Psoriatic Arthritis: Symptoms, Causes & Treatment
Reviewed: March 24, 2026 Medical Review: Cassandra Calabrese, D.O., Cleveland Clinic
On This Page:Overview|Symptoms|Causes & Triggers|Diagnosis|Treatment & Management|Prevention|Outlook/Prognosis
Overview
Psoriatic arthritis (PsA) is a chronic (long-lasting or recurring) disease related to the immune system. It causes swelling, pain, and stiffness in your joints and entheses (places where tendons and ligaments connect to bones). Psoriatic arthritis can develop at any age.[1] The severity of your psoriasis (mild, moderate, severe) does not affect the risk of developing psoriatic arthritis.
Roughly 1 in 3 people living with
also have psoriatic arthritis [2]; typically, with psoriasis developing before psoriatic arthritis.[1] While as many as 2.4 million Americans live with psoriatic arthritis, more than 15% of people living with psoriasis may also have undiagnosed psoriatic arthritis.[3]
Symptoms
Signs of psoriatic arthritis include:
Pain, swelling, or stiffness in 1 or more joints
Morning joint stiffness (joint pain that is worse in the morning or after inactivity)
Joints that are red, discolored, or warm to the touch
Frequent joint tenderness or stiffness
Dactylitis (sausage-like swelling in 1 or more of the fingers or toes)
Pain in and around the feet and ankles
Changes to the nails, such as pitting or separation from the nail bed
Pain in the lower back, above the tailbone
Just like psoriasis, psoriatic arthritis can range from mild to severe. There is little connection between psoriasis severity and PsA severity. You could have few skin lesions, but many joints affected by arthritis.
The average number of joints involved depends on the subtype of psoriatic arthritis. Polyarticular disease means 5 or more joints are affected, while oligoarticular disease involves ≤ 4 joints. Regardless of the severity, psoriatic arthritis can be very painful and can affect the ability to do daily tasks and move comfortably.
Dactylitis
Enthesitis
Spondylitis
Images courtesy of Evan L. Siegel M.D.
Domains of Psoriatic Arthritis
PsA can occur in any joint or wherever your ligaments and tendons connect to bone, most commonly affecting the finger joints and knees. You may experience PsA symptoms in certain areas of your body, which are commonly called domains. The six domains of psoriatic arthritis include spondylitis (e.g., back involvement),
, dactylitis, peripheral arthritis,
, and nail changes.
Causes & Triggers
Like psoriasis, the cause of psoriatic arthritis is not completely known. The
and genetics play a role in the development of psoriatic arthritis. Having a first-degree relative with psoriatic arthritis increases your risk of developing psoriatic arthritis. [2] Other factors likely contribute to developing psoriatic arthritis, including environmental factors and infections.
A psoriatic arthritis flare may include new or increased joint pain, tenderness, swelling, or stiffness. Flares can last for different amounts of time and differ in level of severity.
Triggers are different from person to person. What may worsen your psoriatic arthritis might not have any impact on someone else. Common psoriatic disease triggers include:
Stress
Smoking or alcohol use
Injuries or trauma to the skin or joints
Illness, such as infections
Certain medications
Changes in weather
Diet
Learn more about triggers and flares by requesting a free
Flare Guide and Symptom Tracker
.
Diagnosis
Psoriatic arthritis is largely a clinical diagnosis, meaning there is no specific diagnostic test. The diagnosis is made by a doctor’s evaluation of your history, physical exam, labs, and imaging, as well as excluding other possible causes for your symptoms, such as
and
.
Psoriatic arthritis is best diagnosed and treated by a
(a doctor who specializes in the diagnosis and treatment of diseases that affect the muscles, joints, and bones and related immune-mediated conditions). Early diagnosis and treatment can not only help relieve symptoms but may also help prevent permanent joint damage. Your rheumatologist will work with your dermatologist.
To make a diagnosis of psoriatic arthritis, your rheumatologist may consider several factors:
Examination of your skin, joints, and nails
X-rays
MRI scans
Ultrasounds
Blood tests
Each step will help to rule out other conditions and lead to an accurate diagnosis.
Until a diagnostic tool for psoriatic arthritis is developed, it may take a few appointments with a rheumatologist to get the correct diagnosis. Although it may take time, getting an accurate diagnosis is very important for managing your symptoms, preventing permanent joint damage, and caring for your overall health.
Screening for Psoriatic Arthritis
If you think you may have psoriatic arthritis, you can learn more by taking a short
. You can share the results with your health care provider. The quiz is based on the Psoriasis Epidemiology Screening Tool (PEST).
Treatment & Management
Treating psoriatic arthritis is important to help lessen pain, reduce inflammation, help keep joints healthy, and possibly prevent permanent joint damage. Generally, biologic, biosimilar, and oral systemic treatments are prescribed to treat psoriatic arthritis.
and
are medications made from living cells that are given as an injection or intravenous (IV) infusion. Biosimilars are medications that are modeled after a biologic that has already been approved by the FDA. They target specific proteins in the immune system that play a role in psoriatic arthritis.
are medications taken by mouth, most often in the form of a pill. There are several oral systemic treatment options that treat psoriatic arthritis. These treatments work by targeting the immune system.
Prevention
There is no known way to prevent the onset of psoriatic arthritis, however, there are many ways that you can manage your triggers to reduce
.
Outlook/Prognosis
Psoriatic disease is lifelong, and symptoms may resolve and recur throughout the lifetime.
While there is no cure for psoriatic arthritis,
today are more effective than ever before and research into new treatments, as well as a cure, is ongoing. Treating psoriatic arthritis can help improve symptoms, prevent joint damage, and may decrease the associated inflammation that can lead to
such as heart disease, diabetes, anxiety, and depression.
Life with Psoriatic Arthritis
As with other chronic diseases, psoriatic arthritis may affect a variety of areas of your life including your physical and mental health, participation in social activities, and your work life. Learn about the importance of physical activity, pain management, and stress reduction for living with psoriatic arthritis as well as tips on how to manage your disease on the job.
Additional Resources
PsA Resource Center
Find resources, including what to know about PsA, patient stories, ways to thrive, and more, on our new resource center.
Go to the resource center
Psoriatic Arthritis or Rheumatoid Arthritis?
Dr. Cassandra Calabrese explains the similarities and differences between PsA and RA.
Read more
What is the Right Treatment for PsA?
We are here to help you navigate your psoriatic arthritis treatment options.
Read more
Request Your PsA E-Kit
Learn about common symptoms of PsA, treatment options, and assistive devices.
Ritchlin CT, Colbert RA, Gladman DD. Psoriatic Arthritis [published correction appears in N Engl J Med. 2017 May 25;376(21):2097]. N Engl J Med. 2017;376(10):957-970. doi:
Mease PJ, Gladman DD, Papp KA, et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J Am Acad Dermatol. 2013;69(5):729-735. doi:
Villani AP, Rouzaud M, Sevrain M, et al. Prevalence of undiagnosed psoriatic arthritis among psoriasis patients: Systematic review and meta-analysis. J Am Acad Dermatol. 2015;73(2):242-248. doi:
Last updated on 3/24/2026 by the National Psoriasis Foundation.
Medical Reviewer: Dr. Cassandra Calabrese, D.O., is an Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine and is a rheumatologist at the Cleveland Clinic, with appointments in the Infectious Disease Department and Taussig Cancer Center. She specializes in infections in the setting of immunosuppressive treatment for rheumatic diseases, rheumatic manifestations of infectious diseases, infection prevention and immunizations, and immune related adverse events from checkpoint inhibitor therapy. Dr. Calabrese has published extensively on immune mediated inflammatory diseases in medical and scientific journals. She serves on the National Psoriasis Foundation's
and has contributed to several NPF articles.