“Does anyone have numbness in their fingers?” asked a MyPsoriasisTeam member. “It really is so unpleasant. It recently started just on my one hand. The tips of my fingers get numb, too.”

Numbness in people living with psoriatic arthritis (PsA) can be related to neuropathy. “Neuropathy” is the medical term for damage to the neurons, which are nerve cells that send signals to and from the brain. Neuropathy also commonly causes unusual sensations such as numbness, tingling, and pain.

Research shows that neuropathy and neuropathic-like pain appear in some people with psoriatic arthritis, but the true rate of neuropathy directly caused by PsA is still unclear. One study found that about 27 percent of people with PsA had “likely neuropathic pain,” and another 22 percent had “possible neuropathic-like pain” based on symptom questionnaires.

A separate study using nerve testing found 9 out of 100 people with psoriasis and/or PsA had polyneuropathy, a type of nerve damage that affects multiple nerves.

Neuropathy can also occur in people with psoriasis without arthritis, but it appears to be less common and may be linked to other health issues rather than psoriasis itself.

Read on to learn what neuropathy feels like, why it happens in people with PsA, and what you can do to manage it.

What Does Neuropathy Feel Like?

Neuropathy is classified into three main types depending on which neurons are affected. Each type of neuropathy can lead to different symptoms.

Peripheral Neuropathy Symptoms

PsA can lead to problems with the sensory neurons, which help you notice sensations like pain, touch, pressure, and temperature. It can also affect the motor neurons, which are the nerves responsible for controlling how you move. Together, the sensory and motor neurons are known as the peripheral nerves. Problems with these nerves are known as peripheral neuropathy.

Damage to the sensory neurons may lead to numbness, tingling, or a pins-and-needles sensation. These sensations usually affect the hands and feet. Sometimes the sensations radiate up the arms and legs. The numbness and tingling may also make you feel clumsier than usual or cause you to drop items you’re carrying.

Neuropathy that affects the motor neurons may make it hard to move the muscles in your hands, arms, feet, or legs. Over time, your muscles may shrink.

Peripheral neuropathy is a potential cause of pain for people with PsA. Neuropathic pain may:

• Cause stabbing or burning sensations
• Last for a long time
• Stick around even after you take pain medications
• Make it more difficult to fall asleep
• Lead to depression or anxiety
• Cause you to need to visit the doctor more often, resulting in increased healthcare costs

MyPsoriasisTeam members have talked about their experiences with the condition. “My neuropathy was the worst today,” one member wrote. “I wish my feet didn’t hurt so much.”

Another commented, “My fingers on my right hand are really swollen, and my hand kept going numb all night while I was trying to sleep.”

“My fingers on my right hand are really swollen, and my hand kept going numb all night while I was trying to sleep.”

— A MyPsoriasisTeam member

In some cases, neuropathy may make daily tasks more difficult. “I have a weakness in my left arm,” wrote a member. “I find it difficult to unscrew bottles and get an ache or numbness in my arm if I carry shopping bags.”

A member with neuropathy in both hands and arms said, “Typing is an ordeal.”

“I find it difficult to unscrew bottles and get an ache or numbness in my arm if I carry shopping bags.”

— A MyPsoriasisTeam member

Autonomic Neuropathy Symptoms

Nerve damage can also occur in the autonomic nerves, which are the nerves that control automatic body functions you don’t have to think about — such as heart rate, digestion, sweating, and blood pressure. When these nerves are damaged, it can lead to autonomic neuropathy.

Autonomic neuropathy can cause:

• Lightheadedness
• Fast heart rate
• Excess sweating
• Inability to sweat
• Blurry vision
• Changes in bladder or bowel function
• Sexual problems

What Causes Neuropathy for People With PsA?

Neuropathy can sometimes happen in people with psoriatic arthritis, but it may not always be caused by PsA itself. Other health problems or treatments might be the real reason for nerve symptoms.

PsA May Lead to Neuropathy

While PsA can cause long-term inflammation, recent studies show that nerve problems like neuropathy might not be directly caused by PsA itself. Instead, people with PsA often have other health issues or take certain medicines that can affect the nerves. These other factors may explain why nerve symptoms are more common in people with PsA.

If you have PsA, your nerves may become too sensitive, sending signals to the brain when they shouldn’t — causing your brain to perceive extra pain.

You may be more likely to experience neuropathy if you have more severe PsA. In one study, researchers found that people with nerve pain were more likely to have symptoms of psoriatic arthritis like swollen joints and dactylitis (swollen fingers or toes).

Other Potential Causes

In some cases, PsA may not be the cause of neuropathy. Some people have other medical conditions that lead to this symptom, including:

• Type 1 or type 2 diabetes
• Deficiencies in vitamin B1, vitamin B6, vitamin B12, folic acid, copper, or other nutrients
• Other autoimmune disorders including lupus, rheumatoid arthritis, or Guillain-Barré syndrome
• Genetic disorders such as amyloidosis or Fabry disease
• Infections like Lyme disease, shingles, hepatitis B, or hepatitis C
• Alcohol use disorder
• Kidney disease
• Liver disease
• Thyroid problems
• Cancer
• Pinched nerve caused by degenerative disc disease or herniated disc, referred to as radiculopathy

Neuropathy can also be caused by medications like antibiotics and treatments for arrhythmias (abnormal heart rhythms). Chemotherapy may also cause this symptom. In some cases, surgery can damage the nerves in a particular location, leading to neuropathy.

Other neuropathy causes include injuries that damage the nerves or exposure to lead, mercury, or certain chemicals.

Treatment Options for Neuropathy

Symptoms of neuropathy can be lessened with several types of medications, including:

• Antidepressants, including nortriptyline and duloxetine
• Topical medications (creams or ointments applied to the skin) such as lidocaine
• Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Anti-seizure drugs like pregabalin or gabapentin

These medications have been successful for some MyPsoriasisTeam members. “I started taking duloxetine, not for depression but for pain from neuropathy,” said one member. “It’s helping a lot with psoriatic arthritis pain.”

Certain medical procedures may also help with neuropathy. For example, your rheumatologist may recommend applying an electric current through the affected area using a procedure called transcutaneous electrical nerve stimulation (TENS).

If neuropathy is making it difficult to move around, physical therapy may help you build up strength, learn how to move more effectively, reduce pain, and improve your quality of life. Some people find it easier to get around using a cane or walker.

Finally, keeping your PsA under control can help lessen symptoms like neuropathy. Treatments like disease-modifying antirheumatic drugs (DMARDs), biologics, and Janus kinase (JAK) inhibitors can minimize flares, slow down PsA and prevent new damage from occurring.

Preventive Care

Neuropathy can lead to a higher risk of infections or injuries. If you can’t feel a certain part of your body, you may not notice if a problem develops. Regularly check any part of your body affected by neuropathy, such as your feet, for signs of infection or damage. Make sure to treat any injuries right away.

Physical activity is also good for nerve health. However, check with your healthcare provider to learn more about which exercises are safe for you. Be careful — performing a lot of repetitive motions may further damage your nerves.

Join the Conversation

On MyPsoriasisTeam, people share their experiences with psoriasis and psoriatic arthritis, get advice, and find support from others who understand.

Do you experience numbness or tingling? Let others know in the comments below.