What is psoriatic arthritis?

PsA is a type of inflammatory arthritis linked to immune system activity. Inflammation can irritate joint tissue and surrounding structures. As a result, you may notice swelling, heat, stiffness, and reduced function. Over time, ongoing inflammation may contribute to joint damage, so early assessment matters.

Common symptoms

Symptoms vary between people and can change over time. Common signs include:

• Joint pain and morning stiffness
• Swollen fingers or toes (dactylitis)
• Heel pain or pain where tendons attach to bone (enthesitis)
• Buttock pain, stiff back, or neck pain (spinal involvement)
• Nail changes (pitting, thickening, discolouration)
• Fatigue and reduced exercise tolerance

What causes PsA and how is it diagnosed?

PsA likely develops due to a mix of genetic risk, immune triggers, and environmental factors. Weight, smoking, and long-term stress may also influence inflammation for some people. Diagnosis can take time because symptoms overlap with other conditions. Your GP or rheumatologist may use a history, physical examination, imaging, and blood tests (such as CRP or ESR) to assess inflammation and rule out other causes.

People also ask: can psoriatic arthritis go into remission?

Yes, some people experience periods where symptoms settle significantly (often called low disease activity or remission). Treatment plans commonly aim for “treat-to-target”, which means adjusting care until symptoms and inflammation improve. Regular movement, joint protection, and early flare-up action can also help you stay steadier over time.

Latest treatment approaches

PsA care often combines medication with non-drug strategies like exercise and education. Medical options may include anti-inflammatory medicines, DMARDs, biologic therapies, and targeted oral medicines. Your rheumatologist guides medication choices based on which areas PsA affects (joints, spine, skin, nails, or tendons).

For current medication guidance, the European Alliance of Associations for Rheumatology (EULAR) publishes updated recommendations here: EULAR recommendations management.

How physiotherapy may help

Physiotherapy supports function and confidence with movement. Your physiotherapist may recommend:

• Therapeutic exercise to maintain mobility and build strength
• Graded activity planning to manage flare-ups and fatigue
• Heat or cold strategies (learn more about heat packs)
• Joint protection and pacing strategies for work and sport
• Hydrotherapy for low-impact conditioning
• Adjunct pain options such as acupuncture (when appropriate)
• Advice on supports when a joint needs unloading (for example a wrist brace or support)

The role of exercise

Exercise supports joint health, muscle strength, mood, and cardiovascular fitness. Many people do well with a mix of low-impact aerobic work (walking, cycling, swimming) and progressive resistance training. Start below your flare-up threshold, then build gradually. If hands, feet, or heels feel sore, your physio can adjust load and swap activities to keep you moving.

If you prefer group-style movement, gentle options such as Pilates or yoga may help with flexibility and body awareness. The key is the right dose and the right progressions.

Self-management that supports your treatment plan

• Track patterns: note what triggers flare-ups (sleep, stress, workload, new training).
• Pace load: spread tasks across the day to reduce joint overload.
• Use heat or cold: heat may help stiffness, while cold may help settle hot, swollen joints.
• Support sore areas: short-term taping can help some people (see kinesiology tape).
• Look after soft tissues: some people find soft tissue massage helps with muscle tightness around painful joints.

When surgery may be considered

Surgery is not common, however some people consider it when a joint develops severe damage or persistent pain despite good treatment. Options vary by joint and may include repair procedures or joint replacement. Your specialist team will guide the decision.

What to do next

If you suspect PsA or your symptoms have changed, book an assessment with your GP or rheumatologist. Then, consider physiotherapy to plan safe exercise, reduce joint stress, and stay active through flare-ups. Bring a list of your main problem areas (for example hands, heels, back, or knees) so your physio can tailor your plan.