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What are the Signs and Symptoms of Psoriatic Arthritis?
People with PsA can have varying degrees of discomfort and problems with joint mobility. Typically symptoms of joint pain and stiffness are worse in the morning or after periods of inactivity (like sitting for a long time). The morning pain and stiffness caused by PsA can get better with certain exercises and activities. But if PsA is severe, exercise and activity might not make the pain and stiffness feel any better.
Like other types of inflammatory arthritis, the main target of the immune system attack is the joints. In most cases only a few joints are affected at first. Over time, more joints can become affected. Eventually, PsA can also affect other parts of the body. For example, tendons at the backs of the heels, under the bottoms of the feet, around the knee, on the outside of the hips, or those between the ribs can become inflamed. More rarely, inflammation can also affect the eye. This is called “iritis.”
Psoriatic arthritis can affect the joints in different ways.
There are five basic patterns:
- The most common way is for a few joints to be affected. In other words, PsA “picks on” a few different joints, like the knee, a wrist or a finger.
- Sometimes many joints are affected. This type of PsA can look a lot like rheumatoid arthritis.
- Joints at the ends of the fingers or toes may be involved. When one finger or toe swells up like a sausage, it is called “dactylitis.”
- Joints in the spine are sometimes – but not often – involved. This usually happens later in the course of the disease. It is less common for the joints in the back to be involved from the start of PsA.
- The least common type of PsA is a very destructive form of the disease. It is called “arthritis mutilans.” This type of PsA can be especially painful.
If PsA is left untreated, it can destroy the joints affected.
In people with PsA, the immune system also attacks the skin. This causes the skin to become red (inflamed). Sometimes, the skin becomes covered by a silvery-white scale. In most people with PsA, psoriasis can be mild. It can also hide in places like the scalp. That means some people might not even know they have psoriasis at all. Psoriasis can also affect the fingernails and/or toenails. When this happens, the nails can be pitted. Other times, the nails can lift off the nail bed.
Work and Psoriatic Arthritis
The pain and stiffness caused by PsA can sometimes limit people’s normal activities, including work. But there are things you can do to lessen the impact of PsA on your work and daily routine. If your work involves physical labour, it’s important to learn how to protect your joints. A trained arthritis physiotherapist can help.
If you have a job where you sit for much of the day, adjusting features of your workplace can help make working with PsA easier on your joints. For example, adjusting the position of chairs and desks for proper posture can help. You can also make adjustments to the seat of your vehicle to make driving more comfortable and reduce the stress on the joints in your spine.
Travel and Psoriatic Arthritis
Traveling is still possible when you have PsA. It is best to be organized prior to your trip to ensure a smooth, comfortable, and enjoyable time. See our travel check list.
Sex and Psoriatic Arthritis
Although PsA does not particularly cause a loss of sex drive, it can cause pain, fatigue and emotional hardships. These hardships can create barriers to sexual needs, ability and satisfaction. Take comfort knowing that sex and intimacy can be maintained in people with PsA … it can even draw partners closer together, especially through improved communication between mates.
For more information on intimacy and arthritis, a great book is Rheumatoid Arthritis: Plan to Win by Cheryl Koehn, Taysha Palmer and John Esdaile.
Pregnancy and Psoriatic Arthritis
Psoriatic arthritis does not affect a woman’s ability to become pregnant or raise a child. Added weight gain during pregnancy may cause increased stress on the joints. Some medications (i.e. methotrexate, leflunomide) used to treat PsA should never be used when trying to get pregnant or if you are pregnant.
Read more – Treatment of Psoriatic Arthritis