8 Psoriatic Arthritis Symptoms: Signs, Types, Causes & Treatment

Psoriatic arthritis symptoms can start quietly—morning stiffness that lingers a little longer than usual, swelling in a finger or toe, or fatigue that doesn’t quite make sense. Over time, those symptoms can become harder to ignore.

Psoriatic arthritis is a chronic inflammatory condition that affects the joints and, often, the skin. Without treatment, it can lead to lasting joint damage.

While many people are familiar with osteoarthritis or rheumatoid arthritis, psoriatic arthritis often flies under the radar. According to the National Psoriasis Foundation, psoriatic arthritis affects about 1.3% of Black Americans, compared with 2.5% of white Americans—a difference experts believe reflects gaps in diagnosis and access to specialty care rather than true prevalence.

Understanding psoriatic arthritis symptoms and signs is one of the most important steps toward early diagnosis, effective treatment, and long-term joint protection.

Early Psoriatic Arthritis Symptoms

Early psoriatic arthritis symptoms are often subtle and easy to dismiss. Some people notice joint stiffness in the morning that improves throughout the day. Others experience mild swelling, fatigue, or discomfort in the fingers, toes, or lower back.

Because early psoriatic arthritis symptoms can resemble overuse injuries or aging, many people delay seeking care—allowing inflammation to progress silently.

Most Common Psoriatic Arthritis Symptoms

Most common psoriatic arthritis symptoms include joint pain, swelling, morning stiffness, fatigue, nail changes, and sausage-like swelling of fingers or toes.

These symptoms may appear gradually or flare suddenly and can vary widely from person to person.

Psoriatic Arthritis Symptoms and Signs to Watch For

According to the U.S. National Institutes of Health, psoriatic arthritis psoriatic arthritis symptoms can affect multiple systems in the body and often occur in cycles, with periods of flare-ups and improvement.

Key psoriatic arthritis signs and symptoms include:

Joint pain, swelling, and stiffness, especially in the morning or after rest
Dactylitis, or painful “sausage-like” swelling of an entire finger or toe
Nail pitting, crumbling, or separation from the nail bed
Heel or foot pain, caused by inflammation where tendons attach to bone (enthesitis)
Fatigue that interferes with daily activities
Eye inflammation (uveitis), leading to redness, pain, or blurred vision
Psoriasis patches on the scalp, elbows, knees, or other areas
Inflammatory bowel disease symptoms in some people

Psoriatic arthritis symptoms in fingers and toes are especially common and often mistaken for injuries or other forms of arthritis.

What Does a Psoriatic Arthritis Flare Feel Like?

A psoriatic arthritis flare can cause a sudden worsening of symptoms, including:

Increased joint swelling and stiffness
Sharp or throbbing pain
Fatigue spikes
Worsening skin psoriasis
Reduced mobility

Symptoms of a psoriatic arthritis flare may last days or weeks and are often triggered by stress, infection, or changes in medication.

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is a chronic autoimmune disease in which the immune system mistakenly attacks healthy joints and connective tissue. The inflammation affects joints and areas called entheses, where tendons and ligaments attach to bones.

Psoriatic arthritis is closely linked to psoriasis. Most people develop psoriasis first, followed by joint symptoms—but some experience psoriatic arthritis symptoms before any visible skin changes, making diagnosis more difficult.

Diagnosis delays are especially common among people of color.

“Many of my patients receive late diagnoses, because people of color are less likely to see a specialist early on who can make a proper diagnosis,” says Dr. Ashira D. Blazer, MD, MSCI, a rheumatologist at Hospital for Special Surgery. “This can lead to more severe symptoms and a delay in starting effective treatment.”

Left untreated, psoriatic arthritis symptoms can worsen over time, leading to joint damage and reduced quality of life.

Psoriatic Arthritis vs. Rheumatoid Arthritis: Key Symptom Differences

Although psoriatic arthritis and rheumatoid arthritis share similarities, symptoms can differ:

Psoriatic arthritis often affects fingers, toes, nails, and the spine
Rheumatoid arthritis typically affects symmetrical joints and does not involve psoriasis
Nail changes and dactylitis are more common in psoriatic arthritis

Understanding these differences can help guide an accurate diagnosis.

Can You Have Psoriatic Arthritis Without Psoriasis?

Yes. Some people develop psoriatic arthritis symptoms before psoriasis appears. In these cases, joint pain, swelling, or stiffness may be the first warning signs.

Psoriatic Arthritis Causes and Risk Factors

Experts at the American College of Rheumatology believe psoriatic arthritis develops due to genetics combined with environmental triggers.

Risk factors include:

Family history of psoriasis or arthritis
Severe or widespread psoriasis
Obesity
Infections, including strep throat
Joint or bone trauma
Chronic stress

How Psoriatic Arthritis Is Diagnosed

There is no single test for psoriatic arthritis. Diagnosis typically includes:

Medical and family history
Physical examination of joints, skin, and nails
Imaging tests (X-ray or MRI)
Blood tests to rule out other conditions

Why Psoriatic Arthritis Is Often Missed in Black Patients

Psoriatic arthritis symptoms are often missed or misdiagnosed in Black patients. Psoriasis can appear differently on darker skin tones, making skin symptoms harder to recognize.

Joint pain and fatigue may be dismissed as stress, aging, or overuse. Limited access to rheumatology specialists can also delay diagnosis.

Culturally informed care, early referral, and patient self-advocacy are key to closing this gap.

This article is for educational purposes only and does not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment.

Treatment Options for Psoriatic Arthritis

Managing psoriatic arthritis symptoms usually requires a combination of medical treatment and lifestyle support.

Medications

NSAIDs
DMARDs
Biologic therapies
Corticosteroid injections (short-term)

Supportive Therapies

Physical or occupational therapy
Low-impact exercise
Stress management
Heat and cold therapy
Water-based exercise

When to See a Doctor

See a healthcare provider for psoriatic arthritis symptoms if you experience:

Swelling in fingers or toes
Joint pain with a history of psoriasis
Eye pain or redness
Symptoms lasting more than two weeks

FAQs: Psoriatic Arthritis Symptoms

What are the first symptoms of psoriatic arthritis?

Early symptoms include joint stiffness, fatigue, and mild swelling.

Can psoriatic arthritis occur without psoriasis?

Yes, joint symptoms may appear before skin changes.

How do doctors confirm psoriatic arthritis?

Through clinical exams, imaging, and medical history.

Is psoriatic arthritis more common in Black patients?

Rates appear lower, but underdiagnosis likely plays a role.

Living Well With Psoriatic Arthritis

Living with psoriatic arthritis can be challenging, but early treatment and ongoing care make a meaningful difference. Many people successfully manage their psoriatic arthritis symptoms and protect joint health over time.

By Jessica Daniels, BDO Staff Writer | Published January 30, 2025