Psoriatic arthritis and ankylosing spondylitis: what to know

Both conditions belong to the spondyloarthritis family and can cause inflammatory pain, stiffness, tendon-attachment pain, and swelling in fingers or toes. Psoriatic arthritis often includes a history of psoriasis or nail changes and may affect the hands, feet, knees, or other joints.

Ankylosing spondylitis mainly involves the spine and the joints between the spine and pelvis. Back stiffness that is worse after rest and improves with movement can be a useful clue, although symptoms overlap. A person can have psoriasis and inflammatory spinal symptoms, so diagnosis relies on the whole pattern, examination, and appropriate imaging or tests.

Ask for a rheumatology assessment if persistent back stiffness, reduced spinal movement, swollen joints, or tendon pain is limiting activity. Bring details about psoriasis, eye redness or pain, bowel symptoms, family history, and how symptoms behave overnight and with movement.

Treatment may combine anti-inflammatory medication with an exercise plan. Physiotherapy can maintain spinal and joint movement, while exercise therapy can build strength and endurance. Hydrotherapy may make movement more comfortable for some people. Your plan should be adjusted to active inflammation, fitness, and other health needs.

Seek urgent help for a painful red eye with light sensitivity or blurred vision, sudden loss of strength or sensation, loss of bladder or bowel control, chest pain, or severe breathing difficulty. Contact a clinician promptly for a hot swollen joint with fever or rapidly worsening spinal pain.

Which features suggest spinal involvement as well as peripheral psoriatic arthritis? Do I need imaging or a rheumatology referral? Which combination of medication, exercise therapy, hydrotherapy, and physiotherapy fits my symptoms?