Did you know that psoriatic arthritis doesn’t always start with joint stiffness? For some, the first sign isn’t stiff fingers or swollen knees — it’s fatigue, nail changes, or even eye irritation. Psoriatic arthritis is a sneaky condition that can mimic other diseases, making it tricky to diagnose early.1 The sooner you recognize the warning signs, the better your chances of preventing long-term joint damage.
What Is Psoriatic Arthritis?
Psoriatic arthritis (PsA) is a chronic autoimmune disease that causes inflammation in the joints, skin, and other parts of the body. It develops when the immune system mistakenly attacks healthy tissues, leading to pain, swelling, and stiffness. Over time, this inflammation can cause permanent joint damage if left untreated.
What makes PsA unique is its connection to psoriasis, a skin condition that causes red, scaly patches. While many people with psoriasis will never develop PsA, about 30% do — and in some cases, the joint issues appear before any skin symptoms.1,2
Psoriatic arthritis can affect any joint, from fingers and toes to the spine, and it often comes with additional symptoms like fatigue, eye inflammation, and nail changes.3 The severity of psoriatic arthritis symptoms varies widely — some people experience mild symptoms, while others face significant joint deterioration over time. Because its symptoms can mimic other types of arthritis, early diagnosis is key to managing PsA effectively.1
Who Is at Risk?
While anyone can develop PsA, some people are at a significantly higher risk due to genetic and environmental factors. Here are the key risk factors:
- Psoriasis Severity and Distribution: Psoriasis affecting multiple body areas, especially the scalp, intergluteal, or perianal regions, is linked to a higher PsA risk.1,2,3
- Nail Disease: Psoriasis affecting the nails has been identified as a strong predictor of psoriatic arthritis. Pitting, thickening, or separation from the nail bed indicate underlying inflammation that may precede joint involvement.2
- Obesity: Higher body mass index (BMI) is associated with increased inflammation and joint stress, raising PsA risk.2
- Joint Trauma or Physical Stress: Injuries or repetitive strain on joints may trigger PsA in genetically predisposed individuals.2
- Infections & Stress: Strep throat, gastrointestinal infections, and high-stress levels can trigger immune system overreactions, which might lead to PsA. More research is required to address these potential risk factors.2
Common Early Symptoms
Early psoriatic arthritis can present itself in many ways, often making it difficult to distinguish from other forms of arthritis. Here’s what you should look out for:
Swollen Fingers and Toes (Dactylitis)3,4
One of the most distinct early signs of PsA is dactylitis — severe swelling of the fingers and toes that gives them a sausage-like appearance. Unlike typical joint swelling seen in conditions like rheumatoid arthritis, dactylitis affects the entire finger or toe, making it red, painful, and difficult to move.
Nail Changes3,4,5
Nail abnormalities are common in psoriatic arthritis and can serve as an early warning sign. Look for pitting (small dents in the nail surface), thickening, discoloration, or nail separation from the nail bed. These nail symptoms often resemble a fungal infection but are actually linked to PsA.
Joint Pain and Stiffness3,4,5
Persistent joint pain, stiffness, and tenderness — especially in the morning or after long periods of inactivity — are hallmark symptoms of psoriatic arthritis. You can experience joint pain anywhere in the body, but it most often targets the hands, wrists, knees, and ankles.
Lower Back Pain3,5
PsA can cause inflammation in the spine, a condition known as spondylitis. This leads to chronic lower back pain and stiffness, especially in the sacroiliac joints (where the spine meets the pelvis). If left untreated, it can limit mobility and affect daily activities.
Fatigue3,4,5
Many people with PsA experience overwhelming fatigue, which isn’t simply due to a lack of sleep. The body’s inflammatory response drains energy levels, making it difficult to complete daily tasks. PsA-related fatigue can be debilitating and is often one of the most frustrating symptoms.
Eye Problems3,5
Inflammation can extend beyond the joints, affecting the eyes and causing conditions like uveitis. Symptoms include redness, pain, light sensitivity, and blurry vision. If left untreated, uveitis can lead to severe eye damage and even vision loss.
Inflammatory Bowel Disease5
Surprisingly, psoriatic arthritis is linked to inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis. Some PsA patients experience abdominal pain, diarrhea, and other digestive issues due to underlying inflammation in the gastrointestinal tract.
How Is Psoriatic Arthritis Treated?
While there is no cure for PsA, the right treatment can help patients manage symptoms, reduce inflammation, and prevent joint damage — allowing them to stay active and live fulfilling lives. Treatment options include:
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic therapies help control chronic inflammation.6,7
- Physical Therapy: Targeted exercises improve joint function and flexibility while reducing stiffness.6,7
- Lifestyle Adjustments: Maintaining a healthy weight, eating a healthy diet, and staying active can help manage symptoms.
When to Consult a Doctor
If you are experiencing any early signs of psoriatic arthritis, it’s important to seek medical advice as soon as possible. Since psoriasis symptoms can be mistaken for other conditions, consulting a rheumatologist is the best way to get an accurate diagnosis. Early intervention can prevent long-term joint damage and significantly improve quality of life.1
Schedule a Consultation with an ARBDA Doctor Today
At Arthritis, Rheumatic & Bone Disease Associates (ARBDA), we understand how challenging psoriatic arthritis can be. Our dedicated team of rheumatologists specializes in diagnosing and treating PsA in New Jersey by offering personalized treatment plans to help you regain control of your health.
If you are showing signs of psoriatic arthritis and need an expert opinion, don’t wait. Schedule an appointment with an ARBDA doctor today and take the first step toward better joint health.
2https://pmc.ncbi.nlm.nih.gov/articles/PMC5278907/
3https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/symptoms-causes/syc-20354076
5https://www.niams.nih.gov/health-topics/psoriatic-arthritis
6https://www.mayoclinic.org/diseases-conditions/psoriatic-arthritis/diagnosis-treatment/drc-20354081
7https://my.clevelandclinic.org/health/diseases/13286-psoriatic-arthritis
