Symptoms, Causes, and Treatment of Psoriatic Arthritis

Updated on December 2, 2018
Pamela99 profile image

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

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 get 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.



  • 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 roll 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 a stress.

Psoriasis on the palm of the hand.
Psoriasis on the palm of the hand. | Source

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.


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, cyclosporines, leflunomide (Avara)
  • TNF-alpha inhibitors: For severe pain. Humira, Enbrel, Simponi, Remicade
  • Apremilast (Otezla): A new drug approved on March 26, 2014, that will be added to the existing class of biologic drugs used for this condition.

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, so be sure to ask your doctor questions about the best medications to treat your specific condition.

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 (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. | Source

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 for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Submit a Comment
  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    2 months ago from Sunny Florida

    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.

  • emge profile image

    MG Singh 

    2 months ago from Singapore

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    2 months ago from Sunny Florida

    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 W profile image

    Peggy Woods 

    2 months ago from Houston, Texas

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    5 years ago from Sunny Florida

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

  • Celticep profile image


    5 years ago from North Wales, UK

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

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    6 years ago from Sunny Florida

    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.

  • pstraubie48 profile image

    Patricia Scott 

    6 years ago from North Central Florida

    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


  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    6 years ago from Sunny Florida

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

  • FreezeFrame34 profile image


    6 years ago from Charleston SC

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    6 years ago from Sunny Florida

    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.

  • fivesenses profile image


    6 years ago from new delhi

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

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

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

  • Cogerson profile image


    7 years ago from Virginia

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

    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.

  • always exploring profile image

    Ruby Jean Richert 

    7 years ago from Southern Illinois

    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..

  • MartieCoetser profile image

    Martie Coetser 

    7 years ago from South Africa

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

    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.

  • teaches12345 profile image

    Dianna Mendez 

    7 years ago

    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.

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

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

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

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

  • Pamela99 profile imageAUTHOR

    Pamela Oglesby 

    7 years ago from Sunny Florida

    drbj, Thank you so much for your comments.

  • unknown spy profile image

    Life Under Construction 

    7 years ago from Neverland

    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.

  • TToombs08 profile image

    Terrye Toombs 

    7 years ago from Somewhere between Heaven and Hell without a road map.

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

  • drbj profile image

    drbj and sherry 

    7 years ago from south Florida

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


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