How Does Psoriatic Arthritis Affect Your Feet?

Walking, running, jumping, standing. Despite all they do for you, it’s easy to take your feet for granted. But when foot pain gets in the way of living, there’s no ignoring it.

Unfortunately for people with psoriatic arthritis, foot pain is a common occurrence, says rheumatologist Rochelle Rosian, MD. “Psoriatic arthritis affects the toes and feet in several ways, causing pain, swelling, stiffness and even changes to the appearance of your foot,” she says.

We talked to Dr. Rosian to learn how the disease attacks your feet — and what you can do to put your best foot forward, despite psoriatic arthritis.

What is psoriatic arthritis?

Psoriatic arthritis is an inflammatory disease that causes pain and swelling in the joints. Most people with the disease also have psoriasis, a skin condition that causes red, scaly, inflamed rashes. Both psoriasis and psoriatic arthritis are conditions that occur when your body’s immune system attacks its own tissues.

People dealing with psoriatic arthritis may experience lots of problems below the ankles — including foot pain, heel pain, swelling and toenail changes.

Symptoms of psoriatic arthritis in feet

Psoriatic arthritis often strikes areas where ligaments and tendons connect to bone. With 26 bones and 30 joints in each foot, that’s a lot of possible targets for arthritis.

The disease can cause symptoms in one foot or both feet. In fact, foot symptoms are often among the early signs of psoriatic arthritis. It’s important for your physician to consider treatments that allow you to continue the activities you enjoy.

Foot-related symptoms include:

• Dactylitis: Also known as “sausage digits,” dactylitis is severe inflammation of an entire toe (or finger), giving it a sausage-like appearance. Most types of arthritis cause swelling. But sausage digits are particularly common in people with psoriatic arthritis.
• Heel pain: You might experience inflammation of the Achilles tendon, which connects your heel bone to your calf muscle. Known as Achilles tendinitis, this can cause significant pain in the heel.
• Bottom-of-the-foot pain: A ligament called the plantar fascia stretches from your heel to your toes. Psoriatic arthritis can inflame and irritate this ligament — a condition known as plantar fasciitis. That inflammation can cause pain from your heel all along the sole of your foot.
• Spur formation: Because the inflammation occurs where the ligaments and tendons attach to bone, this can lead to spur formation — or in some cases, wearing away of the bone, called erosion. These spurs may cause stiffness or fuse your joints and lead to deformity and loss of mobility.
• Nail changes: Most people with psoriatic arthritis have pits or dents on the surface of their nails, including their toenails. Sometimes, the nails become thickened or the nail bed separates from the skin below.
• Other symptoms: It’s also possible to have pain in your joints that connect to your foot (metatarsophalangeal joints, often called MTP joints), swelling at the ball of your feet, hammer toes and an enlargement of the MTP joint in your big toe.

How to treat psoriatic arthritis foot pain

It’s tough to do the things you want to do when your feet are stiff and painful. Dr. Rosian recommends these strategies to help kick foot pain to the curb.

Go hot and cold

Some people find that warm towels, heat packs and hot baths help ease joint pain and swelling. For others, using ice packs can dial down inflammation for cool relief. “Try both hot and cold therapy to see which works best for your symptoms,” Dr. Rosian says.

Exercise

Exercise might be the last thing you want to do when your feet are aching, but regular, gentle exercises can help relieve stiffness and improve the range of motion in your feet. Low-impact activities like walking and swimming are good options. Consider asking for a referral to a physical therapist or foot doctor.

Pamper your tootsies

High heels are not your friends. Opt for comfortable shoes that support your feet and ankles. You might benefit from custom orthotics, as well. These shoe inserts are tailor-made for your feet. They work like shock absorbers to take pressure off of your feet.

Manage your weight

Your feet are responsible for supporting your whole body any time you stand or walk. Maintaining a healthy weight can take some of the stress off these hard-working joints.

Follow your treatment plan

Perhaps the most important thing you can do is talk to your doctor about how foot pain is limiting you. Your healthcare provider will help you find the right medications to control joint pain associated with psoriatic arthritis.

“Foot pain is often an unfortunate reality for people who have psoriatic arthritis, but it doesn’t have to overwhelm you,” says Dr. Rosian. “We have a variety of different medications to treat pain and swelling and prevent permanent joint damage in your feet.”