Psoriatic arthritis (PsA) is a chronic condition that combines the skin symptoms of psoriasis with the joint inflammation of arthritis. It is an autoimmune disorder, meaning the immune system mistakenly attacks healthy cells, causing pain, swelling, and fatigue.

Everyone’s experience with PsA is different — symptoms can range from mild to severe and may affect a few or many joints. Most people with PsA have both psoriatic skin plaques and joint inflammation at some stage.

How It Feels To Have Psoriatic Arthritis

what to expect
If you live with psoriasis, the skin symptoms may already be familiar — red, scaly patches that itch or burn. For about 80% of people with PsA, arthritis symptoms develop years after psoriasis first appears, often between 7 to 10 years later.

The joint symptoms, however, can feel new and unpredictable. PsA-related pain may:

  • Start in one or two joints, then spread to others

  • Appear on one side of the body or both sides (such as the right wrist and left knee)

  • Affect the spine, hips, or pelvis

  • Fluctuate between flare-ups and remission

  • Feel different depending on treatment and lifestyle habits

Mild symptoms might be managed with over-the-counter pain relievers or topical creams, while more severe PsA often requires prescription medications like corticosteroids or immune-suppressing drugs.

Some people manage PsA well enough to work, exercise, and care for their families, while others experience pain that interferes with everyday activities such as dressing, writing, or getting out of bed.

Common Symptoms

Psoriatic arthritis affects multiple systems — skin, joints, nails, tendons, and sometimes internal organs.

skin plaques: Psoriasis causes skin cells to grow too quickly, forming thick, scaly patches called plaques. These are often red, silver, and itchy, appearing most commonly on the scalp, elbows, and knees.

joint problems: Inflamed joints may feel swollen, stiff, tender, and warm. PsA can affect fingers, toes, arms, and legs, as well as larger areas like the hips, back, or pelvis.

swollen fingers or toes: Dactylitis, sometimes called “sausage digits,” causes entire fingers or toes to swell and stiffen, often making movement difficult.

fatigue: Chronic inflammation, disrupted sleep, and persistent pain can leave you feeling exhausted. Around half of those with PsA report moderate to severe fatigue.

nail changes: Nails may thicken, crumble, or lift from the nail bed. These changes are more common in PsA than in psoriasis alone and can be an early sign of joint involvement.

tendon and ligament pain: Inflammation where tendons and ligaments attach to bones (called enthesitis) can cause pain, especially in the heels or the soles of the feet — often worse after waking up.

Potential Complications

Without proper management, long-term inflammation from PsA can lead to other health problems.

uveitis: Inflammation may affect the eye’s middle layer, causing redness, pain, and blurred vision. This condition can cause permanent vision loss if untreated.

inflammatory bowel disease (IBD): Some people with PsA experience gut issues like diarrhea or abdominal discomfort. PsA is linked with conditions such as Crohn’s disease and ulcerative colitis.

permanent joint damage: Ongoing inflammation can erode bones and cause abnormal bone growths called spurs. These changes reduce mobility and may lead to irreversible joint deformities if left untreated.

Tips for Management

how to reduce pain and protect joints
Early diagnosis and treatment are critical for slowing PsA progression and preventing joint damage. Studies show that untreated PsA can worsen symptoms and lower quality of life over time.

You can manage PsA more effectively by:

  • Working with your healthcare provider to create a personalized treatment plan

  • Using assistive tools like ergonomic keyboards, jar openers, or electric toothbrushes to reduce strain

  • Making lifestyle changes such as quitting smoking, maintaining a healthy weight, and staying physically active

  • Joining support groups or online communities to share experiences and advice

  • Consulting specialists like rheumatologists, dermatologists, and physical or occupational therapists

  • Listening to your body — rest during flare-ups and pace yourself to prevent overexertion

  • Tracking symptoms and triggers in a journal to identify patterns and reduce future flares

When To See a Healthcare Provider

If you already have psoriasis and start noticing joint pain, stiffness, or swelling, talk to your healthcare provider as soon as possible. Even if you don’t have visible psoriasis, you should seek medical advice for unexplained joint or skin symptoms.

watch for signs such as:

  • Thickened, itchy, or scaly skin plaques

  • Swollen fingers or toes

  • Nail pitting or separation

  • Heel or tendon pain that appears suddenly

These symptoms are not always urgent, but early evaluation prevents worsening inflammation and joint damage. However, eye redness and blurred vision require prompt medical attention, as they could indicate uveitis.

A Quick Review

Psoriatic arthritis blends the symptoms of psoriasis and arthritis, leading to joint pain, stiffness, swelling, and skin inflammation. Recognizing early signs and getting proper treatment can help prevent permanent damage and improve your quality of life.

Working closely with your healthcare team and maintaining healthy habits can reduce pain, lower inflammation, and help you stay active.