If you’re living with psoriatic arthritis (PsA) on your feet, you know the way it can set fire to the dozens of tiny bones and joints in your toes and ankles. Add to that the crumbly toenails and swollen “sausage” toes and it can get really challenging (both physically and emotionally).
Flare-ups happen, but what can you do to put out the flames? Keep reading to find out about the symptoms of PsA on your feet, when to see a doctor, and what treatments you can try at home.
Dealing with psoriatic arthritis on your feet
When you’re living with PsA on your feet, you might experience debilitating joint pain, foot swelling, sole tenderness, and pitted toenails. This autoimmune condition is linked to psoriasis, but it is possible to have one without the other.
Your doctor might recommend prescription medications or injections for moderate to severe PsA on your feet. At-home management strategies like regular exercise, proper footwear, and icing the area can also help.
PsA affects about 30 percent of folks who have psoriasis. So on top of your regular ol’ psoriasis symptoms (hello, relentless itching, sore patches, and dry skin), you might experience:
- painful swelling (aka “sausage toes”)
- joint stiffness and swelling
- pain at the back of your heel (aka Achilles tendinitis)
- pain on the soles of your feet (aka plantar fasciitis)
- dented or crumbling toenails and fingernails
Some folks report more swelling and stiffness in the morning, before they’ve had a chance to limber up. In general, symptoms severity can ebb and flow by the week or month.
Got a psoriasis flare-up? Your PsA will probably flare too. But the reverse is also true. Once your psoriasis symptoms are under control, your PsA will likely improve.
If you have psoriasis and you’re noticing a new kind of joint pain, it’s time to call your doc. You need a PsA diagnosis in order to unlock a medical treatment plan.
Once your rheumatologist knows about the PsA on your feet, make sure you’re following the treatment plan they prescribe. If your symptoms stop responding to at-home remedies and prescribed treatments, talk with your doctor about new medications.
TBH, there’s no magic medicine for PsA. But by working closely with a doctor you trust, you can troubleshoot treatment options until you find a strategy that works for you.
Remember that PsA foot pain is like a roller coaster. Even when you’re treating it properly, PsA can suddenly get worse because of stress, triggering foods, or other factors outside your control.
Here are 10 tips to manage your PsA symptoms.
1. Take your meds
If you have moderate to severe PsA, your doctor will probably prescribe medications specific to your condition. Taking your drugs on schedule is so, so important to successfully soothing foot pain and managing ongoing joint damage.
A few common PsA meds are:
- Methotrexate. This disease-modifying antirheumatic drug (DMARD) helps block inflammation caused by an unnecessary immune response.
- Biologics. This class of drugs targets specific parts of your wonky immune system instead of the whole darn thing.
- Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDS aren’t prescription meds, and you shouldn’t take them daily without your doctor’s blessing. But it’s A-OK to take an over-the-counter NSAID like ibuprofen to reduce inflammation and discomfort from time to time.
2. Choose your kicks wisely
Do you *really* need to cram your swollen toes into a strappy stiletto this weekend? You do you, but know that high heels and shoes with narrow toe boxes are notoriously bad for your feet.
Fortunately, foot-friendly shoes have come a long way in the style department. When trying on new shoes, ask yourself if they feel:
Cushioned inserts take comfy shoes to the next level. Your podiatrist might even recommend a custom pair of insoles (#fancy) designed to cradle your foot and reduce pressure on your joints.
3. Move it, move it
When your feet feel like flaming balloons, the last thing you want to do is jog. But some movement is necessary to keep your joints well-oiled.
A few PsA-friendly ideas:
- swimming (buoyancy is a great way to relieve the pressure!)
- elliptical training
- yoga or gentle stretching
PSA: The Centers for Disease Control and Prevention recommends that folks with any kind of arthritis ease into new fitness routines and modify as needed during flare-ups. If you’re not sure how to modify exercises according to your needs, a physical therapist may be able to help.
4. Maintain a healthy weight
Inflamed and irritated or not, your feet are responsible for carrying your body. Obesity can place extra strain and pressure on them.
Research suggests that obesity also increases the risk of developing PsA. That’s because excess body fat can lead to low grade inflammation — a major contributor to your swollen ankles and toes.
If possible, establish a daily movement routine and stick to a nutritious diet. That means a balanced plate of veggies, fruits, lean protein, and complex carbs. The more you can do to reach or maintain a moderate weight for your body, the better your feet will feel.
5. Don’t forget to rest
Yes, fitness is important. But when your dogs start barking, it’s time to give ’em a rest!
A few easy ways to incorporate foot rest into your day include:
- opting for low impact exercise (like swimming!)
- keeping a stool or footrest in your office to prop up your feet
- propping your feet up at the end of each day to reduce swelling
6. Soak your pain away
Warm water works wonders. Got half an hour? Run a full Epsom salt bath. Got 10 minutes? Soak your feet in a bucket of warm water. The heat from the water can help soothe pain while the buoyancy and rest reduce swelling.
Heads up: Don’t keep your feet in for *too* long. All that water can start to dry out your skin, which is no good for your psoriasis rash.
7. Break out the nail tool kit
PsA on your feet = fragile, crumbly toenails.
Avoid potential snags, scrapes, and bumps by giving your toenails a little TLC. Keep the nails trimmed short, and file them down for a smooth finish.
TBH, toenail psoriasis can be tricky to treat. If impeccable hygiene and nail TLC don’t help, talk with your doc about treatments like biologic DMARDs or corticosteroid injections to your nail beds.
8. Ice, ice, baby
Wanna slay the inflammation in your feet? Just apply ice.
It’s the oldest trick in the book because it works. The cold will constrict your blood vessels, literally chilling out your swelling and pain.
Try this method to get the best results from your icing sesh:
- Make sure your feet are dry.
- Wrap an ice pack or bag of ice in a towel. The towel acts as a buffer to prevent freezer burn.
- Hold the ice pack against your feet for about 10 minutes.
- Repeat several times a day.
Pro tip: Got plantar fasciitis? Freeze a water bottle and roll it under your foot for a chilly massage!
We get it. Telling your PsA-stressed self to stop stressing is, like, super stressful. But it’s also kinda vital.
Stress is a major trigger for psoriasis and PsA. Even if it’s not the only culprit for your flare-up, it’s bound to be driving the getaway car.
So, what can you do? Here are some tried-and-true practices that could help you relax:
- mindful breathing
- taking a break from doomscrolling
- talking it out with a trusted loved one or therapist
10. Talk with your doc about steroid shots
If your meds and these home remedies aren’t cutting it, ask your doctor about corticosteroid injections. These dramatically reduce swelling in your joints and nail beds.
Like all meds and injections, corticosteroid shots come with possible risks and side effects. Only you and your doctor can decide whether this is a solid treatment choice for you.
PsA can be frustrating. Treatments can take time and energy, which can get overwhelming. But knowing your triggers, staying disciplined in at-home management, and staying in touch with your podiatrist or rheumatologist helps. Consistency is key.
If the management tips in this article don’t ease your PsA foot pain, talk with your doc. Sometimes surgery is necessary. Sometimes it takes a bit of trial and error to land on a treatment that works for you. And even then, occasional flare-ups could happen.
By teaming up with a doctor you trust, you can live your best life, even with PsA. You’ve got this! 💪