8 Tips on How to Treat a Psoriatic Arthritis (PsA) Flare-Up
Key takeaways:
A psoriatic arthritis (PsA) flare-up is a temporary worsening of symptoms. To treat it, you might need treatment for a short time or a change to your PsA medications.
Missed doses of medications, stress, and infection can all trigger PsA flares.
If you’re having a PsA flare, focus on rest and self-care. Contact your healthcare team to find out if new medications or an appointment are needed to help.
Psoriatic arthritis (PsA) is a lifelong autoimmune condition that can cause inflammation in the skin (psoriasis), joints, spine, and tendons. About 30% of people who have psoriasis also have PsA.
There’s no cure for PsA yet. But there are many medications to manage it. The goal of PsA treatment is to find medication that treats all of your symptoms: psoriasis rashes, joint pain, and tendon problems.
Even with great medications, PsA flares sometimes happen. This is when symptoms temporarily worsen. Learning about what can trigger flares and how to recognize them can help you take control of your PsA. It’s also helpful to know what to do when you have one.
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What are the symptoms of a PsA flare?
When your PsA flares, your symptoms — involving your joints, skin, or both — will be worse than normal. Sometimes, new symptoms can also occur. PsA flares are different for everybody, since everyone has their own version of PsA. But it’s safe to say that flares can affect your quality of life and daily productivity.
Some typical PsA symptoms include:
Joint pain or swelling
Worsening of psoriasis rashes — in new areas or areas that have been involved before
Enthesitis (tenderness and inflammation at the site where tendons attach to bone, like the back of your heel)
Dactylitis (swelling of an entire finger or toe, sometimes called a “sausage digit”)
Spondylitis (inflammation of the sacroiliac joints or the spine)
Fatigue
How to treat a psoriatic arthritis flare
If you notice your PsA symptoms worsening, you may be having a flare. Here are some steps you can take to feel better sooner:
Call your rheumatologist and let them know you’re having a flare. They can help determine if it’s a flare or something else.
Follow the treatment plan. It’s important to continue to take your medications as directed.
Take it easy on swollen and painful joints. But remember that gentle movement can help ease stiffness.
Ice swollen and painful joints. Ice can temporarily decrease warmth, pain, and swelling in joints that hurt the most.
Don’t skimp on sleep. This might mean taking some time off of work or asking for extra help from family or friends.
Try to focus on decreasing stress levels. This could include self-care, low-impact exercise, mindfulness, or a number of other options.
Lean on your support system. An arthritis support group can also be a great resource.
Keep track of what might be causing your flares. This can help you prevent them in the future.
Some PsA flares can improve with just 1 to 2 weeks of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids to stamp out the extra inflammation. A healthcare professional may be able to prescribe these without seeing you in person. But these can also worsen psoriasis, so it’s worth a discussion about risks and benefits.
Psoriatic arthritis (PsA) flare vs. infection: It’s not always easy to tell the difference between them. But there are certain signs to look for, and your healthcare team can always help.
Can diets help prevent PsA flares? Fad diets aren’t recommended, but some foods may help prevent inflammation.
Triggers can vary from person to person. Read how one person with PsA manages her flares and prioritizes self-care.
If your flare doesn’t improve, or you’re having many flares, these could be signs that your PsA medications aren’t working as well anymore. You should schedule an appointment so your healthcare team can take a closer look. You might need a change in your PsA medications to get things back under control.
What can cause a PsA flare?
A variety of things can trigger a PsA flare. Some triggers you can prevent, but some you can’t. The good news is that the most common cause of a PsA flare — missing doses of your medication — is within your control. The best favor you can do for yourself is taking your medications as directed.
If you’re having trouble getting or taking your medications for any reason, talk to your healthcare team or pharmacist. They can help troubleshoot, problem solve, or find an alternative medication if needed.
If it’s hard for you to remember to take your medications, you could try using a medication reminder app or setting an alarm on your phone.
Aside from missed medication, other causes of PsA flares include:
Stress
Lack of sleep
Weather changes
Infections of any kind (bacterial and viral)
Smoking
Pay attention to what triggers your psoriasis as well. It may help to avoid psoriasis triggers (like skin injuries and certain foods).
What’s the best way to prevent a PsA flare?
PsA flares can make it hard to work, play, and take care of your family. But there are things you can do to decrease your chances of having flares in the future.
To help prevent PsA flares, focus on the following:
Take your medications as prescribed.
Stop smoking.
Get enough sleep.
Get regular activity.
Maintain a comfortable weight.
Stay up-to-date on recommended vaccines.
Avoid known food triggers of your psoriasis rashes, if you have them.
Frequently asked questions
Yes, you can experience PsA flares even if you’re taking a biologic medication. It could be because you were exposed to something that triggered a flare, such as a change in eating habits or extra stress. And sometimes medications lose their effectiveness over time. Treatment guidelines often recommend what to do when this happens. When in doubt, talk to your rheumatologist about how well your treatment is working.
Similar to the symptoms, the duration can also vary. A flare can last for hours, a couple of days, or even up to a week. It really depends on the person. So be sure to contact your rheumatologist if you’re struggling to manage your symptoms.
Maybe. There’s some research to suggest a connection between following a Mediterranean diet and improved PsA symptoms. So avoiding foods that can contribute to inflammation may help.
But there’s not a direct link between certain foods or drinks and PsA flares. That said, diet may cause psoriasis flares in some people. If you know certain foods or drinks worsen your psoriasis rashes, it makes sense to avoid them when trying to prevent PsA flares too.
The bottom line
PsA flares can seriously affect your day-to-day life, making simple tasks feel impossible. If you’re suffering from a flare, talk to your healthcare team about your options. It’s important to focus on self care and to lean on your support system to get you through it. To prevent PsA flares, the best thing you can do is take your medications as directed.
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References
Centers for Disease Control and Prevention. (2024). What vaccines are recommended for you.
Donvito, T. (2019). Psoriatic arthritis flare-ups: Exactly what to do when you get one. CreakyJoints.
Gossec, L., et al. (2024). EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2023 update. Annals of the Rheumatic Diseases.
Kambach, B. (2015). When and why to apply cold to an arthritic joint. Arthritis-health.
Katsimbri, P., et al. (2024). Mediterranean diet and exercise are associated with better disease control in psoriatic arthritis. Clinical Rheumatology.
National Psoriasis Foundation. (2025). Classification of psoriatic arthritis.
Orbai, A., et al. (2023). Impact of physician-defined flares on quality of life and work impairment: An international survey of 2238 patients with psoriatic arthritis. The Journal of Rheumatology.
