This autoimmune condition can come with a breadth of symptoms and side effects, and dizziness can be one of them.
Those who have psoriatic arthritis (PsA) are likely to experience common symptoms such as fatigue, tenderness, and joint pain, according to the National Psoriasis Foundation. But because this autoimmune condition can cause inflammation throughout the body, there may also be side effects that seem to be unrelated at first, but are actually connected to the condition. One example? Dizziness.
“This is uncommon as a part of psoriatic arthritis, but it can happen,” says Orrin Troum, M.D., rheumatologist at Providence Saint John’s Health Center in Santa Monica, Calif. “Much like other symptoms that are related to increased inflammation throughout the body, you may experience this more during a flare if you have PsA, since your inner ear could be affected.”
To maintain stability and balance as you move, several systems in the body work together, and that includes the structures inside your ears. Within the inner ear are three fluid-filled, semicircular canals that respond to factors like head rotation, changes in elevation (which is why your ears “pop” when you’re in a plane or driving up a mountain), and shifts in body movement. These are the main components of the vestibular system, which creates a sense of balance and coordination.
Inflammation can throw off this function, and since that’s a major characteristic of PsA, it wouldn’t be surprising if this negatively affected both hearing and balance—resulting in some hearing difficulties as well as dizziness.
In a study published in The Journal of Rheumatology, researchers looked at 60 people with PsA who had no history of problems with inner ear infections or other conditions that might affect their auditory function. They found that 60 percent of participants had abnormal hearing loss, indicating strong evidence for inner ear damage related to having psoriatic arthritis.
Another study in Ear, Nose & Throat Journal found that the autoimmune mechanisms which drive the condition can make certain parts of the body more susceptible to inflammation, and this includes the inner ear. Those researchers suggested this can lead to vertigo and dizziness as a result.
Vision issues can play a part here as well, since the vestibular system and visual system coordinate with each other through specific brain pathways, according to the Vestibular Disorders Association. Inflammation with PsA can affect the eyes, and if this happens, it may make dizziness more likely, says Dr. Troum.
An additional factor could be the presence of other issues that might also boost your risk of dizziness. According to Cleveland Clinic, other causes unrelated to inner ear issues can include:
Another potential cause may be medication use, says Anca Askanase, M.D., professor of medicine in the division of rheumatology at Columbia University College of Physicians and Surgeons.
“Whenever there’s a symptom like dizziness, we need to look at which medications you’re taking since this may not be related to psoriatic arthritis directly, but could instead be a side effect of medication,” she adds. “Dizziness is a potential effect of many commonly prescribed options, so if you’re starting to experience this after starting a new medication, that may be the problem.”
She says some medications known to have dizziness or vertigo as a side effect include antidepressants, anti-seizure drugs, sedatives, and drugs that control high blood pressure.
Although the terms dizziness and vertigo are often used interchangeably, there are differences between them that can be helpful for understanding what’s going on and inform the way you talk to your doctor about the symptom, says Dr. Askanase.
“Dizziness is when you feel off balance, like you’re going to fall or you’re walking on unsteady ground,” she notes. “Vertigo can have dizziness as part of that issue, but it also involves a feeling of spinning, as if your surroundings are moving.” While both can impact your balance, vertigo tends to be more intense, she adds, and tends to prompt nausea more than dizziness does.
One more possibility is being lightheaded rather than feeling dizzy or having vertigo. With this, you may feel other symptoms like weakness, confusion, sweating, and feeling faint. This can be worsened with other factors like dehydration, low blood pressure, iron deficiency, and low blood sugar, says Dr. Askanase. You could also have a combination of these problems, such as feeling both dizzy and lightheaded.
Autonomic nervous system dysfunction (dysautonomia) may also cause positional lightheadedness. This can happen if you go from lying down to standing or sitting. The lightheadedness may be accompanied by abnormal sweating or lack of sweating, temperature dysregulation, and GI motility issues.
Although there are no medications that treat only dizziness or vertigo for those with PsA, it’s often helpful to address the underlying inflammation that comes with the condition, and that tends to ease or eliminate the problem, says Dr. Troum. That’s especially the case if inflammation is affecting the inner ear and can be brought down with PsA treatments.
“Like other symptoms, reducing the PsA flare can often bring relief,” he says. “Not only can that resolve dizziness but it could help with other symptoms like pain or fatigue, too.” Treatment will depend on the severity of your issue, but may include:
Lifestyle changes might be part of treatment as well, says Dr. Troum. For example, because dehydration can prompt lightheadedness, making sure to have enough water could be a simple fix. A more long-term solution would be addressing stress.
“Stress and anxiety don’t cause psoriatic arthritis but they can increase the risk of flares, and that would include different symptoms, including dizziness,” he says. “Addressing these would not only help prevent the problem, but would also ease many other issues that come with the condition as well.”
If you haven’t been diagnosed with PsA and you’re experiencing dizziness along with more common signs and symptoms like psoriasis, joint pain, and reduced range of motion, you may want to see your primary care physician, says Dr. Askanase. Be sure to mention any medications you’ve just started, as well as how long these symptoms have been bothering you.
If you already know you have PsA and dizziness or vertigo is a new symptom, check in with your rheumatologist, she says. You may also get referred to an ear, nose, and throat doctor, to assess whether inflammation in the inner ear is the culprit for your symptoms.
Medically reviewed on October 04, 2023
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