If you have psoriasis, imagine waking up with stiff, swollen joints, or feeling fatigue that just won’t go away. These could be early warning signs that your skin condition is now affecting more than just your skin — it might be creeping into your joints.

About 30 percent of people with psoriasis develop psoriatic arthritis (PsA). PsA happens when the immune system attacks the joints, leading to painful flare-ups and joint damage over time. Most people who have PsA experience skin symptoms first, but sometimes, the joints are the only areas affected.

Learning to recognize the signs and symptoms of PsA can help you get treatment before too much damage occurs. When left untreated, joint damage from PsA can cause a reduced range of motion and joint deformation. By keeping PsA under control in the early stages, you can protect your joints and feel your best. Next to some classic, “old-school” anti-arthritis medication, like methotrexate (Otrexup), rheumatologists can now prescribe some very modern and effective biologic treatments. Biologic treatments are made from living cells or proteins and are designed to target specific components of the immune system.

Early Symptoms and Signs of Psoriatic Arthritis

Like psoriasis, PsA symptoms may come and go. PsA can attack joints anywhere in the body, causing pain and limiting mobility. It’s possible to get PsA in one joint or several at a time. Both large and small joints can be affected. Some people experience mild symptoms, and others have severe flare-ups.

Below are some early symptoms of PsA:

• Joints that look swollen or feel warm to the touch
• Swollen fingers or toes (dactylitis)
• Joint stiffness, especially first thing in the morning
• Foot pain in the sole of the foot and heel
• Back pain, particularly in the lower back

One MyPsoriasisTeam member described noticing symptoms while exercising. “Today, during yoga, I felt pain in my right shoulder. It was the position we were asked to do. I just adapt and do what I can without pain,” they said.

Another member described their PsA this way: “The pain feels like a stiff neck but in my arm and shoulder.”

One member described how the disease seemed to move to different areas over time. “For years, I had it in my hip, and then it just went away,” they said. “Now I have it in my right knee, which is very painful. My knee is swollen, and bending it is difficult. I struggle to walk up and down the stairs as well. I also have it in four of my fingers, which is horrible, as I use my hands daily to work on a computer.”

Symptoms Beyond the Joints

You may experience early symptoms of PsA that seem unrelated to your joints. These include:

• Eye inflammation and redness (uveitis)
• Nail pitting and other nail changes
• Fatigue

“I’m newly diagnosed with PsA,” one member wrote. “All 10 of my nails were affected.”

Next Steps

Reach out to your doctor if you notice any signs and symptoms of PsA. While a dermatologist is the right person to talk to about your psoriasis skin symptoms, a rheumatologist can help address issues with your joints. You can ask your dermatologist for a referral to a rheumatologist. Other providers you may want to involve in your care include a physical therapist, an occupational therapist, or a podiatrist.

“After seeing my rheumatologist, who diagnosed it as a new area of PsA, I saw a podiatrist, who prescribed an orthotic, which I’m waiting for,” explained a MyPsoriasisTeam member. “But in the meantime, I found a great pair of sneakers that cause no pain at all. So I’m looking forward to the orthotic so I can wear other shoes as well. And now that I’m wearing these sneakers, the pain has eased up a lot, even without them.”

Some people also find relief through complementary therapies, like this member of MyPsoriasisTeam who wrote, “I started acupuncture four weeks ago now, and I can finally walk with shoes. My pain is at a minimum.” Talk to your doctor before trying any complementary therapies, home remedies, or supplements.

Depending on the severity of your symptoms, specialists can help you find safe ways to exercise, find relief, and move safely through your day.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 121,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you experienced any early signs of psoriatic arthritis? What early symptoms did you have first, and how does this form of arthritis affect your quality of life? Post your suggestions in the comments below, or start a conversation on MyPsoriasisTeam.