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Warning Signs of Psoriatic Arthritis You Shouldn’t Ignore

15. Psoriasis Flare-ups Psoriasis flare-ups, characterized by red, scaly patches of skin, can often coincide with the onset or worsening of psoriatic arthritis symptoms. Psoriasis patches… kalterina - September 25, 2024

Psoriatic arthritis (PsA) is a chronic inflammatory disease that affects individuals with psoriasis, a skin condition marked by red, scaly patches. PsA can cause joint pain, stiffness, swelling, and fatigue, leading to significant physical limitations if left untreated. Early recognition and treatment are key to preventing irreversible joint damage and improving quality of life. This article outlines 20 warning signs of psoriatic arthritis, with detailed explanations to help identify and understand these symptoms.

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20. Joint Pain

Joint pain is one of the most prevalent symptoms of psoriatic arthritis and can range from mild discomfort to severe, debilitating pain. Unlike pain from mechanical injuries, PsA-related joint pain is caused by chronic inflammation, which can worsen with activity or even persist during rest. This pain may be felt in various joints, but it is especially common in the hands, knees, ankles, and lower back. Living with chronic joint pain can significantly affect one’s ability to perform daily tasks, from walking and bending to carrying objects, ultimately limiting physical activities and impacting mental health due to the constant pain.

If you experience persistent pain in your joints that does not subside after rest or with the use of over-the-counter pain relievers, it could be a sign of PsA. Joint pain associated with PsA tends to worsen with movement and can be accompanied by other symptoms like swelling or stiffness. If the pain occurs in the same joints on both sides of your body, or if you notice flare-ups coinciding with changes in your psoriasis, it is important to seek medical advice for evaluation and potential treatment.

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19. Swollen Fingers and Toes (Dactylitis)

Swollen fingers and toes, known as dactylitis or “sausage digits,” are a distinctive symptom of psoriatic arthritis. This condition occurs when the entire digit swells due to inflammation in both the joints and surrounding tissues. Dactylitis can cause intense pain and make it difficult to perform fine motor tasks like writing, buttoning clothes, or gripping objects. It can also affect walking if the toes are involved, leading to mobility issues. The swelling is often sudden and may occur in one or more fingers or toes at the same time, with the skin over the affected area sometimes becoming red and warm.

You may notice this symptom if one or more of your fingers or toes becomes significantly swollen, to the point that the digit resembles a sausage in appearance. The swelling is often painful, and the digit may feel stiff or difficult to move. If dactylitis occurs frequently or lasts for an extended period, it may indicate psoriatic arthritis, especially if you have a history of psoriasis or other joint-related symptoms.

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18. Stiffness

Stiffness is another hallmark symptom of psoriatic arthritis and can severely limit your range of motion. The stiffness is typically most pronounced in the morning or after long periods of inactivity, such as sitting for extended durations. Morning stiffness can last for 30 minutes or longer, and the joints may feel rigid, making it difficult to start your day. Over time, chronic stiffness can reduce mobility, affecting your ability to exercise, complete daily chores, or even perform simple movements like getting dressed or climbing stairs.

This stiffness can be recognized when you feel a general tightness in your joints, especially after waking or periods of rest. The affected joints may feel difficult to move, and stretching or light movement might be required to “loosen up.” If this morning stiffness becomes a persistent problem, and it doesn’t ease with movement throughout the day, it may be an early indication of psoriatic arthritis.

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17. Fatigue

Chronic fatigue is a common and often overlooked symptom of psoriatic arthritis, but it can be one of the most debilitating. This type of fatigue is not simply the result of a lack of sleep; it is caused by the body’s ongoing inflammatory processes. PsA-related fatigue can make you feel drained of energy, even after a full night’s rest, and may persist throughout the day. This relentless tiredness can affect productivity at work, social interactions, and overall quality of life. For many individuals with PsA, fatigue can also lead to feelings of depression or frustration, as they may feel incapable of keeping up with daily demands.

Fatigue related to PsA is different from ordinary tiredness—it is more profound and often described as feeling like your body is weighed down or that your energy is being sapped by an internal force. If you consistently feel exhausted, even after sleeping well or taking time to rest, and especially if this fatigue is coupled with joint pain or stiffness, it’s important to discuss it with a healthcare provider.

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16. Nail Changes (Nail Pitting)

Nail pitting, which involves the formation of tiny depressions or dents in the nails, is a well-known sign of psoriatic arthritis. In addition to pitting, nails may develop other abnormalities, such as ridges, thickening, discoloration, or even separation from the nail bed (a condition called onycholysis). Nail changes can make everyday activities like typing, playing musical instruments, or grooming more difficult. In severe cases, the nails may become brittle and susceptible to infections, further complicating the condition.

If you notice that your nails are developing pits, ridges, or are becoming discolored or thickened, it may be an early sign of PsA. These changes often precede joint symptoms, particularly in individuals with psoriasis. If nail changes occur alongside other signs like swollen fingers or joint pain, they should be evaluated by a healthcare professional.

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15. Psoriasis Flare-ups

Psoriasis flare-ups, characterized by red, scaly patches of skin, can often coincide with the onset or worsening of psoriatic arthritis symptoms. Psoriasis patches are commonly found on the scalp, elbows, knees, and lower back, but they can appear anywhere on the body. The presence of psoriasis, particularly when it flares up after periods of remission, may signal an increase in inflammation in the body, which can also affect the joints. For many people, stress, infections, or changes in medication can trigger psoriasis flare-ups, which in turn can lead to joint pain or stiffness.

You may recognize psoriasis flare-ups by the appearance of red, inflamed skin patches covered with silvery scales. These patches can be itchy, painful, or prone to cracking and bleeding. If your psoriasis is accompanied by joint pain or stiffness, it’s important to monitor these symptoms closely and seek medical advice to determine whether psoriatic arthritis is also present.

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14. Lower Back Pain

Lower back pain is a common symptom of psoriatic arthritis, particularly in cases where the spine is affected, a condition known as axial PsA. This type of pain is usually due to inflammation in the joints of the spine (called spondylitis) and the sacroiliac joints, which connect the spine to the pelvis. The pain can range from mild discomfort to severe, chronic pain that interferes with mobility and daily activities. Lower back pain from PsA is typically worse in the morning or after periods of rest and improves with movement.

If you experience persistent lower back pain that doesn’t improve with rest and is more pronounced after inactivity, it could be a sign of PsA. This type of pain often affects both sides of the lower back and may radiate into the buttocks or hips. If lower back pain is accompanied by stiffness or swelling in other joints, consider discussing it with a healthcare provider.

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13. Reduced Range of Motion

Reduced range of motion is a key indicator of psoriatic arthritis, especially when joint inflammation leads to stiffness and swelling. As PsA progresses, the inflammation can cause permanent damage to the joints, further limiting movement. This reduction in flexibility can make it difficult to perform everyday tasks like bending, reaching, or stretching. Over time, untreated PsA can lead to joint deformities, making even the simplest movements painful and difficult.

You may notice this symptom if you have difficulty moving your joints as freely as you once did. For example, bending your knees, stretching your arms overhead, or twisting your torso may become challenging or painful. If this reduced range of motion persists or worsens, it could indicate joint inflammation caused by PsA.

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12. Eye Inflammation (Uveitis)

Eye inflammation, particularly in the form of uveitis, can occur in individuals with psoriatic arthritis. Uveitis is characterized by redness, pain, light sensitivity, and blurred vision, and it can affect one or both eyes. In severe cases, uveitis can lead to permanent vision loss if left untreated. This inflammation can interfere with daily activities, making it difficult to read, use a computer, or drive, as bright light may become intolerable.

You can spot this symptom if you experience sudden eye pain, redness, or sensitivity to light. Blurred vision or the feeling of having something gritty in your eye can also be warning signs. If these symptoms occur, it’s important to seek immediate medical attention, as uveitis requires prompt treatment to prevent long-term damage.

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11. Tendon and Ligament Pain (Enthesitis)

Enthesitis refers to inflammation where tendons and ligaments attach to bones and is a common symptom in psoriatic arthritis. This condition can cause localized pain and tenderness, particularly in areas such as the Achilles tendon, the bottoms of the feet (plantar fascia), the elbows, and around the knees. Enthesitis can make physical activity difficult and painful, limiting your ability to walk, exercise, or even stand for long periods. Over time, the chronic inflammation can cause the tendons or ligaments to become damaged, leading to stiffness and reduced mobility in the affected areas.

This symptom is typically recognized by deep, localized pain near tendons or ligaments, particularly in areas that bear weight or are frequently used. For example, you might feel a sharp pain in your heel when walking or tenderness in your elbows after lifting something. If this pain persists and is accompanied by joint stiffness or swelling, it may be a sign of PsA-related enthesitis. Early intervention is important to prevent long-term damage to the tendons and ligaments.

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10. Heel Pain

Heel pain is a frequent and often disabling symptom of psoriatic arthritis, commonly caused by inflammation in the Achilles tendon or the plantar fascia (the thick band of tissue on the bottom of the foot). This pain can make walking or standing for long periods extremely uncomfortable, impacting your ability to carry out daily tasks. Heel pain can also affect your posture and gait, leading to compensatory pain in other areas of the body, such as the knees, hips, or lower back. Over time, untreated heel pain can lead to chronic inflammation, increasing the risk of long-term damage to the foot and ankle.

You may notice this symptom if you experience a sharp, stabbing pain in your heels, particularly after periods of rest, such as first thing in the morning. The pain may improve slightly with movement but return after prolonged walking or standing. If you have recurring or persistent heel pain, especially if it worsens after physical activity, it could be related to PsA and should be evaluated by a healthcare provider.

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9. Rib Pain

Psoriatic arthritis can cause inflammation around the ribs, leading to pain and discomfort in the chest, particularly when breathing deeply, coughing, or performing physical activities that strain the torso. This rib pain, often referred to as costochondritis, can make it difficult to take full breaths and may worsen with movement, further restricting your ability to exercise or engage in strenuous activities. Rib pain can also interfere with sleep, as lying down in certain positions may exacerbate the discomfort.

If you experience sharp or aching pain in your chest or ribs, especially when taking deep breaths or moving your upper body, it could be a sign of inflammation in the joints between the ribs and the sternum (breastbone). This symptom, combined with joint pain or stiffness elsewhere in the body, may indicate psoriatic arthritis, and medical attention is recommended to rule out other conditions and manage the inflammation.

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8. Anxiety and Depression

Living with a chronic, painful condition like psoriatic arthritis can significantly impact mental health, leading to anxiety and depression. The physical limitations caused by PsA, such as chronic pain, fatigue, and reduced mobility, can be emotionally draining. Over time, the frustration of dealing with these symptoms may lead to feelings of helplessness, isolation, or sadness. Many individuals with PsA struggle with the unpredictability of the disease, as flare-ups can occur unexpectedly, adding to the emotional burden. Additionally, the visible skin changes from psoriasis, such as red, scaly patches, can affect self-esteem and contribute to social withdrawal.

You may recognize this symptom if you frequently feel anxious, overwhelmed, or depressed about your physical health. If PsA symptoms interfere with your ability to participate in activities you once enjoyed, or if you feel a persistent sense of hopelessness, it is important to seek help. Mental health care, including therapy or support groups, can be a valuable part of managing life with psoriatic arthritis.

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7. Swollen Joints

Swelling in the joints is a common sign of psoriatic arthritis, and it can cause discomfort, stiffness, and restricted movement. The swelling is usually caused by inflammation in the synovial tissue, which lines the joints, leading to an accumulation of fluid. This can make the affected joints feel warm and tender, and they may appear visibly larger than usual. Swollen joints can make it difficult to perform daily activities, especially if the hands, wrists, or knees are affected. Tasks that require fine motor skills, such as writing, typing, or opening jars, may become challenging, while swelling in the knees or ankles can limit mobility.

You may spot this symptom if you notice that your joints feel puffy or swollen, particularly after periods of rest or activity. The joints may be tender to the touch, and the swelling may persist for several days or weeks. If you experience swelling in conjunction with joint pain or stiffness, it could be a sign of psoriatic arthritis, and early diagnosis is key to preventing long-term joint damage.

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6. Difficulty Using Hands

Psoriatic arthritis often affects the small joints of the hands, causing pain, swelling, and stiffness that can make it difficult to perform everyday tasks. Over time, the inflammation in these joints can lead to deformities, reducing hand function and making activities such as gripping, lifting, or manipulating objects challenging. For individuals with PsA, tasks like cooking, typing, or even holding a cup can become difficult or painful, impacting their ability to maintain independence or participate in hobbies they enjoy.

This symptom may become apparent when you start to struggle with simple tasks that previously felt effortless. For example, you might notice difficulty opening jars, fastening buttons, or maintaining a steady grip. If hand stiffness or pain persists, especially in combination with other PsA symptoms like swelling or joint pain, it is important to seek medical evaluation to prevent further damage and preserve hand function.

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5. Nail Separation

Nail separation, known as onycholysis, is a common symptom of psoriatic arthritis and involves the lifting or separation of the nail from the nail bed. This condition can affect both fingernails and toenails, and in severe cases, the nails may become discolored, thickened, or brittle. Nail separation can be uncomfortable, and it increases the risk of infections, as the space between the nail and the nail bed can harbor bacteria or fungi. This condition can make everyday tasks, such as typing or handling small objects, more difficult and painful.

You can spot this symptom if your nails begin to lift away from the nail bed or if they become discolored, crumbly, or develop ridges. Onycholysis often occurs in individuals with PsA who also experience joint pain and swelling in the fingers or toes. If you notice changes in your nails alongside other PsA symptoms, it’s important to seek medical advice to prevent complications and manage the condition effectively.

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4. Reduced Flexibility

Psoriatic arthritis can cause a reduction in joint flexibility, making it difficult to move affected joints through their full range of motion. This stiffness and reduced flexibility can be particularly noticeable in the morning or after periods of inactivity, and it may worsen over time if the inflammation is not adequately managed. Reduced flexibility can make activities like reaching, bending, or stretching more challenging and can affect posture and gait. In severe cases, joint deformities can develop, further limiting movement and increasing pain.

You may notice this symptom if you find it difficult to perform tasks that require flexibility, such as bending down to pick something up or reaching for objects on high shelves. If reduced flexibility persists and is accompanied by joint pain, stiffness, or swelling, it could be a sign of PsA. Early intervention is important to preserve joint function and prevent further mobility issues.

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3. Pain in the Neck or Upper Back

In some cases, psoriatic arthritis can affect the cervical spine (the neck area), leading to pain, stiffness, and discomfort in the neck and upper back. This pain can make it difficult to turn your head, look up or down, or move your neck through its full range of motion. The pain may radiate into the shoulders or arms, further limiting mobility and causing discomfort during daily activities like driving, reading, or using electronic devices. In more severe cases, inflammation in the cervical spine can lead to long-term stiffness and reduced flexibility.

You may recognize this symptom if you experience persistent neck or upper back pain that worsens with inactivity and improves slightly with movement. If neck pain is accompanied by joint stiffness or swelling in other parts of the body, it may be related to PsA and should be evaluated by a healthcare provider.

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2. Skin Redness and Warmth Around Joints

Psoriatic arthritis can cause inflammation around the joints, leading to redness and warmth in the affected areas. These changes are usually a sign of active inflammation and may be accompanied by swelling and pain. The skin over the inflamed joints may feel tender to the touch, and in some cases, the redness may be more noticeable during flare-ups. This symptom can make the joints feel uncomfortable and may limit your ability to use the affected areas for everyday tasks.

You can spot this symptom by observing areas around the joints that appear red or feel warm. If the redness and warmth are persistent and coincide with joint pain or stiffness, PsA may be the underlying cause. Seeking medical attention early can help manage the inflammation and prevent joint damage.

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1. Joint Deformities

In advanced cases of psoriatic arthritis, untreated inflammation can lead to permanent joint deformities, particularly in the fingers, toes, and hands. Joint deformities occur when chronic inflammation damages the cartilage and bones within the joints, leading to misalignment, reduced mobility, and increased pain. These deformities can severely limit the function of the affected joints, making it difficult to use your hands or feet for basic tasks like walking, gripping, or typing. Joint deformities may also cause discomfort and can significantly impact quality of life, as they interfere with daily activities and physical independence.

You may recognize this symptom by noticing changes in the shape or alignment of your fingers, toes, or other joints. If you observe any deformities alongside other PsA symptoms, such as swelling, pain, or stiffness, it is crucial to seek medical attention. Early treatment can help slow the progression of joint damage and improve long-term outcomes for people with psoriatic arthritis.

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