The 10 Most Common Symptoms of Psoriatic Arthritis

Most people think of psoriasis as a condition that only affects the skin. While that is true, about 25% of people who have psoriasis can one day develop another condition called “psoriatic arthritis” (PsA). This is an autoimmune, inflammatory condition that affects the joints, tendons, and sometimes the eyes. So it’s important to keep an eye out for certain symptoms if you have psoriasis. 

In this article, we walk you through the most common symptoms of PsA along with prognosis and prevention.

What are the 10 most common symptoms of psoriatic arthritis?

PsA is different for everybody. In general, PsA is psoriasis rash plus joint pain and swelling. Other symptoms can occur, too. Everyone gets their own version of PsA, so the specific symptoms you get is luck of the draw.  

The most common PsA symptoms include:

1. Joint pain or swelling: PsA really likes the fingers and toes, but it can affect any joint.

2. Skin rashes (psoriasis): There are a few different types of psoriasis rashes. Red, scaly patches on the scalp, elbows, and knees are the most common. But psoriasis rashes can happen anywhere — even in the genital and buttock areas.

3. Changes in the nails (nail psoriasis): These changes include color changes, tiny pits, or nails that appear crumbly.

4. Pain and inflammation where tendons connect to bones (enthesitis): PsA likes the entheses (areas where tendons connect to bone) at the back of the heel, elbows, and spine. 

5. Pain and inflammation in the cartilage between the rib cage (costochondritis): Pain might get worse when your rib cage expands to take a deep breath in.

6. Swelling of an entire finger or toe: This is also called “sausage digit” (dactylitis). 

7. Low back pain and stiffness: This is caused by inflammation in the sacroiliac joints in the low back where the pelvis meets the spine (sacroiliitis).

8. Mid-back or neck pain and stiffness: This is due to inflammation in the spine itself (spondylitis). 

9. Eye inflammation (uveitis): This is a less common symptom of PsA. Eye pain and redness, sensitivity to light, and blurry vision raise concern for uveitis.

10. Fatigue: Untreated inflammation in the body can make you feel run down, even when you get a decent night’s rest.

What are the symptoms of a psoriatic arthritis flare?

A PsA flare is when symptoms temporarily get worse. PsA flares are different for everyone, since everyone has their own specific symptoms of PsA. Worsening rashes and joint pain are common during flares. Sometimes new symptoms can also show up.  

What are the early warning signs of psoriatic arthritis?

The early signs of PsA are the same as the symptoms listed above. Studies show that the earlier you get a PsA diagnosis and treatment, the better you’ll do in the long run. So it’s important to be aware of the early warning signs.

If you have psoriasis and develop any of these other symptoms, talk to your dermatologist or primary care provider. They can refer you to a rheumatologist (autoimmune specialist) who can determine if your symptoms are due to PsA or something else.

Is there anything I can do to prevent psoriatic arthritis?

If you have psoriasis, you’re probably wondering if there’s anything you can do to decrease your chances of getting PsA. We don’t currently have any medications that can prevent the development of PsA. But here’s the good news: Studies show that there are a few things you can do that might help.

To help decrease your risk of PsA, you can:

• Stop smoking. Studies suggest that quitting smoking can improve psoriasis and decrease the chance of getting PsA in general. There are other health benefits of smoking cessation, too. 

• Maintain a healthy weight. A recent study showed a link between having overweight or obesity and an increased risk of developing PsA if you have psoriasis. So it helps to do your best to maintain a healthy weight via a healthy diet and exercise.

• Consider vitamin D and fish oil supplements (omega-3 fatty acids) if you are a woman older than 55 or a man older than 50. A recent study showed a decreased risk of developing autoimmune disease in general (including PsA) in adults this age who took these supplements. Of note, vitamin D and fish oil haven’t been studied yet specifically in people with psoriasis for the prevention of PsA.

What’s the prognosis like for someone with psoriatic arthritis?

The prognosis is pretty good — if you take your medications. There’s no cure for PsA, but living a healthy and fulfilling life is possible thanks to the many medications available to treat it. Treatments might include pills, infusions (into the vein), or injections (biologics). The goal of treatment is clear skin and happy joints. It can take a little time to find the medications that work best for you, but better days are in your future!

If you don’t treat psoriatic arthritis, uncontrolled inflammation can lead to complications (problems) in the skin, joints, and other parts of the body. Taking your medication(s) is the best way to protect your body from permanent complications of PsA.

Why trust our experts?

Written by:

Samantha C. Shapiro, MD

Samantha Shapiro, MD, is a board-certified rheumatologist and internist with expertise in autoimmune and inflammatory conditions. She founded the division of rheumatology at Dell Medical School at The University of Texas at Austin.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Our editorial standards

Meet our experts