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.

About one-third of people with psoriasis develop PsA, but some people can have PsA without any skin symptoms of psoriasis. Because PsA is a long-term condition, pain can come and go depending on what’s going on in your life and how well your treatment is working.

What Does Psoriatic Arthritis Foot Pain Feel Like?

PsA 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 from PsA can make it hard to stand, walk, and get through daily activities. About half of people with PsA have foot pain. Here are six ways to help manage it.

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 can help relieve pain and inflammation from PsA, but they don’t slow joint damage.

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. Medications That Help Slow PsA Progression

While NSAIDs decrease pain and inflammation, they don’t slow the progression of PsA. There are several systemic medications that can help slow joint damage and relieve your pain. These drugs work to stop your body’s overactive immune response that causes joint pain, swelling, and inflammation.

Examples of drugs that slow PsA progression include:

• Traditional disease-modifying anti-rheumatic drugs (DMARDs) — These medications suppress your immune system to help stop the inflammation that is causing PsA symptoms. This might be the first type of systemic medication you try.
• Biologics — This class of drugs targets a specific part of your immune system to control inflammation. There are several different types of biologics with different immune system targets.
• Oral systemic medications — There are a few types of oral medications for PsA that work to control inflammation. They include JAK, PDE4, and TYK2 inhibitors.

3. 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.

4. Hot Baths

You can also use heat to help relieve foot pain. Try wrapping your feet in a warm towel, using a heating pad, or taking a warm bath to help ease swelling and joint pain.

5. Exercise and Healthy Habits

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.

6. Comfortable Shoes

Wearing comfortable shoes is one of the most important things you can do to manage foot pain with PsA. 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 healthcare 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

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

How do you manage PsA-related foot pain? Let others know in the comments below.