Psoriatic arthritis: symptoms, causes, treatment and which doctor to see
How psoriasis can affect the joints, the signs to look for, how it is diagnosed, the medicines that control it, and why acting early matters.
Also known as: Arthropathic psoriasis; Psoriatic arthropathy
What psoriatic arthritis is
Psoriatic arthritis is a long-term inflammatory arthritis that affects some people who have psoriasis, the skin condition that causes thick, red or darker, scaly patches. In psoriatic arthritis the immune system, which normally fights infection, causes inflammation in and around the joints, in the places where tendons and ligaments attach to bone, and sometimes in the spine.
In most people the skin psoriasis appears first, often years before the joints are affected. But some people develop joint symptoms first, or at the same time, and some have only mild skin patches in hidden places such as the scalp, navel or between the buttocks. The severity of the skin disease does not predict how bad the arthritis will be.
It is often mild, but in some people it affects many joints and, if not treated, can permanently damage them. Modern treatment can control inflammation well for most people, so early diagnosis matters.
Symptoms
Symptoms tend to come and go, with flares and calmer periods. Common features are:
- Joint pain, tenderness and joint swelling, often in the fingers, toes, wrists, knees or ankles, and sometimes on one side only
- Morning stiffness, or stiffness after rest, that lasts more than half an hour and eases with movement
- Swollen fingers or toes — a whole digit becomes puffy, like a sausage (dactylitis)
- Heel pain or pain at the back of the ankle or the sole of the foot, where tendons attach to bone (enthesitis)
- Nail changes — small pits, ridges, thickening, discolouration, or the nail lifting off the nail bed
- Lower back or buttock pain and stiffness, worse in the morning, if the spine is involved
- Tiredness, and sometimes red, painful eyes from inflammation inside the eye
Psoriatic arthritis can be confused with other kinds of arthritis, such as rheumatoid arthritis, gout or ankylosing spondylitis. If you have psoriasis and develop any joint, heel or back pain, mention it to your doctor rather than assuming it is wear and tear.
Causes and risk factors
The exact cause is not known. It results from an overactive immune response in people who are genetically prone to it, and an outside trigger such as an infection or stress on a joint may set it off. Things linked with a higher chance include:
- Having psoriasis, especially psoriasis that affects the nails or scalp
- A parent, brother or sister with psoriasis or psoriatic arthritis
- Excess body weight
- Age — it most often starts between about 30 and 50, though it can begin at any age, including in childhood
It is not infectious and cannot be passed to other people. People with psoriatic arthritis also have a higher chance of high blood pressure, diabetes, raised cholesterol and heart disease, so it is worth having these checked regularly.
How it is diagnosed
There is no single test for psoriatic arthritis. A doctor puts the picture together from your symptoms, a careful examination of joints, skin, nails and spine, and tests that support the diagnosis or rule out other conditions:
- Blood tests — markers of inflammation such as ESR and CRP, and rheumatoid factor and anti-CCP antibodies, which are usually negative in psoriatic arthritis and help distinguish it from rheumatoid arthritis; uric acid if gout is possible
- X-ray of the hands, feet or spine to look for joint damage and changes typical of psoriatic arthritis
- Ultrasound to show inflammation in joints and tendon attachments that may not be obvious on examination
- MRI, particularly of the spine and pelvis when back pain suggests inflammation there
- Sometimes, fluid drawn from a swollen joint to rule out gout or infection
Treatment
There is no permanent fix, but treatment aims to control pain and inflammation, prevent joint damage, and keep you working and active. The choice depends on which joints and tissues are involved, how active the disease is, your skin psoriasis, and your other health conditions.
- Anti-inflammatory painkillers (non-steroidal anti-inflammatory drugs) to ease pain and stiffness in mild disease; they do not prevent joint damage, and need medical advice if you have stomach, kidney or heart problems
- Steroid injections into a single inflamed joint or tendon area to settle a flare; steroid tablets are used sparingly and briefly, because stopping them can cause the skin to flare
- DMARDs — disease-modifying anti-rheumatic drugs such as methotrexate — which calm the immune response over weeks to months and can help both skin and joints
- Biologic medicines and newer targeted tablets, which block specific signals in the immune system, for disease that is not controlled by standard DMARDs or that affects the spine
- Physiotherapy and regular exercise to keep joints moving, muscles strong and the spine flexible
- Surgery, rarely, to repair or replace a badly damaged joint
Many of these medicines need regular blood tests to check the liver and blood counts. Before starting biologic medicines, you will be checked for tuberculosis and hepatitis, because these treatments can allow a hidden infection to become active — an important step in India, where latent tuberculosis is common. Do not stop or change a medicine without discussing it with your rheumatologist, and tell them if you are planning a pregnancy, because some medicines must be changed beforehand.
Living with psoriatic arthritis
- Stay active: walking, swimming, cycling and yoga-style stretching are joint-friendly; a physiotherapist can tailor exercises
- Losing excess weight reduces load on joints and may help medicines work better
- Stop smoking and limit alcohol, especially if you take methotrexate
- Pace yourself on bad days, and plan rest around tiring tasks
- Have your blood pressure, blood sugar and cholesterol checked regularly
- Keep vaccinations up to date, and ask your doctor which vaccines are suitable before starting immune-suppressing treatment
- Look after your mood; living with a long-term condition can be hard, and support helps
When to see a doctor urgently
See a doctor promptly if you have psoriasis and develop new joint swelling, a swollen finger or toe, or back pain with morning stiffness. Seek same-day care for a painful red eye with blurred vision, or a single hot, very painful joint with fever, which may be an infection.
If you take immune-suppressing medicines and develop a high fever, shivering, breathlessness, confusion or feel very unwell, call 112 or 108 or go to the nearest emergency department, because serious infections can progress quickly.
Which doctor to see
A rheumatologist diagnoses and manages psoriatic arthritis. Your dermatologist treats the skin and nails and is often the first to notice joint symptoms; the two specialists frequently work together, since some medicines treat both. A physiotherapist helps with exercise and joint protection.
You can find rheumatologists in Bengaluru or dermatologists in Bengaluru on The Doctor Index, each with a registration you can check.
Common questions
Questions people ask
- Can you have psoriatic arthritis without psoriasis?
- Yes. In some people the joint symptoms appear before the skin rash, or the psoriasis is very mild or hidden on the scalp, nails or skin folds. A family history of psoriasis can be an important clue for the doctor.
- Is psoriatic arthritis the same as rheumatoid arthritis?
- No. Both are inflammatory arthritis, but psoriatic arthritis is linked to psoriasis, often affects the end joints of fingers, whole swollen digits, heels and the spine, and usually tests negative for rheumatoid factor. Treatment overlaps but is chosen for each condition.
- Can diet treat psoriatic arthritis?
- No diet has been shown to replace medical treatment. Losing excess weight and eating a balanced diet can reduce joint strain and support overall health, and may help treatment work better. Discuss any big diet changes with your doctor or a dietitian.
- Are biologic medicines safe?
- Biologic medicines are widely used and help many people, but they lower some immune defences, so infections need prompt attention. You will be screened for tuberculosis and hepatitis first, and monitored during treatment. Your rheumatologist will weigh the benefits and risks with you.
This condition is usually assessed by a rheumatologist. Every profile shows the doctor’s registration and what has been checked.
Rheumatologists in Bangalore
A few rheumatologists listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Psoriatic Arthritis; ask the clinic whether the doctor sees it.
Related conditions
- Ankylosing Spondylitis
- Arthritis
- Fibromyalgia
- Gout
- Juvenile Arthritis
- Lupus
- Osteoarthritis
- Rheumatoid Arthritis
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Psoriatic Arthritis
- MedlinePlus Genetics — Psoriatic arthritis
- Government of India — Emergency Response Support System (112)
- MedlinePlus, National Library of Medicine — Psoriatic Arthritis — Public-domain health-topic summary
- MedlinePlus Genetics — Psoriatic arthritis — Public-domain Genetics summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Psoriatic arthritis: symptoms, causes, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1982.