Around 1 in 3 people with psoriasis develop psoriatic arthritis (PsA). Usually, PsA symptoms start after you’re diagnosed with the skin disease. However, it’s also possible to get psoriatic arthritis before psoriasis symptoms occur.

Psoriatic arthritis affects the joints and skin. Joint pain and stiffness in the hands can seriously affect daily activities, as members of MyPsoriasisTeam have described. “My pain can migrate to different joints each day,” one member said.

Another member reported that the worst symptoms were usually in their fingers: “I get pain in my fingers, usually the joint closest to the tip of my finger — and the same for my toes, actually. Every now and then, my elbows and knees will hurt too.”

Here are the PsA symptoms to watch out for and treatments to discuss with your health care provider.

Symptoms of Psoriatic Arthritis

Psoriatic arthritis symptoms usually happen over time, so it’s not always easy to tell when the problem started. Common PsA symptoms include:

• Skin and nail psoriasis — Itchy discolored patches with white scales may appear on skin, and nails may develop white spots and cracking, splitting, and pitting (denting). Skin and nail changes usually appear together, but some people have only nail changes.
• Arthritis — Psoriatic arthritis causes inflammation in the joints near the end of the fingers and toes.
• Dactylitis — Dactylitis is the term for swollen, painful fingers, sometimes called “sausage digits.”
• Back and neck spondylitis — Pain may develop in the neck and lower back and be worse at night or in the morning. Over time, stiffness may increase and mobility may decrease.
• Enthesitis — In this condition, tendons and ligaments that attach to the bone become inflamed. The Achilles tendon is most commonly affected.
• Inflammation of other organs — Psoriatic arthritis can affect the eyes (uveitis) and colon (colitis).

Doctors can tell the difference between psoriatic arthritis and other types based on a physical exam and testing, such as blood tests and X-rays.

Watch rheumatologist Dr. Ashira Blazer explain how you can manage pain and stiffness in your fingers and wrists.

Lifestyle Changes To Help With Psoriatic Arthritis

Sometimes simple lifestyle changes can improve PsA symptoms and help prevent further joint damage. Lifestyle changes may be combined with medications and other treatments to help you feel your best.

Exercise and Physical Therapy

Joints become stiffer with lack of use, and muscle weakness can increase joint pain. Low-impact exercise, such as walking, can help ease those symptoms.

Some people with psoriatic arthritis find it easier to exercise in water. For example, swimming or walking in a pool won’t strain affected joints. “I like walking when I can, and swimming,” shared one member. “I start in a cooler pool and then hop into the hot tub. It seems to work.”

Another member warned that chlorine in pools could aggravate psoriasis: “I find chlorine makes my psoriasis worse.”

Physical and occupational therapy can also teach you how to protect your joints, strengthen your muscles, and manage pain with strategies like hot and cold therapy or paraffin baths for your hands. One member reported good results from physical therapy. “Went to a physiotherapist to get an exercise routine (basically yoga stretches) that worked for me,” they said.

“Hand exercises, stretching, and heat help with the pain and swelling,” shared another member.

Eating Healthy

A healthy diet can also reduce inflammation. Members have reported improvement after eliminating certain foods. “Avoid gluten,” one member advised. Another said, “The more I stay away from wheat products, the better I feel.” A third member advised staying away from dairy and nightshade plants.

Avoiding Alcohol

Alcohol can make arthritis symptoms worse and interfere with arthritis medications, depending on your current treatment plan. Be sure to discuss your drinking habits with your health care provider.

Protecting the Joints

People with psoriatic arthritis in the hands may find new ways to do everyday tasks to limit the strain on the joints. Simple ways to reduce joint pain in the fingers and hands include:

• Lifting objects with both hands
• Pushing doors open with your body
• Using devices to open cans and jars

A physical or occupational therapist can teach you strategies to move better in everyday life.

Medications for Hand Psoriatic Arthritis

Several types of medications for psoriatic arthritis are available. These drugs can reduce pain and inflammation or sometimes slow the progression of the condition. Your health care team of doctors (rheumatologist and dermatologist) will also consider your lifestyle, preferences for drug administration, and any other medical conditions to help determine the best way to treat your psoriatic arthritis.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first medications people take to manage mild psoriatic arthritis.

Members of MyPsoriasisTeam have reported mixed results with NSAIDs:

• “Advil helps me and I also take Diclofenac; both help.”
• “I can’t use Aleve, aspirin, and some other over-the-counter pain relievers because they upset my stomach.”
• “I had to stop using NSAIDs because they were tearing up my stomach.”

Taking NSAIDs with food can help reduce negative side effects.

Corticosteroids

Corticosteroid injections can help relieve swollen joints. They can also be taken orally (by mouth) to target inflammation throughout the body. It’s best to use corticosteroids only occasionally. Taking them for too long can cause side effects like:

• Weight gain
• Insulin resistance or high blood sugar
• High blood pressure

“I had cortisone injections in my hands, and it helped tremendously, not only with the psoriasis, but also the joint pain,” one member of MyPsoriasisTeam said.

Disease-Modifying Antirheumatic Drugs and Biologics

Disease-modifying antirheumatic drugs (DMARDs) slow the progression of psoriatic arthritis and can save joints and tissues in the hands from further damage. Your doctor may prescribe a DMARD soon after you’re diagnosed with psoriatic arthritis.

One type, biological DMARDs, targets specific parts of the immune system to reduce inflammation. Some biologics are given through an IV at a doctor’s office, whereas others are taken as injections at home. These medications can help prevent destructive changes in joints and also help with skin symptoms.

DMARDs affect the immune system, so you’ll need to be monitored while taking them.

Janus Kinase Inhibitors

Janus kinase (JAK) inhibitors offer a newer way to treat PsA. These small molecule drugs target a specific pathway of the immune system to lower inflammation, joint pain, and swelling.

Two JAK inhibitors are approved to treat PsA — upadacitinib (Rinvoq) and tofacitinib (Xeljanz). These medications can be a good option for people who haven’t responded well to biologics or DMARDs. It can take a few months of treatment before you notice a difference in joint symptoms.

Before you start a JAK inhibitor, your doctor can review the potential side effects, health risks, and ongoing monitoring that’s required when taking this type of medication.

Surgery and Other Arthritis Treatment Options

If lifestyle changes and medication aren’t making enough of a difference in hand psoriatic arthritis, it may be time to consider alternatives. For some people, surgery can help repair joint damage. Others may benefit from complementary therapies.

Joint Replacement Surgery

Surgery is always a last resort when dealing with psoriatic arthritis. However, if you have a lot of joint damage, surgery can be the best option.

The two types of surgery for hand PsA include:

• Arthrodesis — Fuses bones together and allows for stronger knuckles but may limit movement
• Arthroplasty — Replaces the knuckle or finger joint with an artificial implant

Your doctor can recommend your best surgery options based on the condition of your hands.

Complementary Therapies

Members of MyPsoriasisTeam have tried a wide variety of other treatments to deal with psoriatic arthritis in the hands. Not everyone gets good results with alternative methods, but members have described their experiences in comments like these:

• “I have tried CBD water by Nature’s Remedies. It helped me with anxiety [and] a little for [the] pain.”
• “[I have] begun acupuncture once weekly.”
• “I take 2,000 milligrams of cod liver oil, 2,000 milligrams of omega-3 oils, and 1,000 milligrams of turmeric.”

Be sure to check with your doctor before trying a complementary therapy or taking supplements. They can advise you on what’s best for your psoriatic arthritis and discuss how to use these approaches safely.

Find Your Team

On MyPsoriasisTeam, you gain community support of over 130,000 members who understand life with psoriasis and PsA.

What home remedies or prescribed medications do you find helpful for treating psoriatic arthritis? How does PsA in your hands impact your range of motion and quality of life? Share your experience in a comment below, or start a conversation on your Activities page.