What is the cause of psoriatic arthritis?

Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects people with psoriasis. Psoriasis is a condition that causes red patches of skin with silvery scales.

According to the National Psoriasis Foundation, 30% of people with psoriasis develop PsA at some point. PsA causes pain, swelling, and tenderness in your joints.

PsA has many symptoms similar to other types of inflammatory arthritis, but it has specific hallmarks. Problems in the feet are included in these hallmarks.

PsA can cause a variety of problems in the feet, including pain and swelling.

Swelling of the toes

A common feature of PsA in your feet is the swelling of one or more toes. This condition is known as dactylitis of the toes. The swelling tends to affect your entire toe rather than a single joint.

The swelling is caused by inflammation of the tendon sheath. It can give your toe a sausage-like appearance.

Swelling of the ankles

You may notice swelling in the heels.

Swelling can be accompanied by a red or purple tint. The areas may be very tender.

Heel pain

People with PsA are more likely to develop a condition called enthesitis. This refers to inflammation at a point where the bones and the muscles are not completely healed. Enthesitis is a problem in people with PsA. The hard band connecting your calf muscles to your heel is called the antarctic tendon.

You may experience pain at the back of your foot or swelling in your ankle. You may notice that your ankle is stiff in the morning or after a period of rest.

Pain on the soles of the feet

Pain in the soles of your feet can be caused by enesitis. The plantar fascia is a sheet of tissue on the bottom of the foot that connects the tounge of the foot to the tounge of the heel. It runs along the bottom of your feet.

If you have pain at the bottom of your foot, especially after waking, this may be the cause.

Inflammation of the tissue is called plantar fasciitis. It is a common condition that affects people with and without PsA.

Nail changes

People with PsA are more likely to have nail problems. You might notice that your nails are discolored, or that they have ridges. You might also find that you have more infections in your nails.

Inflammation and cellular disruption caused by PsA cause nail changes.

The goal of treating PsA is to reduce pain. The feet can become damaged without treatment. A number of medications can help reduce inflammation and protect your joints.

Common medications for PsA.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), help reduce inflammation and treat pain.
  • Disease-modifying antirheumatic drugs (DMARDs): DMARDs, such as methotrexate (Trexall), leflunomide (Arava), sulfasalazine (Azulfidine), tofacitinib (Xeljanz), and apremilast (Otezla), work to prevent PsA from permanently damaging the joints.
  • Biologic agents: Biologics are a newer generation of arthritis drugs, formed through genetic engineering, that target inflammation in the body.

The severity of the PsA symptoms in the feet are managed with oral medications. The drugs treat inflammation in the body.

For severe flare-ups in the feet, you may want to consider a more local approach.

  • Cortisone injections: Cortisone injections can be given directly into your heels, the soles of your feet, or a single inflamed toe. They can reduce inflammation and treat painful flare-ups.
  • Ice: Ice can also help reduce inflammation in the joints of the feet. Roll your foot on a frozen water bottle wrapped in a towel or apply an ice pack to the affected area for 20 minutes. You can repeat the process two to four times a day.
  • Medicated foot powders: Cracks in your nails or skin can provide an opening for infections that can trigger PsA flare-ups. A medicated foot powder can help control moisture while addressing fungus and bacteria.
  • Night splints: A night splint prevents you from relaxing your plantar fascia while you sleep, which may help prevent heel pain.
  • Custom orthotics: Orthotics are inserts for your shoes that help you maintain a good posture while protecting the joints of your feet. They’re designed specifically for you to relieve foot, ankle, and heel pain.

You can take other steps to manage PsA symptoms in your feet.

  • You should also consult a rheumatologist, a dermatologist and a foot doctor.
  • Avoid shoes that may cause flare-ups.
  • Extra padding, wide sizes, andremovable inserts are included in the shoes.
  • Adding over-the-counter heel pads or heel cups to your shoes will add support and cushion.
  • Compression socks are worn to reduce swelling.
  • Maintaining a moderate weight helps reduce the amount of stress on the joints in your feet.

PsA can cause a range of foot problems. There are several medications that can help with PsA symptoms. You can reduce pain at home by taking steps. Talk to your healthcare team about the steps you can take to manage PsA.