Psoriatic Arthritis and Your Feet: What You Need to Know

Did you know that psoriatic arthritis usually shows up in your feet before it shows up anywhere else? August is Psoriasis Awareness Month, so we’re here to break down how this chronic condition affects your feet and what can be done about it. Whether you’ve been formally diagnosed or you’re noticing new symptoms, here’s what you need to know:

What is psoriatic arthritis?

Psoriatic arthritis is a chronic inflammatory condition that affects people with psoriasis, a skin condition that causes itchy red, scaly patches. Psoriatic arthritis causes the immune system to attack healthy joint tissue, which leads to pain, stiffness and swelling. In some cases it can develop years after psoriasis symptoms begin, and in others it can develop before any symptoms impacting the skin appear. Because it’s a progressive condition, early diagnosis and treatment can make a huge difference in terms of comfort.

How does psoriatic arthritis affect your feet?

The feet are one of the most commonly affected areas for people with psoriatic arthritis, and it’s often one of the first places symptoms appear. With over 20 bones and 30 joints in each foot, there’s a lot of room for inflammation to take hold. Symptoms can range from mild discomfort to severe pain that impacts your ability to walk or stand comfortably.

Swelling in the Feet and Toes (Dactylitis)

Swelling in the feet and toes is one of the hallmark signs of psoriatic arthritis. In the toes specifically, the swelling is referred to as dactylitis, which causes the toes to puff up and is often referred to as “sausage toes.” More often than not, the swelling is accompanied by pain, stiffness and warmth in the affected areas. It can also make wearing shoes and participating in daily activities very uncomfortable.

Heel and Arch Pain (Enthesitis)

Enthesitis, or inflammation where tendons and ligaments attach to bone, is another common symptom of psoriatic arthritis. This usually shows up as pain along the heel or arch of the foot, which feels similar to and can lead to plantar fasciitis or Achilles tendonitis. It can feel like a sharp and throbbing pain, tenderness or stiffness. Many patients report worse symptoms first thing in the morning or after long periods of rest.

Ankle and Joint Pain

Psoriatic arthritis can cause pain, stiffness and swelling in the ankles and joints in the feet, including the tiny joints in the toes. This makes everyday movements like walking, climbing stairs and even standing for long periods difficult. Over time, untreated joint pain from psoriatic arthritis can lead to a reduced range of motion, which is what makes early diagnosis and intervention essential.

Toenail Issues

Some people with psoriatic arthritis experience changes to their toenails. In fact, nail psoriasis is a common condition affecting up to 50% of people with psoriasis. It causes pitting (small dents), discoloration (yellowish-brown “oil drops”), thickening, crumbling, and onycholysis (the nail separating from the skin bed). These issues are caused by rapid or abnormal tissue growth in the nail bed. Because these symptoms are similar to those of fungal infections, toenail issues from psoriatic arthritis are often mistaken for a fungus, which makes it important to get professionally evaluated by a podiatrist.

How to Treat Foot Pain from Psoriatic Arthritis

Managing foot and ankle pain from psoriatic arthritis mainly involves addressing the swelling and making lifestyle adjustments to increase comfort. This includes:

• Taking anti-inflammatory medications
• Applying a cold pack to swollen areas
• Wearing supportive footwear and using custom orthotics
• Doing gentle foot stretches or light exercises
• Maintaining a healthy weight
• Getting medical treatment from a podiatrist

Is pain from psoriatic arthritis affecting your mobility or quality of life? Our Lewisville podiatrists at North Texas Foot & Ankle understand just how much foot and ankle discomfort can impact daily life, and we’re here to help you get back on your feet! Give us a call at (214) 574-9255 or contact us online to schedule an appointment at our Irving office.