Enthesitis can be asymptomatic or it can cause swelling and pain around the affected area.8 Your doctor may want to do an MRI to look for tendon or ligament enlargement and thickening (which are signs of enthesitis) when assessing whether you might have psoriatic arthritis.
When psoriatic arthritis involves the feet, the pain can seem like plantar fasciitis, which feels like a stabbing pain10 along the bottom of your foot near the heel. It can be easy to assume something like this is the cause of your foot pain, but if you have ongoing symptoms, exhibit other signs of psoriatic arthritis, and have a family history of psoriatic arthritis, then you may want to talk to your doctor about psoriatic arthritis screening.
Psoriatic arthritis ankle
Anyone with psoriatic arthritis can experience pain, tenderness, stiffness, and swelling in their ankles. Ankle pain is often related to inflammation of the enthesis11 (that area we mentioned above where the tendons and ligaments meet the bone and help us move our joints). Generally, psoriatic arthritis ankle stiffness and swelling can be worse in the mornings and improve when you are active. Some people may have a hard time walking at all during a particularly painful flare-up. If you can, doing some range of motion exercises first to warm up can help alleviate your pain and stiffness.
Psoriatic arthritis toes
About 50% of people with psoriatic arthritis experience dactylitis, a condition that’s also referred to as “sausage digits.”12 As the nickname implies, your toes can become very swollen and painful due to inflammation in the toe joints and connective tissue around your toes and ligaments. Dactylitis can be present in all toes, and the swelling can be acute or chronic.13 It is important to treat and manage dactylitis because your pain and swelling can become worse. Having swollen toes doesn’t automatically mean you have psoriatic arthritis—dactylitis is also associated with a few other conditions, like gout, tuberculosis, and sarcoidosis (an inflammatory condition that is associated with granulomata, or inflammation that is caused by growths in your organs). However, dactylitis is a strong indicator of psoriatic arthritis, so if you experience toe swelling, be sure to bring it up to your doctor who can take this into consideration when diagnosing you.
Psoriatic arthritis nails
Psoriatic arthritis nail symptoms are common and roughly 80% of people with psoriatic arthritis14 have nail lesions, according to a 2017 paper published in Reumatologia. These changes aren’t the direct result of psoriatic arthritis but instead happen when you develop nail psoriasis. As a result, you may experience issues like pitting, deformity, nail plate thickening, and separation of the nail from the nail bed15 (just to name a few). If you have foot or ankle pain, toe swelling, and changes in your toenails, then you might want to talk to your doctor about whether you could have nail psoriasis and psoriatic arthritis. If you are already diagnosed with psoriatic arthritis and notice any nail changes as we described, then it’s a good idea to talk to your doctor about whether your condition is progressing.
There are various reasons that your feet may feel stiff in the morning, including going on a new hike. However, morning stiffness is a common symptom among people with psoriatic arthritis, especially during a flare. In the morning your feet may feel extra stiff and sore, which occurs because your joints can stiffen up from lack of movement16 when you sleep. Generally, light movement can help mobility, so going for a short walk if you are able to might alleviate some of your discomfort.
Gout is a painful type of inflammatory arthritis that initially affects just one joint17 (usually the big toe), but later it may affect other joints, even at the same time, such as the ankles, knees, elbows, wrists, and fingers. However, it can also affect the ankles, knees, elbows, wrists, and fingers. Similar to psoriatic arthritis, gout symptoms include pain and swelling and may flare and subside. If your toes become very painful and swollen, then you may wonder whether it’s related to gout or psoriatic arthritis. There is no single test to confirm psoriatic arthritis or gout, but X-rays, lab tests, physical exams, and patient histories can help physicians differentiate between the two. And it’s important to get an accurate diagnosis because gout and psoriatic arthritis are two very different diseases with different treatments.