Psoriatic arthritis (PsA) is an ongoing condition. If left untreated, it can get worse over time, often leading to pain and swelling throughout the body. For many people with PsA, pain is 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.

One study found that nearly half of people with PsA may experience this issue. About 27 percent had pain that was “likely” to be caused by neuropathy, and 22 percent had pain “possibly” caused by the condition. Neuropathy can also occur in people with psoriasis, but it is less common.

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

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 most often leads 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. It may also make you feel clumsier than usual or drop items you’re carrying. When this type of neuropathy occurs in the wrists, it is known as carpal tunnel syndrome.

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 one of the main causes 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 health care 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.”

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 lamented, “Typing is an ordeal.”

Autonomic Neuropathy Symptoms

Nerve damage can also occur in the autonomic nerves, leading to autonomic neuropathy. These neurons are found in the brain and spinal cord, collectively known as the central nervous system (CNS). Autonomic neuropathy is less common in people with PsA.

Damage to the CNS neurons can cause many problems with mind and body processes. Autonomic neuropathy can lead to:

• Lightheadedness
• Fast heart rate
• Excess sweating
• An inability to sweat
• Blurry vision
• Changes in bladder or bowel habits
• Sexual problems

What Causes Neuropathy for People With PsA?

Neuropathy may arise directly from psoriatic arthritis. Other unrelated conditions or treatments could also cause neuropathy in people with PsA.

PsA May Lead to Neuropathy

Psoriatic arthritis causes inflammation, which leads to tissue damage when it lasts for long periods of time. Inflammatory chemicals released by the immune system can damage the nerves, making them not work as well as they should.

If you have PsA, your nerves may not pick up signals that they normally would. They could also 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 2 diabetes
• Deficiencies in vitamin B1, vitamin B6, vitamin B12, folic acid, copper, or other nutrients
• Other autoimmune disorders (conditions when the immune system attacks the body), 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 (Pamelor) and duloxetine (Cymbalta)
• Topical medications (creams or ointments applied to the skin) such as capsaicin cream or lidocaine (Xylocaine)
• Pain medications, including over-the-counter options like ibuprofen (Advil) or other nonsteroidal anti-inflammatory drugs (NSAIDs), or prescription options like tramadol (Ultram)
• Anti-seizure drugs like pregabalin (Lyrica) or gabapentin (Gralise)

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

“Some nights, I feel it all over,” commented another. “Tramadol helps me sleep.”

Certain medical procedures may also help with neuropathy. For example, your doctor 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 anti-rheumatic drugs (DMARDs) can slow down PsA and prevent new damage from occurring.

Preventive Care

Neuropathy can lead to a higher risk of developing 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 health care provider to learn more about which exercises are safe for you. Be careful — performing a lot of repetitive motions may further damage your nerves.

Talk With Others Who Understand

On MyPsoriasisTeam, the social network for people with psoriasis and their loved ones, more than 113,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you been experiencing numbness or tingling? Share your experience in the comments below, or start a conversation by posting on MyPsoriasisTeam.