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How Psoriatic Arthritis Affects the Fingers

Managing PsA

February 24, 2023

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Eclipse Images/Getty Images

Eclipse Images/Getty Images

by Kristeen Cherney

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Medically Reviewed by:

Stella Bard, MD

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by Kristeen Cherney

•••••

Medically Reviewed by:

Stella Bard, MD

•••••

•••••

Psoriatic arthritis can cause painful swelling and stiffness in your fingers. Symptoms can affect your ability to grip and handle things, but there are treatment options that can help.

Psoriatic arthritis (PsA) is an inflammatory disease of the joints that can progress, getting worse over time.

Most people with PsA already have psoriasis, with the average time of onset between 7 and 10 years after first developing the skin condition.

PsA may affect any joint in your body, including those in your fingers. If you have psoriasis and are experiencing pain or stiffness in your fingers, you may consider talking with a doctor about possible arthritis.

Here’s what you need to know about PsA and how it affects the fingers.

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How psoriatic arthritis affects the fingers

Psoriatic arthritis can cause pain and stiffness in one or more joints throughout the body. When your fingers are affected, you may experience:

  • pain and heat that radiates through your entire finger
  • redness in your affected fingers
  • stiffness that can make it difficult to bend your fingers
  • stiff fingers that are worse in the morning or after other long periods of rest
  • decreased range of motion that can cause difficulty with everyday movements, such as grasping and holding objects
  • swelling in the affected fingers, which can cause a “sausage-like” appearance
  • psoriasis skin patches around your hands, or on top of the affected finger joints

PsA tends to affect joints asymmetrically. This means you might experience symptoms on one hand and not the other.

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Pictures of PsA in the fingers

Close up of a hand.

PsA inflammation of the skin and joints. (Photo credit: Iri-s/Shutterstock)

psoriatic-arthritis

PsA swelling and joint deformity. (Photo credit: Emiliano Rodriguez / Alamy Stock Photo)

psoriatic arthritis psoriasis dactylitis

PsA with dactylitis. (Photo credit: Pustake M, Vidhale T, Nadgire S. Psoriatic Arthritis With Dactylitis: A Case Report and Concise Review of Treatment Options. Cureus 13 CC-BY 4.0)

nail psoriasis

Psoriasis fingernails. (Photo credit: sweetheart studio/Shutterstock)

What causes PsA in the fingers?

As with other autoimmune diseases, it’s not clear exactly what causes PsA, though a combination of genes and environmental factors such as infections, stress, and injuries may trigger this arthritis.

Additionally, adults with severe psoriasis may be at an increased risk.

While PsA can affect any joint, it’s most common in the large joints located in your legs and feet. It also commonly develops in the small joints of your fingers and toes, especially the finger joints closest to your nails.

As PsA progresses, it may eventually affect joints in your spine and hips.

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How is PsA diagnosed?

A doctor may diagnose PsA in the fingers based on multiple tests.

First, they will do a physical exam to see if you have swelling or tenderness that could indicate other types of arthritis. They may also look for signs of psoriasis, as well as changes to your nails.

A doctor may then use the following information to help them make a PsA diagnosis:

  • a personal or family history of psoriasis
  • whether PsA runs in your family
  • blood tests to confirm inflammation, as well as to rule out other conditions with similar symptoms, such as rheumatoid arthritis (RA)
  • X-rays to look for changes in the affected joints
  • ultrasounds or MRIs to look for inflammation in your joints

Treating PsA in the fingers

Treating PsA in the fingers involves the same medications used to treat arthritis in other parts of the body. This includes:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs, such as ibuprofen, may help relieve pain and swelling in your fingers.
  • Corticosteroid injections: If pain and swelling don’t improve with NSAIDs, a doctor may try a low dose steroid injection to help decrease the underlying inflammation in your finger joints.
  • Biologics: Used for more severe PsA, these injections work by targeting your immune system to decrease inflammation.
  • Disease-modifying antirheumatic drugs (DMARDs): Also used for more severe cases of PsA, these oral medications suppress your immune system in order to control the inflammation caused by PsA.

Aside from medications, other therapies may help treat finger PsA. This includes physical therapy to help improve finger joint functioning, as well as occupational therapy to help you navigate everyday activities more comfortably.

While exercises can help with PsA symptoms, a doctor may recommend avoiding unnecessary strain on your finger joints whenever possible. For example, you might use your body weight to push open a door, rather than your fingers only.

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Fingernail psoriasis

Both psoriasis and PsA affect the nails. This can cause:

Treatments

Treating nail symptoms caused by PsA or psoriasis may involve:

It can take at least 6 months to see results since you need to wait for your nails to grow in.

Frequently asked questions

Does psoriasis cause trigger finger?

“Trigger finger” refers to inflamed tendons in your fingers that cause your finger to get stuck in a downward position (like pulling a trigger).

You can often manually straighten the finger, but it tends to curl back in overnight. You might also experience stiffness and pain.

Psoriasis isn’t a known cause, but other conditions such as PsA and RA may increase your risk of developing trigger finger.

Does psoriasis cause “sausage fingers?”

Up to almost 50% of people with PsA experience dactylitis, or “sausage fingers.”

Psoriasis, on the other hand, doesn’t cause this type of swelling of the joints. See a doctor if you have psoriasis and are experiencing sausage fingers or thumbs.

Does psoriasis turn into psoriatic arthritis?

While anyone may develop PsA, it most commonly affects adults who have had psoriasis for at least 7 to 10 years. It’s estimated that around 15% of people with psoriasis are affected.

Having severe psoriasis may also increase your risk of developing PsA later in life.

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Takeaway

If you’re experiencing ongoing pain, swelling, or stiffness in your fingers, it’s important to see a doctor for diagnosis and treatment. This is especially the case if you have a history of psoriasis.

While there’s no cure for PsA, a prompt diagnosis can help decrease your risk of developing permanent joint damage in your fingers. Treatments can also help you feel better while improving your quality of life.

Medically reviewed on February 25, 2023

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About the author

Kristeen Cherney

Kristeen Cherney, PhD, is a mental disabilities scholar, freelance writer, and author who specializes in topics related to mental health, disabilities, women’s health, skin health, diabetes, thyroid disease, asthma, and allergies. Her recently finished dissertation explores intersections of disability studies and literacy studies. When she’s not researching or writing with the help of her office manager pup, Kristeen enjoys getting outdoors as much as possible. Read more about her work at her website http://kristeencherney.com/.

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