Imagine a disease where your body stops recognizing parts of itself and begins to attack healthy tissue it sees as “invaders.” While this may sound like the plot of a science fiction novel, there are conditions that do just that. Autoimmune disorders develop when the immune system malfunctions in a way that causes it to attack healthy parts of your body. One such condition is Psoriatic Arthritis. Here’s what it is and early psoriatic arthritis symptoms to watch out for.
What is psoriatic arthritis?
Psoriatic arthritis is just one of the more than 100 different types of arthritis that affects 175 million people worldwide.
This inflammatory condition primarily affects people who are diagnosed with psoriasis, but it can also be diagnosed in those who have a close relative with psoriasis even when they do not have that condition themselves.
What are the first signs of psoriatic arthritis?
The earliest sign of the potential for psoriatic arthritis is the development of psoriasis. Other than that, psoriatic arthritis early symptoms can be easily mistaken for early symptoms of other conditions. You might experience increasing stiffness in the joints when you wake up or sit still for a period of time. You might notice swelling in a finger or a toe. Maybe you see some changes in your fingernails, such as ridges or grooves or maybe nails separating from the nail bed. You may notice a sudden increase in fatigue, or feel very tired for no apparent reason.
It can be easy to dismiss these psoriatic arthritis signs, but it’s important to pay attention to them. Over 200,000 cases of psoriatic arthritis are diagnosed annually. Most people develop this condition between the ages of 30 and 50, but it can occur in children as well. Psoriatic arthritis is an equal opportunity condition, with men and women diagnosed in equal numbers.
The exact cause of psoriatic arthritis is not well known. In all cases, approximately 40% of patients have a close relative with the disease, suggesting a genetic component. For those without a close relative with this condition, they may have experienced an infection that triggered their immune system.
It is important to note that psoriasis and psoriatic arthritis is not contagious. This type of autoimmune disorder is also completely unrelated to the HIV/AIDS autoimmune disorder. For some people, this misconception can prevent them from seeking treatment. It is important to recognize the distinction and seek treatment to help control your symptoms.
11 of the most common psoriatic arthritis symptoms
Although psoriatic arthritis signs are similar to some other conditions, there are symptoms specific to this condition alone. The eleven most common symptoms for psoriatic arthritis include the following:
- Scaly, patchy skin rashes
- Stiff and swollen joints
- “Sausage fingers” or swollen fingers
- Ligament and tendon pain
- Changes to the nails
- Extreme fatigue
- Limited range of motion in the joints
- Issues with the eyes
- Lower back pain
- Asymmetrical pain
- Flares
Let’s take a closer look at each symptom.
Scaly, patchy skin rashes
Scaly, patchy skin rashes are the hallmark of psoriasis. An estimated 30% of people with psoriasis will develop psoriatic arthritis, so it’s important to pay attention to this potential early symptom.
When more symptoms are present, psoriasis and psoriatic arthritis may be diagnosed at the same time.
Stiff and swollen joints
Whether caused by inflammation or joint damage, stiff and swollen joints are a characteristic symptom of many types of arthritis, including psoriatic arthritis.
Often, this is worse when sufferers first wake up in the morning or after resuming activity following a period of stillness. This stiffness and swelling may decrease with continued activity during the day, only to return the following morning.
“Sausage fingers”
This description of the type of swelling experienced by psoriatic arthritis sufferers is apt. Unlike rheumatoid arthritis that causes swelling just around the joint, psoriatic arthritis sufferers experience swelling for the entire length of the affected digit. Formally known as dactylitis, this swelling can make movement painful and, at times, impossible.
Swelling in the fingertips may be misdiagnosed as psoriatic arthritis but is more commonly associated with the swelling caused by gout.
Ligament and tendon pain
Ligament and tendon pain where bones and muscles attach is a common early psoriatic arthritis sign.
Called enthesitis, this tenderness occurs most often at the Achilles tendon and the bottom of the foot (in the plantar fascia) but can also manifest itself as tennis elbow.
Changes to the nails
An often-ignored diagnostic tool for a variety of conditions is the fingernails. Psoriatic arthritis early signs include pitted, infected-looking fingernails that may begin to separate from the nail bed.
While other vitamin deficiencies can be diagnosed looking at the fingernails, this type of change is specific only to psoriasis and psoriatic arthritis and is often used to confirm the diagnosis.
Extreme fatigue
Fatigue is more than just feeling tired after a long day or poor night of sleep.
Fatigue that comes with psoriatic arthritis and other conditions is a weary-to-the-bone feeling that makes simple, everyday tasks challenging. Ironically, this fatigue may not result in restful sleep, which can exacerbate pain later on.
Limited range of motion in the joints
Stiff and swollen joints decrease pain-free range of motion.
In a vicious cycle, people with psoriatic arthritis may further restrict their movements, causing ligaments and tendons to shorten, which only further decreases their range of motion in the future.
Issues with the eyes
Psoriasis can involve the eyes, which means psoriatic arthritis symptoms can appear in this area as well.
Redness and irritation that resembles pink eye (conjunctivitis) is possible, as are disturbances in vision as well as pain.
Lower back pain
Lower back pain has a wide variety of causes, including ankylosing spondylitis (which also shares other symptoms with psoriatic arthritis).
On its own, the presence of lower back pain is not enough to properly diagnose psoriatic arthritis, but it can be a factor.
Asymmetrical pain
Unlike fibromyalgia, another widespread pain condition that shares similar symptoms with psoriatic arthritis, pain with psoriatic arthritis is felt asymmetrically on the body. That means that in general, psoriatic arthritis symptoms appear on one side of the body. If you have patches of psoriasis on your right side, symptoms may also appear mostly on that side as well.
This does not mean that different symptoms cannot be present all over, only that each symptom generally only appears on one side or the other.
Flares
In the “might be good news, might be bad news “column is the characteristic nature of psoriatic arthritis flares. A person with psoriatic arthritis might have long periods with no symptoms, only to experience a sudden rush of symptoms. These may be triggered by a variety of factors, including:
- Stress
- Diet
- Another illness or infection that activates the immune symptoms
Many other conditions have similar symptoms. Proper and thorough diagnosis is crucial to successful treatment of this chronic condition.
How to diagnose psoriatic arthritis
Diagnosis of psoriatic arthritis is a combination of looking carefully at symptoms and risk factors while utilizing blood tests and other diagnostic tools. Taking a complete medical history, including your family history of arthritis or autoimmune disorders is an important first step. Your doctor may also use X-rays or MRIs to look for joint damage due to the inflammation.
There are also blood tests that can rule out other conditions, including gout, osteoarthritis, and rheumatoid arthritis. The presence of inflammation and blood work that reveals slight anemia may help indicate psoriatic arthritis.
If a skin condition is present but psoriasis has not yet been diagnosed, your doctor may take a skin biopsy. Again, it’s important to note that even people without psoriasis can develop psoriatic arthritis symptoms.
Psoriatic arthritis complications
Proper diagnosis of psoriatic arthritis is crucial. More than just a minor irritation in the joints that can usually be managed with medications and exercise, this condition is closely linked with other serious and debilitating conditions.
Inflammatory bowel disease, especially the form called Crohn’s disease, is closely linked to psoriatic arthritis. The diarrhea and other gastrointestinal problems it causes can have a severe impact on a person’s life and can even be fatal if intestinal blockages occur.
Psoriatic arthritis inflammation can also lead to interstitial lung disease in severe cases. Symptoms include shortness of breath, coughing, and even more fatigue.
Further, chronic inflammation damages blood vessels. Damage to the blood vessels increases the risk of heart attack and strokes. But that’s not all: psoriatic arthritis sufferers often develop metabolic syndrome. Metabolic syndrome is an umbrella term that covers conditions like obesity, high blood pressure, and poor cholesterol levels.
Finally, psoriatic arthritis sufferers have higher rates of depression, an increased risk for osteopenia (thinning bones) and osteoporosis, and a higher-than-average risk of developing gout.
Proper treatment and diagnosis is crucial to prevent more serious conditions from developing.
What is the best treatment for psoriatic arthritis?
Although painful and chronic, there are treatments for psoriatic arthritis that can offer lasting relief. The level of intervention is based on your level of pain, duration, severity, and overall inflammation.
For very mild psoriatic arthritis flares, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium may be enough to treat your pain. Gentle exercises and movement can help maintain (and increase) range of motion in the affected joints.
There are a number of prescription medications that can help if the symptoms of psoriatic arthritis do not respond to the above interventions. These may include:
- Sulfasalazine (Azulfidine)
- Methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo)
- Cyclosporine (Neoral, Sandimmune, Gengraf)
- Leflunomide
Your doctor may use a combination of these medications to find an approach that works best for you. For the most severe psoriatic arthritis cases, azathioprine (Imuran) may offer relief when other medications do not.
Interventional approaches
Injections can offer more immediate relief when needed. Some injections such as adalimumab (Humira), etanercept (Enbrel), golimumab (Simponi), certolizumab (Cimzia) and infliximab (Remicade) help not only arthritis symptoms but also the skin symptoms of psoriasis.
Other injections that can help are:
- Secukinumab (Cosentyx) or ustekinumab (Stelara): For both psoriatic arthritis and psoriasis
- Abatacept: This is an option for is patients whose symptoms have not responded to other treatments
- Corticosteroid injections: For swollen and painful joints
If psoriatic arthritis symptoms are advanced and have resulted in damage to the joints, surgery may be necessary to repair them. This could include knee repair or replacement if that joint is most affected.
A good doctor will tailor treatment of your psoriatic arthritis symptoms to your unique condition. Talk to your doctor about what might work for you. If you think you may be experiencing psoriatic early symptoms, it may be time to talk to a pain specialist. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.
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