If you’re living with psoriatic arthritis (PsA) and taking a tumor necrosis factor (TNF) inhibitor, you may notice that certain joints improve faster than others. A recent study found that joints in the shoulders and elbows are more likely to respond quickly, while the wrists, knees, and middle fingers may take longer to heal.

TNF inhibitors are a type of biologic drug that reduces inflammation by targeting a protein called tumor necrosis factor.

Which Joints Improved First?

The study included 1,729 people with PsA who were starting a TNF inhibitor, either alone or with methotrexate. Researchers followed participants for two years and tracked which swollen joints showed signs of improvement.

Among the key findings:

• Overall, swelling improved in 67 percent of affected joints.
• Shoulder and elbow joints responded more quickly.
• The wrist and knee took longer to improve than most joints.
• Among the fingers, the index, ring, and pinky joints healed faster than the middle finger joint.

Why Some Joints Heal More Slowly

Researchers suggested that joints under more physical stress — like the knees — may take longer to recover. The knee, a weight-bearing joint, showed the slowest improvement in the study.

This insight can be helpful for managing expectations about treatment. If some joints aren’t improving as quickly, it may not mean the treatment isn’t working — it may just depend on which joints are affected. Be sure to discuss any concerns with your rheumatologist, especially if you’re not seeing expected improvements.

Do you experience joint pain from PsA? These guided stretches and exercises may help.

Find Your Team

On MyPsoriasisTeam, the social network for people living with psoriasis and psoriatic arthritis, more than 133,000 members connect to share experiences and treatment insights.

Have you noticed some joints improving faster than others with treatment? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.