pain. Without proper treatment, PsA can cause lasting joint damage and reduce mobility.

Taking medications as prescribed, staying active, maintaining a healthy weight, and seeking emotional support can help you manage symptoms and live more comfortably.