Psoriatic arthritis (PsA) is an autoimmune disease. That means the immune system, which usually protects your body, starts attacking your joints by mistake. It’s an inflammatory arthritis that commonly affects people with the skin condition psoriasis.

The main symptoms of PsA include joint pain, swelling, and stiffness, which can become worse over time. However, most people diagnosed with PsA go through periods of remission (when symptoms improve) and flare-ups (when symptoms return or worsen).

When you feel PsA symptoms returning, it’s important to get a handle on the condition quickly. Treating a flare early may prevent symptoms from becoming severe or interfering with daily life. Here’s what you need to know about living with PsA so you can work with your doctor to treat it effectively.

Treating a psoriatic arthritis flare early may prevent symptoms from becoming severe or interfering with daily life.

What Do Psoriatic Arthritis Flares Feel Like?

PsA affects people differently, and that includes flares. But there are some common symptoms to watch out for. Because flares can come up at any time, they can disrupt life significantly. One member told others, “My feet are burning and stinging. Just did a little shopping; that’s all it takes.”

Another said, “Psoriatic arthritis makes you feel so tired and drained that you feel like every step is so heavy and tiring.”

“Psoriatic arthritis makes you feel so tired and drained that you feel like every step is so heavy and tiring.”
— A MyPsoriasisTeam member

Symptoms of Psoriatic Arthritis Flares

During PsA, some people have painful, swollen joints, along with less-characteristic symptoms. This may include fatigue (exhaustion that doesn’t improve with rest) and eye or nail changes. Symptoms may happen simultaneously or at different times during flare-ups. Some people experience a flare as a general feeling of discomfort before more specific PsA joint pain sets in.

How Long Do Psoriatic Arthritis Flares Last?

How long a flare lasts is different in everyone and could range from a couple of days to a week. If symptoms last just a few hours, they’re not considered a flare. However, if the symptoms are severe, contact your doctor, even if they haven’t lasted that long.

The bottom line: No set amount of time defines a PsA flare, but if your daily activities are affected more than usual, it’s time to talk to your rheumatologist.

Managing Psoriatic Arthritis Flares

You and your doctor can work together to manage your PsA flares and limit how many you experience. Some approaches are proactive, meaning they should be done even before PsA flares begin. Taking steps proactively may help prevent or minimize symptoms should a flare-up occur. Proactive treatment can also help you avoid long-term complications, such as joint damage, that can come from not treating the condition.

Other methods for managing flares involve treating symptoms during flare-ups. If your PsA does flare, you’ll need to take steps beyond those you do daily to manage your condition.

Proactive Management of Psoriatic Arthritis Flares

There are several ways to help manage your PsA, limit flares, and improve your quality of life. In addition to following a treatment plan, they include some lifestyle changes.

Take Medications

Many medication options are available for treating PsA. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help you manage mild to moderate pain and inflammation. Prescription NSAIDs are also available.

If a particular joint is causing you pain, corticosteroid injections can help provide immediate, short-term relief. Corticosteroid injections should be avoided if there are severe psoriatic lesions at the site of injection.

Systemic treatment options — medicines that work throughout your whole body — can help you manage disease activity and prevent flares from occurring.

Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate or biologics, can help manage PsA. Biologics are made from living cells and are the only treatment that can help slow down or stop damage to the joints from getting worse.

The right medication depends on several factors, including the severity of your condition, your level of disease activity, any other health conditions you may have, your lifestyle, and the treatments you’ve already tried. Your doctor can help you explore your options and decide which treatment plan may work best for you.

Know Your Triggers

PsA can have many types of triggers, which vary from person to person. One MyPsoriasisTeam member said, “I find that stress is my main trigger,” while another shared that coffee triggers their flare-ups. The key is to get to know which triggers cause PsA flare-ups for you.

Sometimes, comorbidities (co-occurring health conditions) can trigger a PsA flare. As one MyPsoriasisTeam member shared, “Premenstrual dysphoric disorder sucks! Stomach impaction makes it flare, which in turn, flares the psoriatic arthritis.”

Other times, PsA seems to flare on its own. One member who experienced this wrote, “I have plaque psoriasis, psoriatic arthritis, and psoriatic nails. At the present time, my psoriasis is under control, but my arthritis flares. I just never know when it’s going to happen.”

You may want to keep a diary to track all possible triggers, including foods, the temperature, and the weather. Logging your PsA symptoms alongside these factors may help you identify what leads to or worsens your symptoms. Once you know your triggers, you can do your best to avoid them or limit their impact on your life.

Exercise Regularly

Consistent exercise benefits your overall wellness and can help reduce flares. Regular exercise can help you stay at a healthy weight for your body, which is important because excess weight might prevent your medications from working properly and can worsen joint pain. Physical activity can also keep your affected joints working well, help you get good sleep, and reduce your stress levels. All these benefits may stave off PsA flares.

After getting recommendations for specific exercises by a healthcare provider, one member shared, “The exercises are really helping!”

Use Sun Protection

Sunburn can be a significant trigger for many people with PsA — especially those who also have psoriasis. Their skin may be extra sensitive to the sun, and prolonged exposure may lead to PsA flare-ups, too. When you’re in the sun, wear sunscreen and sun-protective clothing.

Avoid Injury

Any sort of injury can trigger PsA, including skin infections, bumps, and bruises. These injuries might trigger psoriasis flares before arthritis also flares up. Take care to avoid bumping your joints or inflicting another injury.

Manage Stress

Stress is a major trigger for many people diagnosed with PsA. Living with a chronic illness is tough enough, and stress can add to the equation. It’s important to look at your life and your schedule and see where and when you might experience extra stress. You and your doctor can develop a plan for what you will do to avoid a flare during those times of anxiety.

Finding effective techniques for reducing your stress levels is key. You may want to try progressive muscle relaxation, biofeedback, meditation, or mindfulness — all have been shown to lower stress. You may also want to speak to a mental health professional about your stress and anxiety.

Active Management During PsA Flares

If you find yourself in the middle of a PsA flare, you can take a few steps to help manage your symptoms at the moment.

Reduce Your Activity Levels

Start by decreasing your physical activity. Less activity doesn’t necessarily mean staying in bed or sitting on the sidelines, but you may need to do the minimum instead of pushing yourself. Stepping back may help you lower your stress levels and give your body time to recover.

Adjust or Change Your Medications

When PsA flares up, it’s time to talk to your rheumatologist. Your medications may no longer be working as effectively, or your body may need more support to get you through this difficult period.

If one type of medication isn’t working, you may need to try another. Ask your doctor for advice — they’ll help you find the right medication while minimizing potential side effects.

Try Heat and Cold Therapy

Both heat and cold can help relieve symptoms of PsA during flares. Heat helps ease pain and tension by loosening the muscles around joints and increasing flexibility and circulation. Cold, on the other hand, helps reduce inflammation, swelling, and pain.

For hot therapy, Cleveland Clinic recommends these options:

• Shower or soak in a warm bath for 20 minutes.
• Use a heating pad.
• Apply a moist dishcloth warmed in the microwave for 20 seconds.

For cold therapy, apply a gel-filled cold pack, a bag of frozen vegetables, or a baggie filled with ice for 20 minutes at a time.

Don’t let your pain get worse and worse. Talk to a rheumatologist about the best medical and at-home treatments to help manage a flare.

Take Your Pain Seriously

Don’t let your pain get worse and worse. Talk to a rheumatologist about finding pain relief as soon as it begins. Your doctor can offer medical advice to manage your discomfort. They may even recommend trying a splint or a brace to reinforce painful joints.

Find Your Team

On MyPsoriasisTeam, the social network for people and their loved ones with psoriasis and psoriatic arthritis, more than 193,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic disease.

Do you have any tips to keep PsA flares from worsening once they start? How does PsA affect your range of motion and quality of life? Share in the comments below or by posting on your Activities page.