PsA and your body

Peripheral arthritis can affect the large joints,^[8] such as the shoulders,^[9] elbows, wrists, knees and ankles,^[8] causing severe swelling.^[5] Peripheral arthritis can also involve dactylitis, which is swelling that can affect the fingers and toes, and enthesitis, or inflammation where the tendon or ligament attaches to the bone.^[8]

When a whole finger or toe becomes inflamed and swollen, it’s called dactylitis [pronounced dack-till-eye-tis].^[10] It can give fingers and toes a ‘sausage’ like appearance,^[7][8] which can make them difficult to use and might affect the way you live your life.^[11] As dactylitis can be the first sign of PsA, if you have it, your doctor may check your skin and nails too, to see if they are affected.^[8]

About half of people with PsA suffer from enthesitis [pronounced enth-ess-eye-tis], or inflammation of the enthesis, where the tendon or ligament attaches to the bone.^[8] It may happen in many different areas of the body, but it is common around the heels, the bottom of the feet and the elbows.^[8] If you have enthesitis in your feet, it could make it painful to walk.^[12]

Nail psoriasis happens in about half of people with psoriasis and 80% of people with PsA,^[13] so it’s worth watching yours in case they start to show symptoms. It can cause changes, such as pitting (indentations) or ridges (lines running from the nail bed to the end), loss of nails, a salmon pink discoloration of the nail,^[14] called the ‘oil drop sign’, and crumbling of the nail.^[15] Nail psoriasis is linked to more severe psoriasis and can affect quality of life,^[16] so speak to your doctor if you think this is true for you.

About 80% of people with PsA may have skin involvement,^[17] which can cause self-consciousness or embarrassment,¹⁸ so if you suffer from this, please remember that you’re not alone. Plaque psoriasis can develop before, during or after PsA does,^[7] and no one’s experience is exactly the same.^[8] Plaques can appear anywhere on your body, but sometimes these itchy, painful lesions appear on the knees, elbows, scalp, lower back¹⁹ behind the ears and between the buttocks.^[14] There may only be a few spaced-out plaques, or several larger plaques.^[14]

Spinal pain in PsA^[6] is caused by inflammation of the spinal column and can affect the neck, lower back and the joints that connect your pelvis and lower spine.²⁰ It can make you feel stiff, make movement difficult²⁰ and even wake you up at night.²¹ Spinal pain often happens at the same time as other PsA symptoms.²⁰