Psoriatic arthritis (PsA) can often mean painful feet. “I have a severe case of plantar fasciitis in my right foot and have been in an Aircast boot for three weeks now,” one MyPsoriasisTeam member said. “It’s a little bit better, but not enough to be on my feet all day.”

Another member wrote: “Can’t wait to start physical therapy and get relief from the tendinitis! The foot and leg pain from it is almost crippling at times, but I have Voltaren for pain and over-the-counter meds for pain.”

PsA foot pain can also get in the way of work and other daily activities. “I just started a new job, and standing hurts my knee. I have plantar fasciitis in my feet, so after seven hours working, my feet are killing me,” one member shared.

Why Does Psoriatic Arthritis Cause Foot Pain?

PsA causes pain because it inflames the joints and the places where tendons and ligaments connect to your bones, called entheses.

Psoriatic arthritis is a chronic (ongoing) condition. About one-third of people with psoriasis end up developing PsA, but you can also have PsA without the skin symptoms of psoriasis. The chronic nature of PsA means your pain might ebb and flow depending on what’s happening in your life and how you’re treating your condition.

What Does Psoriatic Arthritis Foot Pain Feel Like?

Psoriatic arthritis in the feet can feel like tenderness, pain, stiffness, and swelling. When your toes swell up to an extreme degree, this can result in the appearance of “sausage toes” or dactylitis. Nail changes from PsA can also affect the pain in your feet because the nail bed can separate from the skin underneath, causing discomfort.

You might also get Achilles tendinitis, or inflammation of the Achilles tendon, which is often the source of PsA heel pain. Another condition, plantar fasciitis, occurs when the ligament on the bottom of your foot becomes inflamed.

Foot pain can be especially challenging, as it can make it difficult to stand, walk, and perform daily activities. PsA can cause inflammation in the joints of the feet, leading to pain, swelling, stiffness, and difficulty walking. About half of those with PsA experience foot pain. Continue reading to learn about eight ways to manage foot pain caused by psoriatic arthritis.

1. Nonsteroidal Anti-Inflammatory Drugs

Medications such as ibuprofen (Advil), naproxen (Aleve), or prescription painkillers can temporarily relieve foot pain from PsA. These nonsteroidal anti-inflammatory drugs (NSAIDs) work to reduce inflammation by blocking the production of some inflammation-causing chemicals in your body.

NSAIDs have similar effects as corticosteroids, but with fewer side effects. They are often good for people with inflammatory arthritis because they can treat the pain caused by slow tissue damage over time.

Although these drugs can be a good management tool, the relief from NSAIDs is temporary. That means you’ll likely have to take the medication whenever your symptoms crop up.

2. Disease-Modifying Antirheumatic Drugs

Like NSAIDs, disease-modifying antirheumatic drugs (DMARDs) decrease pain and inflammation. However, they are also meant to slow the progression of PsA rather than only manage symptoms. It can take more than a month to feel the effects of these drugs, and your doctor will likely recommend you try one for three months to see how well it works for you.

DMARDs work by suppressing your body’s overactive immune response that causes joint pain, swelling, and inflammation. The drug you take might target a specific immune system pathway, or it could even work on individual proteins.

3. Biologic Drugs

Biologic drugs are a kind of DMARD made using molecular biology. They target the specific molecules, cells, and pathways that lead to inflammation and tissue damage.

Biologics are not a first-line treatment because most of them have to be given by injection or intravenously. Your rheumatologist might prescribe DMARDs or biologics if the goal is to slow disease progression instead of only managing symptoms. In addition, DMARDs are less effective at treating pain around the spine and torso. So if you have significant back pain along with foot pain as part of your psoriatic arthritis, your rheumatologist may recommend going with a biologic first.

4. Topical Painkillers

Topical painkillers may be used before stronger drugs to manage your PsA foot pain. The most common treatments are corticosteroids, which can be found over the counter or by prescription.

Creams and ointments might be used together with DMARDs to treat skin plaques and changes in your toenails, such as pits or dents that appear on their surface.

5. Ice and Cold Therapy

Icing your feet can help reduce the irritation and inflammation associated with PsA symptoms. “Ice cold foot baths can help,” wrote one MyPsoriasisTeam member. “I overdid things, but with ice, rest, and meds, I’m OK. It’s been so long since I’ve felt this good. Almost human again.”

Wrapping an ice pack in a towel, to provide a barrier, and laying it on your feet is another way to feel some cool relief. Freezing a water bottle and rolling it under your foot a few times a day can be helpful as well.

6. Hot Baths

On the other hand, you could also use heat to soothe your foot pain. Wrapping your feet in a hot towel, placing them under a heat pack, or taking a warm bath can all help reduce swelling and ease joint pain.

7. Healthy Eating and Exercising

Keeping up with your self-care can be difficult when you aren’t feeling well, but it can actually help you feel better. Similar to rheumatoid arthritis, another inflammatory condition, PsA flare-ups might occur after you have been inactive.

You might benefit from low-impact activities, such as walking or swimming. These kinds of activities can help strengthen your body without further stressing your joints.

“Having a relaxing day today. Went swimming this morning, which was lovely! 😍” one member shared.

8. Comfortable Shoes

Wearing comfortable shoes is one of the most important things you can do to manage foot pain with psoriatic arthritis. The wrong shoes could further irritate your feet.

“I have to wear flip-flops to work,” wrote one MyPsoriasisTeam member. “My feet hurt so bad, I can’t wear shoes. I need the support of a shoe, but I just can’t do it.”

Some things to keep in mind: You’ll want to find shoes of the correct size, avoid high heels, and strike a good balance between soft and supportive. Custom shoe inserts made specifically to fit your soles can also be a game changer. Consult a podiatrist to be sure you’re getting the right kind of inserts.

One team member shared what shoes work best for them: “My foot pain is the worst pain I have for psoriatic arthritis. I wear Born shoes a lot, with a wide toe box, and never any shoes with backs.”

PsA affects day-to-day life because joint damage and other symptoms can get in the way of your favorite activities. Talking to your health care team about strategies to manage your foot pain is the best way to learn what’s best for your feet.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 116,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic arthritis.

How do you manage PsA-related foot pain? Have you tried any of the strategies above? Share your experience in the comments below, or start a conversation by posting on your Activities page.