8 Joints Impacted by Psoriatic Arthritis

Psoriatic arthritis (PsA) is a type of joint inflammation that typically develops in people who have psoriasis, a chronic autoimmune condition that causes skin cells to overproduce and build up, creating patches of dry, flaky skin. Up to 10% of people with psoriasis also have psoriatic arthritis. Psoriatic arthritis typically develops in adults between 30 and 50 years old, and it can cause pain, swelling, stiffness, and damage to many joints throughout the body. It’s often treated with a combination of stretching, exercise, occupational therapy, and medication. Learn where to look for signs.

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  1. Your hands and fingers.

  A type of psoriatic arthritis called “arthritis mutilans” damages joints in the hands—as well as the feet—to the point of deformity. Severe inflammation can make joints retract like a telescope and hinders movement significantly. Arthritis mutilans is the most debilitating type of psoriatic arthritis, but it’s also the rarest. It only affects about 5% of people with PsA. But even for people without this severe form, psoriatic arthritis can cause pain, stiffness, swelling, redness, and a hot feeling in the hands and fingers. Some people describe their inflamed fingers as looking like sausages. It can be hard to grip items or do activities of daily living like cooking and bathing. You may also notice changes to your fingernails. They may be yellow, thick, ridged, or pitted, and may even start to crumble or fall off.
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  2. Your feet and toes.

  For some people, a change in the foot like a “claw toe” is the first sign of arthritis mutilans, so it’s important to keep track of your symptoms. In general, psoriatic arthritis can cause joints in the feet and toes to swell, feel hot and painful, and get stiff. This can make walking difficult, so it’s important to find supportive shoes that can take some of the pressure off. Toenails can also be impacted much like fingernails.
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  3. Your knees.

  The knee is a common target for psoriatic arthritis. You may find that only one knee is affected. This is known as “asymmetrical.” If both knees are affected, PsA involvement is considered “symmetrical.” As you age, it’s more likely that psoriatic arthritis will start to impact your knee. It can cause severe pain, limit movement, and affect balance. Knee surgery is the second most common joint surgery in those with PsA.
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  4. Your hips.

  Like with the knee, PsA can affect one or both hips. However, PsA in the hip is uncommon. It usually happens in people who develop psoriatic arthritis at an early age. You may feel pain in your hip joint, groin, buttocks, or outer thigh. You may have trouble walking or walk with a limp. While hip surgery is the most common joint surgery for those with PsA, effective medications are available, too.
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  5. Your back.

  Sometimes, psoriatic arthritis targets the joints of the spine, which runs from the tip of your pelvis to the base of your skull. The medical term for this type of psoriatic arthritis is “spondylitis.” You may feel pain or stiffness. This can affect how you move and make it harder to work, play, relax, and sleep.
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  6. Your neck.

  Psoriatic arthritis may also affect your neck–what your doctor may refer to as your “cervical spine.” As with PsA in the knee and hip, surgery is usually only recommended if symptoms can’t be relieved any other way and quality of life is seriously compromised. Treatment plans tend to be highly personalized, informed by a healthcare team that includes a dermatologist, rheumatologist, and orthopedic surgeon.
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  7. Your elbows.

  Psoriatic arthritis can occur any place in the body where tendons or ligaments connect to bones. For many people, this includes the elbow, which can get inflamed and painful, inhibiting your ability to drive, cook, or perform other activities.
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  8. Your ankles.

  PsA can cause ankles to become swollen, stiff, and painful, making it harder to walk and live your normal life. This can make exercise difficult, which may lead to weight gain–and unfortunately, weight gain can make psoriatic arthritis symptoms worse. However, when PsA is well managed with medication, it may be easier to exercise, and if joints are still inflamed, certain activities like swimming and Tai chi can be gentler alternatives that still provide you with necessary movement.