According to the Cleveland Clinic, it’s also possible to have overlapping types of psoriatic arthritis, potentially making this disease even more complicated.
What does psoriatic arthritis pain feel like?
“Often, people with psoriatic arthritis describe generalized feelings of achiness and fatigue before any overt swelling starts,” Rebecca Haberman, MD, a rheumatologist and assistant professor of medicine at NYU Langone Health, tells SELF.
The next clue is joint pain or stiffness, swelling, and warmth. Nail changes, lower back pains, swollen fingers or toes, eye inflammation, and foot pain often follow after that.
When it comes to the question of how painful psoriatic arthritis is, the answer is that it can vary. For some people it can be mild, and for others, severe. With psoriatic arthritis treatment, you may still experience flares-ups that alternate with periods of remission, according to the Mayo Clinic. As the disease advances, Dr. Haberman says they can see joint damage, which is often irreversible once it develops.
Where does psoriatic arthritis usually start?
“In about 85% of people with psoriatic arthritis, skin psoriasis appears before any joint involvement,” says Dr. Haberman. However, she adds, when it comes to joints, there is no one joint or area where psoriatic arthritis typically starts. “This is different for every person, and a single joint or multiple joints may be involved even at the start,” she says.
In addition to having possible joint swelling and pain, Dr. Haberman says people often describe feeling stiff, fatigued, or having more difficulty doing activities that they used to do on a daily basis. “Psoriatic arthritis can also present as back pain and stiffness if it affects the spine or areas of inflammation at the entheses, where ligaments and tendons insert onto the bone, such as the Achilles,” says Dr. Haberman.
What organs does psoriatic arthritis affect?
Yes, psoriatic arthritis can wreak havoc on your joints and skin, but it can also cause problems in other parts of your body. That’s because psoriatic arthritis causes systemic inflammation—from your eyes to your heart, says Dr. Askanase. It can involve the eyes with uveitis, the gut with inflammatory bowel disease, your heart with early cardiovascular disease, lung inflammation, and liver and kidney problems. “In other words, psoriatic arthritis can be a disease of the whole body,” she says.
That said, while psoriatic can increase your risk for these other conditions, it doesn’t mean that you will get them. It’s a good idea to talk with your healthcare team about how to reduce any risk factors you might have, including getting your PsA under control and tweaking your treatment plan, if necessary. These things will help reduce your risk of complications.
Does psoriatic arthritis show up in blood work?
While blood tests are an important factor in supporting a diagnosis of psoriatic arthritis, Dr. Haberman says they cannot alone diagnose psoriatic arthritis. “Psoriatic arthritis is diagnosed by history and physical exam, and often supported by imaging and blood work,” she says.
People with psoriatic arthritis may have elevated levels of inflammation in their blood (such as elevated c-reactive protein or erythrocyte sedimentation rate). However, she says these are non-specific markers of inflammation, meaning that any cause of inflammation—not just psoriatic arthritis—can make them elevated.
The only way to know for sure if you’re dealing with psoriatic arthritis is to talk with your doctor. They will go through the necessary steps to get a proper diagnosis. If you are diagnosed with psoriatic arthritis, starting on a treatment plan will help manage your symptoms and prevent joint damage, and hopefully get you back to feeling a bit more like yourself.