The Effects of Psoriatic Arthritis on the Entire Body

People with psoriatic arthritis (PsA) usually have symptoms of both psoriasis and arthritis. Psoriasis is an inflammatory skin condition where skin cells build up and form scales and itchy, dry patches and arthritis inflammation in one or more joints, causing pain and stiffness. Arthritis is the swelling and tenderness of one or more joints.

The inflammation associated with PsA impacts more than just the joints and skin. It can also affect many body systems. 

Here is what you need to know about the effects of PsA on the body, including on a person’s joints, muscles, skin, vision, digestive health, and respiratory health.

Musculoskeletal System

The musculoskeletal system includes both the muscular and skeletal systems. The musculoskeletal system is made up the skeleton, muscles, tendons, ligaments, joints, and connective tissues. Both systems give humans the ability to move and provide support, form, and stability to the body. In people with PsA, the musculoskeletal system can be adversely affected.

PsA is known for causing inflammation of the joints. It can affect one joint or many. Swollen, stiff, and painful joints are classic symptoms of PsA. Inflammation can limit joint range of motion, making it harder to move the joints. It can cause severe neck and back pain, making it harder to bend the spine. PsA can affect the joints of the fingers and toes, causing them to swell up and take on a sausage-like appearance.

Tendon and ligament pain may also be seen in psoriatic arthritis. That means you may experience pain and swelling in the heels, soles of the feet, and around the elbows.

PsA can cause arthritis mutilans, a condition occurring in 5% of the people with PsA. Arthritis mutilans is a severe form of arthritis that can destroy the joints of the hands and feet, causing permanent disability and disfigurement. Fortunately, medications, including biologics, can help to prevent arthritis mutilans.

Chronic inflammation associated with PsA can damage the cartilage that covers the ends of bones. As PsA progresses, damaged cartilage will cause bones to rub against each other. In addition to damaging joints, chronic inflammation can cause cartilage damage to ligaments, tendons, and muscles, which leads to insufficient joint support and joint and muscle weakness.

Skin, Hair, and Nails

Most people with PsA also have psoriasis, and one in four people with psoriasis also have PsA. Psoriasis causes red, rough skin patches with silvery scales. These patches can appear anywhere on the body, but usually show up around elbows, knees, hands, and feet. Additional symptoms of psoriasis include tenderness and itching. The skin around the joints may appear cracked and blisters may form.

Psoriasis patches that resemble dandruff can appear on the scalp. These patches look like large scales and tend to be red and itchy. Scalp psoriasis patches may cause severe shedding. Scratching causes flakes in the hair and on the shoulders.

Nail psoriasis results in nails to be pitted (dents in the nails), deformed, thick, and discolored. It may also cause nails to separate from the nail bed. Up to 35% of people with psoriasis and up to 85% of those with PsA have nail symptoms, according to the National Psoriasis Foundation.

Eye Health

Inflammation from PsA can affect the eyes. According to the American Psoriasis Foundation, around 7% of people with PsA will develop uveitis, a type of eye inflammation of the middle layer of the eye wall called the uvea. Uveitis often comes on suddenly and will get worse quickly. 

Symptoms of uveitis include eye redness and pain, and blurred vision. The condition can affect one or both eyes. Uveitis—if undiagnosed and untreated—can eventually lead to loss of vision.

Psoriasis can also affect the lid (blepharitis), conjunctiva or cornea, with complications including conjunctival hyperemia and conjunctivitis, ectropion and trichiasis and corneal dryness with punctate keratitis and corneal melting. This may occur in up to 70% of people with PsA .

Immune System

Psoriatic arthritis is an autoimmune disease, which means it affects the way the body’s immune system functions. When the immune system is functioning normally, it fights against bacteria and viruses. Autoimmune disorders cause the body to turn against itself and start attacking healthy issues even though there is no reason to, i.e. there are no viruses or bacteria.

PsA’s overactive immune response causes the body to attack joints, tendons, ligaments, and skin. Researchers are not really sure why this occurs, but they think certain bacterial infections may trigger PsA.

Having a weakened immune system due to the medications used to treat PsA can cause you to get sick more easily, especially when it comes to viruses, such as the flu. A compromised immune system also means longer recovery periods and challenges and setbacks in treating PsA.

Mental Health

Studies have shown people with psoriatic arthritis have an increased risk for anxiety and depression. According to a survey reported in the April 2014 Journal of Rheumatology, more that 36% of people with PsA had anxiety and 22% had depression.

Physical pain and other aspects of PsA will have an impact on a person’s emotional health. In addition to dealing with the disease, a person may feel uncertain about the future because they don’t know the direction their health will take. They may worry about worsening health and providing and carrying for loved ones. PsA may affect self-esteem and cause embarrassment, especially when treatment isn’t helping to manage disease symptoms.

Digestive System

There is a link between psoriatic arthritis and inflammatory bowel disease (IBD). IBD includes Crohn’s disease and ulcerative colitis (UC). Crohn’s is known for affecting the stomach and intestines, while UC affects the lower part of the GI tract, which includes the colon and rectum. 

People with PsA have a higher risk for IBD in comparison to the rest of the population, according to a 2017 report in the Annals of Rheumatic Disease.

Cardiovascular System

Cardiovascular disease in people with chronic inflammatory diseases, such as PsA, is a major cause of illness and death, this according to the American College of Cardiology. Chronic inflammation is known for damaging blood vessels and making them thick, hard, and scarred. These problems increase your risk for heart attack and stroke.

Metabolic Disorders

PsA increases the risk for metabolic syndrome. Metabolic syndrome is a collection of conditions, including high blood pressure and diabetes.

It is a good idea to get your blood pressure checked regularly and work with your healthcare provider to lose weight, if needed. Talk to your healthcare provider if you notice some of the telltale signs of type 2 diabetes, such as constant hunger, increased thirst, and extreme fatigue.

A Word From Verywell

Having PsA doesn’t mean you cannot manage its effects. The best thing you can do is to stay on top of your PsA treatments. If you are experiencing more frequent disease flare-ups (periods where disease activity is high), talk your healthcare provider about changing medications or additional treatment options. You can also reduce your risk for many of the whole-body effects of PsA by staying active, managing stress, eating healthy, and quitting alcohol and smoking.