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Treating Psoriatic Arthritis

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Symptoms of Psoriatic Arthritis Flare Explained

Medically Reviewed By Margaret R. Li, MD, FACR

People with psoriatic arthritis may experience periods when symptoms worsen, known as flare-ups, or flares. The symptoms of a flare can include joint pain and swelling, swollen fingers or toes, and fatigue. Understanding what triggers psoriatic arthritis flares can help you manage them. People with the skin condition psoriasis can also develop psoriatic arthritis. Psoriatic arthritis is characterized by pain, stiffness, and swelling of the joints. Researchers are not sure why some people with psoriasis develop psoriatic arthritis while others do not.

This article explains the symptoms of a psoriatic arthritis flare. It also discusses common triggers of a flare and how they are treated.

What are the symptoms of a psoriatic arthritis flare?

Close up of female hands rubbing together
Alina Hvostikova/Stocksy United

Symptoms of psoriatic arthritis can vary from person to person. They may also come and go. During a flare, you may experience a sudden worsening of symptoms.

Flares can last for days or months.

Psoriatic arthritis is a type of arthritis that occurs in some people who have psoriasis. It occurs when the immune system mistakenly attacks healthy joints. This can lead to pain, swelling, and stiffness.

Along with the joints, psoriatic arthritis can also affect areas where tendons and ligaments connect to bones.

Read more about psoriatic arthritis.

Joint pain and swelling

Joint pain and swelling are common symptoms of psoriatic arthritis. They typically affect your:

  • finger joints closest to the nail
  • knees
  • wrists
  • ankles

You may experience pain, warmth, and swelling on one or both sides of your body.

Stiffness

Joint stiffness is another common symptom of psoriatic arthritis. It typically occurs upon waking or after sitting for long periods of time. Moving can help ease the stiffness, but symptoms may last for 30–45 minutes.

Psoriatic arthritis can also affect Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source the joints in your spine. This can lead to stiffness in your lower back, hips, and neck.

Swollen fingers or toes

In some cases, psoriatic arthritis can cause an entire finger or toe to swell. This can make it painful and difficult to bend. When this swelling occurs, your fingers or toes can become so swollen that they resemble sausages. This is known as dactylitis and is often referred to as sausage digits.

Fatigue

Fatigue refers to a feeling of exhaustion along with Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source reduced physical and mental capacity. It is often a symptom of chronic inflammatory skin and joint conditions, such as psoriatic arthritis.

Fatigue can make you feel tired, even after resting. It is a condition that is often misunderstood. Other factors can also contribute to fatigue, including:

  • age
  • environment
  • social support
  • type of employment

Inflammation of the entheses

The entheses are areas where tendons or ligaments attach to the bone. In psoriatic arthritis, these areas can become inflamed and tender. This is known as enthesitis. 

Enthesitis most commonly affects the back of the heels and soles of the feet.

Nail changes

Psoriatic arthritis can also affect your nails. Some people may experience pitting or discoloration of the nails. In some cases, the nails may also start to separate from the nail bed.

Skin plaques

Skin plaques may also occur with psoriatic arthritis. These are rashes that are typically itchy and have a red or discolored appearance. They may also have a silvery or white buildup of skin.

Rashes related to psoriasis are referred to as plaque psoriasis.

These rashes can develop anywhere on your body. However, they most commonly occur on the:

  • knees
  • elbows
  • scalp
  • ears
  • belly button
  • buttocks

Eye Inflammation

Uveitis is a condition that causes inflammation of the middle layer of the eye. It sometimes occurs in people with psoriatic arthritis.

Uveitis can cause:

  • eye pain
  • eye inflammation
  • redness
  • blurry vision

Without treatment, uveitis may lead to vision loss. If you experience symptoms of uveitis, seek immediate medical care to avoid possible complications.

What triggers a psoriatic arthritis flare?

What triggers a psoriatic arthritis flare can vary from person to person. Some common triggers include:

  • stress
  • skin injuries, such as scratches, sunburns, or insect bites
  • illness, such as ear infection, respiratory infection, or bronchitis
  • weather changes
  • smoking

Less common triggers of a psoriatic arthritis flare include:

  • tattoos and piercings
  • shaving
  • consuming alcohol
  • other conditions such as Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source obesity or injury

How are psoriatic arthritis flares treated?

Treatment for psoriatic arthritis flares can depend Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source on the symptoms you experience and their severity.

Treatments for mild forms of psoriatic arthritis can include:

  • Over-the-counter (OTC) anti-inflammatory and pain medications: These help to reduce swelling and manage pain.
  • Corticosteroid injections: Doctors administer these directly into an affected joint to help manage inflammation.

Treatments for more severe cases may include:

  • Disease-modifying anti-rheumatic drugs (DMARDs): These are oral therapies that help to suppress your immune system. They can help reduce symptoms of psoriatic arthritis.
  • Biologic response modifiers: These are medications that target and interrupt certain immune signals. They can help reduce or relieve inflammation and prevent further damage.

Lifestyle remedies

Making certain lifestyle changes can help reduce the impact psoriatic arthritis has on your daily life. These include:

  • avoiding smoking
  • maintaining a moderate weight
  • practicing regular, low-impact exercises, such as walking, swimming, or yoga
  • protecting your joints, such as pushing open a door with your whole body instead of just your fingertips

Talk with your doctor before starting any new exercise programs.

Other frequently asked questions

Margaret Li, M.D., has reviewed these questions people frequently ask about psoriatic arthritis.

What are the five signs of psoriatic arthritis?

Symptoms of psoriatic arthritis include:

  • swollen fingers and toes
  • inflammation of tendons or ligaments that attach to the bone
  • inflammatory lower back pain, which may be worse in the morning and after resting
  • skin and nail changes
  • eye inflammation

Where does psoriatic arthritis hurt the most?

Psoriatic arthritis mainly affects your joints. It often affects the smaller joints, such as in the fingers and toes. It may also affect other areas such as your pelvis and lower back.

What aggravates psoriatic arthritis?

There are many factors that can aggravate or trigger psoriatic arthritis flares. These include:

  • stress
  • weather changes
  • smoking
  • injuries to the skin
  • illness
  • weight gain and sedentary lifestyle

Summary

The symptoms of psoriatic arthritis may come and go. Periods when symptoms worsen are known as flares.

Symptoms of psoriatic arthritis flares include joint pain and swelling, fatigue, and swollen fingers or toes. Common triggers of flares include stress, weather changes, and smoking.

Treatment for psoriatic arthritis typically includes OTC anti-inflammatory pain medications, corticosteroid injections, or DMARDs.

Talk with your doctor about any symptoms you are experiencing and what may be triggering your flares. They can recommend the most effective treatment for your condition.

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Medical Reviewer: Margaret R. Li, MD, FACR
Last Review Date: 2023 Mar 21
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