Skin and Bones: Understanding Psoriatic Arthritis

How are skin health and joint health connected? For people with psoriatic arthritis, the common denominator is a malfunctioning immune system.

Psoriatic arthritis occurs when the immune system attacks healthy joints, leading to pain and swelling. This autoimmune disorder occurs alongside another — psoriasis, a skin condition in which cells overproduce, causing areas of scaly skin. Not everyone with psoriasis develops psoriatic arthritis, but it can make some everyday tasks more difficult for those who do. If you have this form of arthritis, there is plenty of hope in treatment, which can make the disease manageable and help you stay active.

What Causes Psoriatic Arthritis?

Psoriatic arthritis happens because of a faulty immune system, but what causes the immune system to behave incorrectly isn’t clear. Certain factors, however, may play a role. Family history, for example, may contribute, with some genes passed down in families potentially contributing to the development of this disease.

In addition to genes, some environmental factors may also play a role in prompting your immune system to turn against healthy joints. These factors include your stress level or previous infections.

Spot the Symptoms

Psoriatic arthritis can affect joints throughout the body, but some of the most commonly affected include the finger or toe joints, wrists, knees, and ankles, according to the Arthritis Foundation. Symptoms of this disease include:

• fatigue
• fingernails or toenails separating from the nail bed
• heel pain due to inflammation of the connections between bones and soft tissues
• inflammatory bowel disease
• joint pain
• joint stiffness that tends to be worse after resting or sitting
• pitting in fingernails or toenails
• skin symptoms, including rough red or silvery skin on your elbows, knees or scalp
• swollen fingers or toes

What Is the Difference Between Psoriatic Arthritis and Rheumatoid Arthritis?

Psoriatic arthritis and rheumatoid arthritis have a lot in common. They are both autoimmune conditions. They also share several symptoms, including painful, swollen and stiff joints. These conditions do, however, have key differences.

Rheumatoid arthritis tends to affect the same joints on both sides of the body, such as both elbows, but psoriatic arthritis often affects a joint on only one side. Usually, rheumatoid arthritis and psoriatic arthritis affect different joints, and rheumatoid arthritis may be more extensive.

Every person’s experience is different, so it’s difficult to characterize rheumatoid arthritis or psoriatic arthritis as worse than the other. Both diseases can have a major effect on the quality of life.

Identifying and Managing Psoriatic Arthritis

To diagnose psoriatic arthritis, your primary care provider or rheumatologist will check for visible symptoms, such as swollen joints or fingernail or toenail changes, and ask about your medical history. Blood tests can rule out other conditions. Imaging scans may show joint damage.

There is no cure for psoriatic arthritis, so the goal of treatment is to control the condition and reduce flare-ups so you can do the things you love. You may be able to manage mild symptoms by taking over-the-counter pain medications or getting corticosteroid injections. If you have a more severe case, your medical provider may prescribe medications to target the immune system and reduce symptoms. Discuss these medications’ potential side effects with your medical provider.

You can complement medical therapy by taking steps to adjust to (and ease into) life with psoriatic arthritis. You should switch to low-impact exercises that are easier on your joints, such as swimming. If you smoke, kick the habit as it may exacerbate symptoms. Stress can also worsen symptoms, so make time each day to do something relaxing or enjoyable. Finally, watch your weight — excess weight increases the burden on your joints.