Psoriatic arthritis: how to spot it, treat it, and feel better every day

Think your psoriasis is only skin-deep? Not always. Up to one in three people with psoriasis will get psoriatic arthritis (PsA), a joint condition that can quietly damage joints if ignored. If you have aching fingers, swollen toes that look like sausages, or morning stiffness that won't quit, this page gives clear, useful steps you can use right away.

Symptoms and diagnosis

PsA shows up in different ways. Common signs: swollen fingers or toes (dactylitis), tender spots where tendons attach to bone (enthesitis), stiffness after resting, and reduced range of motion. Nail changes—pitting, lifting, or ridges—often go with joint problems. Sometimes skin symptoms come first; sometimes joints appear before skin. If you notice asymmetric joint swelling (one knee or one finger) or unusual pain with psoriasis, see a doctor.

How doctors figure it out: your GP or dermatologist can refer you to a rheumatologist. Expect a physical exam, blood tests to rule out other conditions (like rheumatoid arthritis), and imaging—X-rays or ultrasound—to check for joint damage. Early diagnosis matters because starting treatment sooner lowers the chance of permanent damage.

Treatment and daily management

Treatment aims to reduce inflammation, stop joint damage, and keep you moving. Options range from simple to advanced. For flare control, NSAIDs ease pain for many people. Short steroid injections can calm a painful joint quickly. Disease-modifying drugs (DMARDs) like methotrexate, sulfasalazine, or leflunomide slow disease activity. If those don't work well, biologic drugs target specific immune signals—common ones are TNF inhibitors (e.g., adalimumab), IL-17 blockers (e.g., secukinumab), or IL-23 blockers (e.g., ustekinumab). These often help both skin and joints.

Safety note: biologics and some DMARDs lower infection defenses. Your doctor will check blood tests, screen for TB, and discuss vaccines before you start treatment.

Daily self-care makes a big difference. Keep moving: low-impact exercises like swimming, cycling, and gentle yoga maintain flexibility without stressing joints. Strength training helps support joints—start light and progress slowly. Use heat for stiff mornings and cold packs for active swelling. Watch your weight: losing even a few kilos eases joint load and pain.

Simple lifestyle moves help too: quit smoking if you can, limit excess alcohol, sleep well, and eat a balanced diet with some omega-3s (fish or supplements) which can ease inflammation for some people. If work or daily tasks are hard, an occupational therapist can suggest braces, tools, or technique changes to protect joints.

When should you act now? Book a rheumatology consult if swelling lasts more than a week, if morning stiffness persists, or if psoriasis is changing and you develop joint pain. Early treatment preserves joints and keeps you active—so don’t delay.

Need more? Talk to your GP about a referral and write down your symptoms: timing, which joints, and whether your skin is changing. That short list speeds diagnosis and gets you on the right plan faster.