Psoriatic arthritis: a practical overview

Symptoms vary between people and can change over time. Joint pain, swelling, and morning stiffness may affect one area or several. A whole finger or toe can become swollen, and pain may occur where a tendon or ligament attaches to bone, such as the heel. The lower back or neck can also feel stiff. Psoriasis of the skin or nails may accompany the joint problem, but it is not required for a clinician to investigate psoriatic arthritis. Examination focuses on swelling, movement, tenderness, skin and nail findings, and the distribution of symptoms; no single symptom establishes the diagnosis.

Start with a medical assessment when symptoms persist, return, or affect work, sleep, walking, or hand function. Bring a list of medicines and a note of morning stiffness, swollen areas, skin or nail changes, and family history. Regular low-impact movement can help preserve mobility, while pacing tasks may reduce strain during a flare. Physiotherapy can address joint protection, strength, posture, and function. A clinician may discuss anti-inflammatory medication or other treatment according to the joints involved, examination, and health history.

Seek prompt advice when a joint becomes increasingly swollen, movement declines, or symptoms interfere with basic activities. Get urgent help for fever with a hot swollen joint, sudden weakness or numbness, inability to bear weight after an injury, or a painful red eye with blurred vision or sensitivity to light. Record when the change began and which body parts are affected so the assessment can be focused.

Ask: Which symptom pattern do you see? Could my nails, skin, spine, or tendon attachments be involved? What activity is suitable during a flare? Would physiotherapy help my specific limitations? What medication benefits and side effects should I understand? Which warning signs require urgent review?