When you are diagnosed with psoriatic arthritis, you may know to expect skin complications and joint pain. Those two symptoms are in the name. In fact, psoriasis and arthritis come from the Greek words for “itch” and “joint,” respectively.
But psoriatic arthritis, or PsA, goes beyond these two symptoms. That’s because this condition causes systemic inflammation throughout the body, which can fuel the development of a variety of symptoms and comorbidities, meaning the presence of two chronic conditions at the same time.
“More than half of patients [with PsA] have more than one additional disease,” says Leah Alon, MD, a rheumatologist at Harlem Health Center and Queens Health Center in New York City. “It’s important to be aware of all the ways psoriatic arthritis can impact your health.”
People with PsA are at an increased risk of the following symptoms and conditions:
Joint pain. This may affect a single joint, or many throughout the body. The inflammation in the joints may result in stiffness, swelling, or pain.
Neck and back pain. People with PsA are at an increased risk of spondylitis, an inflammatory arthritis that causes pain and stiffness in the back.
Dactylitis. This is when the fingers and toes swell up and have a sausage-like appearance.
Tendinitis and fasciitis. “Patients can get soreness where tendons and ligaments connect to the bones,” says Dr. Alon. Common problems include Achilles tendinitis and plantar fasciitis. Find out how to manage foot pain from psoriatic arthritis here.
Red, scaly patches on the skin. Sixty to 80 percent of patients experience psoriasis symptoms before PsA, according to the Arthritis Foundation (AF). However, it’s possible to be diagnosed with psoriasis and PsA at the same time, or even to experience PsA first.
Changes in the fingernails. “Your fingernails and toenails may become thick, ridged, or discolored,” says Dr. Alon.
Vision problems. Inflammation in the eyes can cause pink eye, dry eye syndrome, and a condition called uveitis, which causes pain, redness, and potentially vision loss, according to AF.
Heart disease. Perhaps the biggest health risk among people with PsA is hypertension and heart disease. Because of inflammation, people with PsA are more likely to develop metabolic syndrome—a cluster of risk factors for heart disease including abdominal fat, insulin resistance, high blood pressure, very high triglycerides, and high cholesterol. In fact, heart disease is the leading cause of death among people with psoriatic arthritis, according to the National Psoriasis Foundation (NPF).
Gastrointestinal problems. Research has found that people with psoriasis and PsA develop inflammatory bowel diseases (such as Crohn’s disease or ulcerative colitis) at higher rates than the general population. This is likely because psoriasis and Crohn’s have similar genetic mutations in common, according to NPF.
Type 2 diabetes. Studies have revealed that people with psoriasis or PsA are at an increased risk of type 2 diabetes even if they don’t present other diabetes risk factors, according to a 2012 study from the Perelman School of Medicine at the University of Pennsylvania. In particular, those with severe psoriasis were 46 percent more likely to develop type 2 diabetes (compared to 11 percent for people with mild psoriasis).
Liver diseases. PsA “might also be linked with a higher risk of certain liver problems, known as nonalcoholic fatty liver disease,” says Dr. Alon.
This might feel overwhelming, but luckily, studies have found that treating PsA can help manage inflammation in the body and lower your risk of other complications, such as heart attack, stroke, and type 2 diabetes.
“Making lifestyle changes—such as losing weight, exercising more, and eating a well-rounded diet full of fruits and veggies and fiber—can help ease many of these psoriatic arthritis comorbidities,” says Dr. Alon. To get started, here are 8 healthy-eating tips to help treat psoriatic arthritis.