Psoriatic arthritis and spondylitis: what to know

Psoriatic arthritis is associated with joint inflammation, while spondylitis describes inflammation involving joints between the spinal bones. Symptoms may include back or neck pain, reduced movement, joint swelling, and morning stiffness that eases as you move. Some people also develop inflammation where tendons or ligaments attach to bone, such as around the heel. Skin or nail psoriasis may be present, but joint symptoms can also need assessment when skin changes are subtle.

A clinician considers the symptom pattern, examination findings, psoriasis history, family history, and tests or scans when needed. Joint pain or swelling has many possible causes, so a symptom alone does not establish psoriatic arthritis.

Record which joints or parts of the spine hurt, when stiffness is strongest, whether swelling changes, and how symptoms affect sleep or walking. Arrange an assessment if symptoms persist, recur, or limit ordinary activities. Treatment may combine prescribed anti-inflammatory medication, other disease-directed care, activity adjustments, and physiotherapy. A physiotherapist can help protect spinal mobility, build strength gradually, and adapt exercises during a flare. Do not stop prescribed treatment or add herbal products without discussing possible interactions with your clinician.

Seek prompt medical advice for new or worsening spinal pain with marked stiffness, a swollen joint that is becoming harder to use, or symptoms that keep returning. Seek urgent care for sudden weakness or numbness, loss of bladder or bowel control, severe injury-related pain, fever with a hot swollen joint, or unexplained visual pain and redness.

Could my back symptoms reflect spinal inflammation, a mechanical problem, or another cause? Which joints and tendon attachments should be examined? What monitoring is needed if symptoms improve? Which exercises are suitable during a flare?