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Symptoms, Causes, and Treatment of Psoriatic Arthritis

Types of psoriatic arthritis

Types of psoriatic arthritis

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is an autoimmune disease and a form of arthritis that usually occurs in individuals who have psoriasis. Only about 1 out of every 100 people are afflicted with this disease. Psoriasis is a chronic skin condition characterized by red patches covered with silvery scales.

Approximately 1 in 20 people who have psoriasis develop PsA; the likelihood is increased for those who have lesions on their nails. The cause is currently unknown; however, there may be a genetic component. Stress can also play a role in both conditions. It is possible to develop psoriatic arthritis before developing psoriasis. Early diagnosis is important.

Symptoms of Psoriatic Arthritis

The symptoms of psoriatic arthritis include:

  • Joint swelling and pain
  • Rough skin patches
  • Pitting in the nails

The symptoms can flare up at any time and alternate with periods of remission. They range from mild (only a few joints are affected) to severe (swelling and deformity in the hands and feet).

When the disease is more severe, it will involve more joints, including the spine. When the spine is affected, symptoms include stiffness, pain, and a burning sensation, particularly in the lower spine and sacrum.

An accompanying complication is spondylitis, a condition that causes inflammation of the vertebrae, although some types of spondylitis can also affect other large joints.

Causes and Risk Factors

It is thought that genetic and environmental factors both play a role in the development of this disease. Many people that develop PsA also have a family member with this disease. There are some possible genetic markers, but researchers do not have all the answers at this time. Although it can occur at any age, it is most prevalent in patients from 30-50 years old.

Other causes include viral or bacterial infections in those with a genetic predisposition and physical trauma. It is also well documented that psoriasis can be triggered by stress.

Psoriasis on the palm of the hand.

Psoriasis on the palm of the hand.

The Psoriasis Component

Pictures of psoriatic arthritis reveal a rapid buildup of skin over large areas of skin. These reddened areas with silvery scales tend to be dry, itchy, and sometimes painful. In some cases, this disease causes pitted and deformed nails that become thickened and discolored. The nails may also become separated from the nail bed.

Treatment for Psoriatic Arthritis

Although there are currently no cures, there are medications to treat the symptoms:

  • Anti-inflammatories: To reduce swelling and pain
  • Disease-modifying antirheumatic drugs: Methotrexate, sulfasalazine
  • Immunosuppressant drugs: Imuran, Azasan, cyclosporine, leflunomide (Avara)
  • TNF-alpha inhibitors: For severe pain. Humira, Enbrel, Simponi, Remicade

Each of these medications has potentially harmful side effects, including suppression of the immune system, which makes a patient more vulnerable to infection. Otezla can also have side effects that should be discussed with your physician. Be sure to ask your doctor questions about the best medications to treat your specific condition.

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Read More From Healthproadvice

Psoriatic Arthritis Diet Guidelines

Following a balanced, healthy diet will help reduce inflammation and symptoms of PsA.

Your diet should include:

  • Fresh vegetables and fruits
  • Cold water fish, rich in omega-3 fatty acids—salmon, tuna, sardines, and mackerel
  • Antioxidant-rich foods—apples, beets, blueberries, kale, spinach, and broccoli

Don't skip meals and eat frequent, small meals to maintain steady energy levels. Avoid foods that are processed or high in cholesterol and fats. Limit salt and sugar intake as well as your consumption of red meats (which may exacerbate pain).

Maintaining a healthy weight through diet and exercise can alleviate some of the symptoms.

Phil Mickelson used a biologic, etanercept (Enbrel) to treat the symptoms of his PsA.

Phil Mickelson used a biologic, etanercept (Enbrel) to treat the symptoms of his PsA.

Phil Mickelson's Treatment of Psoriatic Arthritis

Phil Mickelson, one of the highest-ranked golfers in the world, developed psoriatic arthritis in 2010. He has openly talked about his battle with this inflammatory disease; it started very suddenly and almost crippled him.

He went to Mayo Clinic where he was successfully treated with weekly Enbrel injections. He states he is pain-free and has begun a campaign to educate the public on this disease.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Pamela Oglesby (author) from Sunny Florida on April 21, 2020:

Hi MG,

Psoriasis is an unpleasant disease for sure. I would be interested in reading about Ayurvedic medicine for treatment or prevention.

Thanks for reading and commenting on this article.

MG Singh emge from Singapore on April 21, 2020:

Another very informative article. This is a fairly common disease but it can catch anyone, especially the older people. I was told by a doctor in India last year in general conversation that some Ayurvedic medicines can keep this disease at bay.

Pamela Oglesby (author) from Sunny Florida on April 21, 2020:

Hi Peggy,

I feel sorry for them also. Some of those medications are pretty strong also, which can make side effects as issue. Thanks for commenting, Peggy.

Peggy Woods from Houston, Texas on April 20, 2020:

I feel sorry for people who suffer from this condition. It is good to know that some of the medications can alleviate some of the symptoms.

Pamela Oglesby (author) from Sunny Florida on September 24, 2014:

Celricep, I am glads this article was helpful for you and I appreciate your comments.

Celticep from North Wales, UK on September 23, 2014:

Very useful information, my husband has psoriasis and this certainly explains some of his joint aches and pains! thanks

Pamela Oglesby (author) from Sunny Florida on February 08, 2014:

Patricia, I am glad you stopped by and sure hope your medical problems get better, not worse! I am glad this article is helpful to you. Love those angels and I am sending some back to you.

Patricia Scott from North Central Florida on February 07, 2014:

Ouch. That looks painful.

I do not have this type of arthritis but I do have it in my feet and back. But I just keep on keeping on and hope it does not become worse.

This is so informative. I am sharing it with some friends who have this condition.

Hope all is good with you and yours.

voted up and shared

Angels are on the way to you, Pamela


Pamela Oglesby (author) from Sunny Florida on January 31, 2014:

FeeezeFrame, I hope your realtive gets a good doctor and the proper medication to treat this difficult disease. Thank you for your comments.

FreezeFrame34 from Charleston SC on January 30, 2014:

Wow! This hub hits right home!

These pictures unfortunately looks just like what one of my family member suffers from.

I will definitely be sharing!

They've tried countless home remedies and numerous doctors who have diagnosed everything from a fungal infection to pre-diabetes.

Pamela Oglesby (author) from Sunny Florida on September 13, 2013:

fivesenses, I agree knowledge is power. Phil Michelson seems to be such a great guy, and this is a painful disease. It is wonderful that he has been able to continue with his career. Not everyone responds well to medication. Thanks for your comments.

Leena from new delhi on September 13, 2013:

Thanks for educating me about this....knowledge is power.

Pamela Oglesby (author) from Sunny Florida on August 28, 2012:

Cogerson, I am glad that you are better educated about this disease and I appreciate your comments.

UltimateMovieRankings from Virginia on August 28, 2012:

You have written a very detailed hub on psoriatic arthritis.....I first became aware of this condition when Mickelson talked about it a couple of years ago. But I feel I understand the subject much better. It seems you did some massive research on the subject.....well that hard work is greatly appreciated. Voted up and useful.

Pamela Oglesby (author) from Sunny Florida on August 27, 2012:

Ruby, I'm glad you found the hub useful. I know the pain must be awful and I have such sympathy for anyone suffering from the disease. Phil Michelson is such a nice man also. Thanks for your comments.

Pamela Oglesby (author) from Sunny Florida on August 27, 2012:

Martie, Thank you so much for the link and I am glad you find the medical hubs useful. I like to write about complicated medical issues and I'm sure being a nurse for 22 years has a lot to do with that. I appreciate your comments.

Ruby Jean Richert from Southern Illinois on August 26, 2012:

I know this must be terribly painful. Thank's for the information. I knew about Phil Mickelson. ( I am a devoted gulf and tennis fan. ) The age range was surprising to me..Thank's again..

Martie Coetser from South Africa on August 26, 2012:

Very interesting facts about psoriatric arthritis. Thank you for presenting this in such a neat and well-structured hub, Pamela. I like your paragraph dividers.

You have so many excellent hubs about medical issues, so I'm going to post a link to your profile in my personal library.

Pamela Oglesby (author) from Sunny Florida on August 26, 2012:

Dianna, I thought the same thing and feel empathy even for those with psoriasis, let alone the arthritis also. Thanks so much for your comments.

Dianna Mendez on August 26, 2012:

I am feeling much empathy for those who suffer from this auto-immune disease. It looks like it would really hurt. Thanks for the education on this disease and the natural ways to combat the effects. Voted up and shared.

Pamela Oglesby (author) from Sunny Florida on August 26, 2012:

unknown spy, It would be more common to see a person with some mild psoriasis than the full blown disease. I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on August 26, 2012:

TTombs, I do also. This is a terrible disease when its at its worst. Thank you for your comments.

Pamela Oglesby (author) from Sunny Florida on August 26, 2012:

drbj, Thank you so much for your comments.

DragonBallSuper on August 25, 2012:

oh myyy... you really are great to share this one.i never seen a person with this condition before. we'll just have to be careful.

Terrye Toombs from Somewhere between Heaven and Hell without a road map. on August 25, 2012:

Wow, Pamela, this looks horribly painful! I feel for those that suffer from this infliction. Thank you for sharing this.

drbj and sherry from south Florida on August 25, 2012:

Very thorough examination, Pamela, of a fairly uncommon auto-immune disease. Thank you for your painstaking research.

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