ON THIS PAGE ON THIS PAGE What does psoriatic arthritis (PsA) feel like? It’s a question only someone living with this autoimmune disease can really answer. Just ask Cynthia Covert. “It’s like feeling your bones shatter and crumble. It’s like having flu-related body aches that never go away. It’s exhausting,” says Covert, a writer in Riverside, California, who runs the Disabled Diva Chronic Pain Community on Facebook and posts regularly on Instagram. “When my joints swell, it feels like someone has wedged a screwdriver into them and is trying to pry my joints out. Swelling around the spine sends nerve pain down to my toes and up through my skull.” The Joint Pain and Overall Discomfort Are Exhausting While the joint pain and stiffness can be excruciating, the persistent fatigue that often accompanies the condition can be debilitating, too. On top of those psoriatic arthritis symptoms, you may experience the following: Skin Rashes Most people with psoriatic arthritis have skin symptoms before joint symptoms, but this isn’t always the case. Dactylitis This sausage-like swelling that can happen on all parts of the fingers and toes is often a telltale symptom. Nail Changes Many people with psoriatic arthritis have nail psoriasis, which can mean nails become pitted or look like they’re infected. Eye Issues Psoriatic arthritis can cause inflammation of the eyes, which can trigger redness, irritation, and vision problems. These symptoms can take a real toll on your emotional health. A meta-analysis of 37 studies relevant to patients with PsA found that when the disease was poorly controlled, it negatively affected work productivity, and that people with PsA generally had a lower quality of life, particularly with respect to social interactions and mental well-being. The Fatigue of Psoriatic Arthritis Can Be Overwhelming Psoriatic arthritis is a systemic disease, potentially affecting many different areas of the body, and fatigue is a common symptom of PsA. According to one study, more than 78 percent of patients with PsA reported fatigue. Those with greater fatigue severity also reported more pain, a larger area of the body affected by psoriasis, and more swollen and tender joints. Fatigue can make everyday activities from working to running errands and cooking, not to mention socializing challenging. “My biggest problem with PsA is fatigue. I simply run out of steam as my day progresses, to the point that dinner prep is all but impossible many nights,” says one woman, commenting on Tippi PsA, who has been living with psoriatic arthritis for over five years. Her tip? She uses the energy she has in the morning to chop and prep ingredients and then throw it all in a slow cooker so it’s ready and waiting when she’s too tired to cook in the evening. When it comes to having the energy for social activities, “Do things that work for you and don’t feel bad if you suddenly are so tired you need to go home,” says Linda Graham, who has lived with PsA for several years. Unpredictable Flares Can Make Planning Hard One of the biggest challenges facing those with psoriatic arthritis is the unpredictability of flare-ups. These unwelcome episodes can strike at any time, affecting both your personal and professional life. “The hardest part of living with this disease is the unpredictability,” Covert says. “How many naps will I need? Will I even need a nap, or will I be able to get out of bed? Will I be able to walk today? And if so, how long and how far?” Don’t be afraid to let your friends and family know what living with PsA is like. “Tell people. I spent a long time hiding my health problems and, of course, PsA is often hard to see,” says Graham. “I found it difficult sitting for long periods of time when meeting friends. When I told them that meeting for shorter periods worked better for me they were understanding. People are more understanding once they know about your health.” 6 Psoriatic Arthritis Symptoms You Shouldn’t Ignore Psoriatic arthritis can impact both your physical and emotional health. Look out for these common symptoms and see a healthcare provider if you experience them. Manage Your Energy and Get Support When symptoms of PsA are flaring, be gentle with yourself. Understand that sometimes you’ll have to say no to certain plans, activities, or prior commitments, and that’s okay. While PsA can be unpredictable, you can still plan ahead knowing that you may need to manage your energy. “Decide which activities you will do or attend. If the activity doesn’t bring you joy, drop it from your schedule,” says Kimberly Steinbarger, a physical therapist who lives with PsA. “Your energy is precious. Don’t spend it on things that you do not enjoy. For example, I stopped sending out Christmas cards years ago, but I enjoy making cookies, so I still do that.” When a specific event is on the horizon, think about the before and after, not simply the event itself. “If you’re doing a lot of physical activity and not getting sleep or rest before the party, it’s going to be really difficult to get through the party itself,” says Jo Eckler, a clinical psychologist who has PsA. “The same goes for after the party. So if there’s any way to schedule in rest time, do it! This might mean asking someone else to grocery shop, or ordering groceries for delivery, getting help cleaning, or asking guests to bring food.” Don’t be afraid to ask for the help and support you may need. Treatments and Lifestyle Changes Can Ease PsA Symptoms PsA symptoms can be frustrating in part because the condition is often misdiagnosed. It shares some symptoms with other conditions, such as rheumatoid arthritis (RA), osteoarthritis, fibromyalgia, lupus, and gout, which can complicate proper diagnosis. But once you’ve been diagnosed, it’s important to work with your doctor to find a treatment plan that’s right for you. Psoriatic arthritis can cause irreversible joint damage, but certain treatments can prevent or delay permanent changes, manage symptoms, and improve quality of life. It can be helpful, when meeting with your doctor, to have a diary or list of symptoms, concerns, medication side effects, dates of flares to refer to. “Write things in a notebook, so when you are talking to your doctor, you can look in your notebook for details,” advises Cynthia, a woman in her sixties with PsA. Adds another woman who’s been living with PsA for several years, “it’s easier than trying to remember when brain fog is thick, and it seems like doctors pay more attention when it is on paper. We are our own best advocates.” In addition to medication, guidelines from the American College of Rheumatology and National Psoriasis Foundation suggest that you might be able to improve your psoriatic arthritis symptoms by making certain lifestyle modifications, including: Maintain a healthy weight. Use a combination of exercise, physical therapy, occupational therapy, massage therapy, or acupuncture. Avoid smoking. Stress and your mental health are important factors in keeping PsA in check. “Stress can exacerbate symptoms and actually worsen fatigue,” says Kellie Blake, a woman with PsA. “I practice meditation and yoga daily. But find what works for you to quiet your mind and body.” A healthy diet is also key. “Look into anti-inflammatory diets. Cutting out foods that cause inflammation and increasing foods that fight it is a game changer for me,” says Tyrell Hoover, a thirtysomething man living with PsA. “You will also have to keep track to see if other foods affect your PsA symptoms.” The Takeaway Psoriatic arthritis can be challenging because of unpredictable flares, joint pain, and severe fatigue, but managing your energy and communicating needs to loved ones can help you navigate daily living. It’s crucial to speak with your healthcare provider about your symptoms and treatment options, as psoriatic arthritis can be mistaken for other conditions and requires tailored management to prevent irreversible joint damage. While medication is often necessary, incorporating lifestyle changes such as maintaining a healthy weight, exercising, and managing mental health can also support overall symptom management. If you’re experiencing symptoms like significant eye inflammation, joint pain, or persistent fatigue, it’s essential to seek timely medical evaluation to address potential complications and optimize your care plan. EDITORIAL SOURCES Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions. Resources Arthritis Foundation. Psoriatic Arthritis. James L et al. The Impact of Psoriatic Arthritis on Quality of Life: A Systematic Review. Therapeutic Advances in Musculoskeletal Disease. December 22, 2024. Skougaard M et al. Psoriatic Arthritis Fatigue Is Driven by Inflammation, Disease Duration, and Chronic Pain: An Observational DANBIO Registry Study. Journal of Rheumatology. July 2019. Gossec L et al. Effect of Fatigue on Health-Related Quality of Life and Work Productivity in Psoriatic Arthritis: Findings From a Real-World Survey. Journal of Rheumatology. November 2022. Ogdie A et al. Patient Perspectives on the Pathway to Psoriatic Arthritis Diagnosis: Results from a Web-Based Survey of Patients in the United States. BMC Rheumatology. Jan 10, 2020. SIngh JA et al. 2018 American College of Rheumatology/National Psoriasis Foundation Guideline for the Treatment of Psoriatic Arthritis. Arthritis and Rheumatology. November 30, 2018. Meet Our Experts Samir Dalvi, MD Medical Reviewer Samir Dalvi, MD, is a board-certified rheumatologist. He has over 14 years of experience in caring for patients with rheumatologic diseases, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lupus, and gout. Julie Lynn Marks Author Julie Marks is a freelance writer with more than 20 years of experience covering health, lifestyle, and science topics. In addition to writing for Everyday Health, her work has been featured in WebMD, SELF, Healthline, A&E, Psych Central, Verywell Health, and more. Her goal is to compose helpful articles that readers can easily understand and use to improve their well-being. She is passionate about healthy living and delivering important medical information through her writing. Prior to her freelance career, Marks was a supervising producer of medical programming for Ivanhoe Broadcast News. She is a Telly award winner and Freddie award finalist. When she’s not writing, she enjoys spending time with her husband and four children, traveling, and cheering on the UCF Knights.
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