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. Flares can show up without warning and disrupt daily life. 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 a flare, you may have painful, swollen joints, along with other symptoms that are less common. This may include fatigue (exhaustion that doesn’t improve with rest) and eye or nail changes. Symptoms can show up at the same time or at different times during flare-ups. Some people notice general discomfort before more specific PsA joint pain starts.

How Long Do Psoriatic Arthritis Flares Last?

A flare can last anywhere from a couple of days to several months, depending on the person. If symptoms last just a few hours, they’re usually 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 (a doctor who treats arthritis and related conditions).

Managing Psoriatic Arthritis Flares

You and your doctor can work together to manage PsA flares and help reduce how often they happen. Some approaches are proactive, meaning they should be done even before PsA flares begin. Starting treatment early may also help you avoid long-term complications, such as joint damage, that can happen when PsA isn’t treated.

Other methods for managing flares involve treating symptoms during flare-ups. If your PsA flares, you may need to do more than your usual daily steps to manage it.

Everyday Steps To Help Prevent 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, you may want to include some lifestyle changes.

Take Medications

Many medication options are available for treating PsA, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) — Over-the-counter or prescription NSAIDs, such as ibuprofen or naproxen, can help you manage mild to moderate pain and inflammation.
• Disease-modifying antirheumatic drugs (DMARDs) — DMARDs like methotrexate can help slow PsA over time. These medicines work by calming the immune system.
• Biologics — These injected medicines, called biologic drugs, are made using living cells and can slow the disease by targeting specific parts of the immune system.
• Oral medications — Oral medications like Janus kinase (JAK) inhibitors and phosphodiesterase 4 (PDE4) inhibitors can help control inflammation and symptoms and may help protect joints over time.
• Corticosteroid injections — These can help provide immediate, short-term relief. Doctors usually don’t recommend getting these injections often.

The right medication depends on several factors, including how severe your condition is, how active the disease is, any other health conditions you 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 (other health conditions you have at the same time) 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 your symptoms or makes them worse. Once you know your triggers, you can do your best to avoid them or limit their impact on your life.

Exercise Regularly

Regular exercise is good for your overall wellness and may help lower your chance of flares. It can help you reach and stay at a healthy weight for your body. Extra weight can make joint pain worse and may make some medications less effective. Physical activity can also help your affected joints work better, help you get good sleep, and lower stress. These benefits may help you have fewer 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 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 injury can trigger PsA, including skin infections, bumps, and bruises. Sometimes psoriasis symptoms flare first, and joint pain follows. To help lower your risk, protect your joints and avoid hard impacts or repeated movements that can leave you sore or swollen.

Manage Stress

Stress is a major trigger for many people diagnosed with PsA. Living with a chronic illness is a lot to juggle, and stress can make symptoms harder to control.

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 stressful times.

Finding effective techniques for reducing your stress levels is key. You may want to try progressive muscle relaxation, biofeedback (a technique that helps you learn to relax your body), meditation, or mindfulness — all have been shown to lower stress. You may also want to talk to a mental health professional about your stress and anxiety.

Active Management During PsA Flares

When you’re 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 less than usual 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 guidance. They can help you choose a medication that fits your needs and lowers the risk of 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 plastic bag of ice for 20 minutes at a time.

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 brace to support sore joints.

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.

Join the Conversation

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

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? Let others know in the comments below.