Psoriatic arthritis (PsA) is a progressive inflammatory disease that affects the joints and entheses, the areas where tendons and ligaments attach to bones. PsA occurs because the immune system malfunctions and starts affecting healthy tissues. Many people with PsA also have psoriasis, an autoimmune skin condition that causes skin cell overgrowth. 

There is no cure for PsA, but the condition is treatable, and treatments can slow disease progression, improve pain and other symptoms, and prevent joint damage. 

This article covers psoriatic arthritis symptoms, types, causes, flares, treatment, and more. 

Psoriatic Arthritis Symptoms

The symptoms of PsA range from mild to severe. PsA primarily affects the peripheral joints (the joints located in the arms and legs), but it can also affect the axial skeleton, which includes the spine, hips, and shoulders. 

Symptoms of PsA can affect the joints, entheses, nails, and skin and may include the following:¹

• Joint swelling, stiffness, pain, and warmth: Inflammation can cause painful joint swelling. Joints might be warm to the touch. Stiffness may be worse in the morning or after being inactive.
• Low-back pain: According to one 2020 report, 25% to 70% of people with PsA have axial involvement resulting in low-back pain.²
• Dactylitis: Sometimes called sausage digits, dactylitis causes fingers or toes to be so swollen they look like small sausages. 
• Nail problems: PsA can cause the fingernails and toenails to become pitted, separated, or discolored. Nail symptoms are uncommon in other forms of inflammatory arthritis.³
• Eye inflammation: Some people with PsA may also experience eye problems due to the same inflammatory processes that affect the joints. Eye symptoms include redness, irritation, and blurry vision. 
• Foot pain: Two common areas in the foot that PsA affects are the plantar fascia along the bottom of the foot and at the Achilles tendon, which is located between the calf muscle and heel.⁴
• Fatigue: One study reported in 2021 in the International Journal of Rheumatic Diseases found fatigue was very common in PsA.⁵ That study also found severe fatigue was associated with more tender and swollen joints, dactylitis, pain, and general declining health perception. 
• Skin symptoms: The inflammatory processes in PsA and psoriasis can cause raised patches of itchy skin covered in silvery scales. 

Types of Psoriatic Arthritis

There are five types of psoriatic arthritis. It is possible to have more than one of the following types:⁶

• Asymmetric oligoarticular: This type of PsA affects five or fewer joints. It is called asymmetric because it affects one side of the body. For example, it may affect one knee or wrist and not affect the other knee or wrist. According to a 2013 report, asymmetric oligoarticular accounts for 70% of all PsA cases.⁷ Asymmetric oligoarticular PsA may progress to symmetric polyarthritis PsA.
• Symmetric polyarthritis: Symmetric polyarthritis PsA affects the same joints on both sides of your body. This means if one knee is affected, the other will be as well. The symmetric type is seen in 50% to 60% of people with PsA polyarthritis.8 Symmetric polyarthritis PsA is sometimes confused with rheumatoid arthritis (RA)—a different kind of inflammatory arthritis. RA typically does not cause inflammation of the entheses. 
• Distal interphalangeal predominant(DIP): DIP PsA affects the small joints of the fingers and toes closest to the nails. It affects about 5% of people with PsA and causes nail symptoms (pitting, splitting, separation, etc.).⁷
• Psoriatic spondylitis: This type of PsA causes inflammation in the small bones of the spine and the sacroiliac joints (located in the pelvis and lower spine). It affects 5% of people with PsA.⁷
• Arthritis mutilans: Around 5% of people with PsA have this very aggressive type of PsA.⁷ It can lead to severe bone loss and often involves the hands, feet, fingers, and wrists. 

What Causes Psoriatic Arthritis?

PsA prevalence in the United States ranges from 0.06% to 0.25% of the population.⁹ While it has a low prevalence in the general population, it is common among people with psoriasis.

PsA occurs when the immune system malfunctions and attacks healthy tissues. The overactive immune responses cause inflammation of the joints and entheses. It might also cause the overproduction of skin cells. 

Genetic and environmental factors in PsA are believed to trigger the immune system’s overactive response.¹⁰ Many people with PsA have a family history of psoriasis or PsA or a personal history of psoriasis.

PsA is also associated with specific genetic markers that, with environmental factors, can cause the disease to develop. Such factors include smoking, certain medications, physical trauma, illness, or infection.¹⁰

Risk Factors for PsA

Risk factors that might increase your risk of developing PsA include:¹¹

• A personal history of psoriasis: Having psoriasis is the most significant risk factor for PsA. Up to 30% of people with psoriasis will develop PsA within 10 years after psoriasis symptoms start.¹¹
• Family history: Many people who get PsA have a family history of the disease, often a sibling or parent. 
• Age: Anyone can develop PsA, but it most often surfaces in middle age.

What Triggers PsA Flare-Ups?

PsA is characterized by flare-ups (worsening symptoms) and periods of remission (few or no symptoms).¹² Triggers typically cause flare-ups.

PsA triggers can vary from person to person. Common triggers include:¹³

• Mental and physical stress
• An injury or illness
• Certain medications
• Not making your medications as prescribed, including missing doses
• Smoking
• Having a poor diet
• Overconsumption of alcohol 

How Is Psoriatic Arthritis Diagnosed?

An accurate and timely diagnosis of PsA can help you to avoid joint damage and other disease complications. 

No single test can confirm PsA, but your healthcare provider can make a diagnosis based on the following:

• Your symptoms 
• Family history of PsA or psoriasis or personal history of psoriasis 
• A physical exam
• Blood work 
• Imaging

Stages of Psoriatic Arthritis

PsA is a disease that progresses over time. Progression varies from person to person. 

Early Stages 

Signs and symptoms may differ from what you would see with long-established PsA and will change over time.¹⁴

In its early stages, PsA causes pain and swelling in a few joints, often on one side of the body. It will cause inflammation of the smaller joints of the hands and feet, usually the fingers and toes. Most people with early PsA will experience nail and skin symptoms, while around 10% will not.¹⁴

As the disease progresses, you will notice symptoms in larger joints, including the knees. Over time, you may experience dactylitis and enthesitis.

Later Stages

As PsA progresses, it may affect your daily life. You might experience severe fatigue and frequent and painful flares. 

Severe PsA can cause permanent damage to bones and joints. Ongoing inflammation, which might be the case for people with severe PsA, can cause bone erosion and narrowing joint space.¹²

Living with more severe symptoms of PsA can make working or maintaining a social life harder. These symptoms can also lead to depression, and research shows the prevalence of depression is significantly higher for people with PsA than for the general population.¹⁵

Psoriatic Arthritis Treatment

PsA is treated with a combination of medication, therapies, lifestyle changes, and, as a last result, surgery.

Medication

Different classes of drugs used to treat PsA include:¹⁶

• Nonsteroidal anti-inflammatory drugs (NSAIDs) manage joint symptoms, including pain and swelling. NSAIDs are available over the counter (OTC), or your healthcare provider can prescribe a more potent NSAID if needed.
• Disease-modifying antirheumatic drugs (DMARDs) target the immune system to slow down its effects. The most commonly used DMARD is methotrexate. 
• Biologics target specific inflammatory proteins in the immune system that cause inflammation. These drugs are available as injections you can do at home or as intravenous (IV) infusions given at a hospital or clinic.
• Janus kinase (JAK) inhibitors block specific pathways and processes that cause inflammation.
• Topical creams and ointments manage skin symptoms of PsA and psoriasis. Some are available OTC, while your healthcare provider can prescribe others. 

Therapies

Many people with PsA can benefit from physical and occupational therapies to manage joint symptoms.16 Your healthcare provider might prescribe light therapy if you experience skin symptoms of the disease. 

If you are experiencing depression or anxiety, your healthcare provider might recommend mental health therapy options to help you better cope with the effects of PsA.

Surgery

Surgery is a last resort for people with PsA. It is often recommended for people who experience severe pain due to a damaged joint.¹⁷ Surgery aims to improve joint function, reduce pain, and prevent additional joint damage. 

Lifestyle Changes

As part of your treatment plan, your healthcare provider might recommend lifestyle changes to help you better manage PsA.

Lifestyle changes that might better help manage PsA include:¹⁶

• Being active: Regular, low-impact exercise, such as yoga, walking, or swimming, can help keep your joints strong and flexible. 
• Practicing stress management techniques: Stress management techniques can include meditation, deep breathing, and yoga.
• Not smoking: Smoking can increase inflammation in the body. If you need help quitting, let your healthcare provider know. They can provide you with information and resources to help you quit.
• Maintaining a healthy weight: Excess weight places stress on joints so it helps to be at a healthy weight.

Diet for Psoriatic Arthritis

There is no specific diet for PsA, but eating a healthy and nutritious diet can help to control inflammation and relieve PsA symptoms. 

Some foods might increase inflammation, while others might help reduce it. Foods that cause inflammation might include sugars, fried foods, refined carbs, red meats, and alcohol. Foods that might reduce inflammation include fatty fish, nuts, olive oil, leafy green vegetables, and some fruits.¹⁸

Complications of Psoriatic Arthritis

If PsA is not adequately treated, it can lead to complications.¹⁹

Complications and comorbidities linked to PsA include: 

• Joint and bone damage
• Heart disease
• Diabetes 
• Serious, life-threatening infections
• Gout (a type of inflammatory arthritis)
• Osteoporosis (weak and brittle bones)
• Depression 
• Inflammatory bowel disease (IBD) (includes Crohn's disease and ulcerative colitis)
• Vision problems
• Spine damage
• Arthritis mutilans (rare advanced joint disease)

Outlook for Psoriatic Arthritis

The outlook for PsA varies from person to person. For some people, PsA causes mild disease and a few flare-ups a year. PsA can be painful for others, leading to disability and severe joint damage. 

Fortunately, PsA can be managed with appropriate treatment, and most people with the condition can manage pain and will not experience significant joint damage or disease complications.

Let your healthcare provider know if you have questions or concerns about your outlook. They can advise on ways to improve your outlook and the best ways to manage your disease. 

SOURCES

1. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriatic arthritis.
2. Grinnell-MerrickLL, Lydon EJ, Mixon AM, Saalfeld W. Evaluating inflammatory versus mechanical back pain in individuals with psoriatic arthritis: a review of the literature. Rheumatol Ther. 2020;7(4):667-684.doi:10.1007/s40744-020-00234-3
3. Sobolewski P, Walecka I, Dopytalska K. Nail involvement in psoriatic arthritis. Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912
4. Walha R, Dagenais P, Gaudreault N, Beaudoin-Côté G, Boissy P. The effects of custom-made foot orthoses on foot pain, foot function, gait function, and free-living walking activities in people with psoriatic arthritis (PsA): a pre-experimental trial. Arthritis Res Ther. 2022;24(1):124. doi:10.1186/s13075-022-02808-8
5. Lai TL, Au CK, Chung HY, Leung MC, Ng WL, Lau CS. Fatigue in psoriatic arthritis: Is it related to disease activity?. Int J Rheum Dis. 2021;24(3):418-425. doi:10.1111/1756-185X.14069
6. Marchesoni A.Oligoarticular psoriatic arthritis: addressing clinical challenges in an intriguing phenotype. Rheumatol Ther. 2018;5(2):311-316. doi:10.1007/s40744-018-0115-5
7. Sankowski AJ, Lebkowska UM, Cwikła J, Walecka I, Walecki J. Psoriatic arthritis. Pol J Radiol. 2013;78(1):7-17. doi:10.12659/PJR.883763
8. Dhir V, Aggarwal A. Psoriatic arthritis: a critical review. Clin Rev Allergy Immunol. 2013 Apr;44(2):141-8. doi:10.1007/s12016-012-8302-6
9. Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):545-568. doi:10.1016/j.rdc.2015.07.001
10. Meer E, Thrastardottir T, Wang X, et al. Risk factors for diagnosis of psoriatic arthritis, psoriasis, rheumatoid arthritis, and ankylosing spondylitis: a set of parallel case-control studies. J Rheumatol. 2022;49(1):53-59. doi:10.3899/jrheum.210006
11. National Psoriasis Foundation. About psoriatic arthritis.
12. Belasco J, Wei N. Psoriatic arthritis: what is happening at the joint?Rheumatol Ther. 2019;6(3):305-315. doi:10.1007/s40744-019-0159-1
13. Kingston Hospital NHS Foundation Trust. Psoriatic arthritis (PSA) flare self-management.
14. Pennington SR, FitzGerald O. Early origins of psoriatic arthritis: clinical, genetic and molecular biomarkers of progression from psoriasis to psoriatic arthritis. Front Med (Lausanne). 2021;8:723944. doi:10.3389/fmed.2021.723944
15. Mathew AJ, Chandran V. Depression in psoriatic arthritis: dimensional aspects and link with systemic inflammation. Rheumatol Ther. 2020;7(2):287-300. doi:10.1007/s40744-020-00207-6
16. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriatic arthritis: diagnosis, treatment, and steps to take.
17. NYU Langone Health. Surgery for psoriatic arthritis.
18. Arthritis Foundation. The ultimate arthritis diet.
19. Haddad A and Zisman D. Comorbidities in patients with psoriatic arthritis. Rambam Maimonides Med J. 2017;8(1):e0004. doi:10.5041/RMMJ.10279

Psoriatic arthritis (PsA) is a type of arthritis affecting people with the skin condition psoriasis. Flare-ups­—also called flares or relapses—are periods where symptoms of PsA get worse. Not everyone with PsA has psoriasis, but psoriasis and PsA­—also called psoriatic disease—are chronic inflammatory diseases resulting from a problem with the immune system.

PsA can cause the joints to become swollen, stiff, and painful. Some people with PsA may also have nail and skin changes and chronic fatigue. Treatment can help manage these symptoms and their causes, but PsA does get worse with time, and persistent inflammation can cause permanent damage to joints.

It is difficult to know when a flare-up­ may come about, but avoiding certain triggers may prevent disease flares. Your treatment plan can also reduce the risk and severity of flares. And if flare-ups occur, there are things you can do to heal quicker, manage the flare, and reduce the risk of damage to joints during this time.

Here is what you need to know about flare triggers, signs of flares, and treating and preventing flares.

Flare Triggers

Every person with PsA has unique triggers that cause PsA to flare up. Something that may cause your disease to flare up may not affect others with PsA. Common PsA triggers may include the following.

Stress

Stress is one of the most common triggers of PsA flares. Stress unleashes chemicals that cause inflammation. With PsA, you are already vulnerable to inflammation, and the increased stress causes further inflammation, eventually causing symptoms to flare up.

Injury or Illness

A skin infection or injury can cause symptoms of PsA to flare up, especially at the site of injury. Sunburns, in particular, can trigger flares, so protect yourself when outdoors with sunscreen and clothing that blocks ultraviolet rays.

Other illnesses­—such as a cold—can also trigger a flare. Bumps and bruises are additional triggers, as trauma to any area with PsA means inflammation will follow.¹

Not Taking Your Medications on Time

Even if you are feeling fine, you should still be taking your medications as prescribed. If you miss a mediation dose or two, PsA can flare up. In addition, skipping your medications can make it harder for the medicine to do its job.

If you have side effects that are bothering you, talk to your healthcare provider about switching to another medicine. To avoid missing doses, keep a daily pill log or download a smartphone reminder app.

Medication Changes

A person with PsA may find their symptoms get worse when they change medications. This is because it may take some time for the medication to be effective. If you experience a flare after starting a new treatment, talk to your healthcare provider about a prescription steroid treatment, like prednisone, that may help to reduce the intensity of the flare and help you to recover quicker. However, steroids should always be prescribed with caution, as the eventual discontinuation of these drugs can sometimes cause a severe exacerbation of psoriasis.

Having an Unhealthy Diet

Eating sugary and fried foods can cause PSA to flare up more often. It helps to limit fatty meats, processed foods, and sugary treats. Weight gain can also overload joints and make it harder to move.² It can also cause PsA medications to be less effective.

Healthier foods that reduce inflammation include sources of omega-3 fatty acids (such as fatty fish, nuts, and seeds), olive oil, lean protein, and colorful vegetables.²

Smoking

You shouldn’t smoke with PsA. Studies have shown that people with PsA who smoke experience more pain and don’t respond as well to treatments, in comparison to people with PsA who don’t smoke.³ Smoking can also set off flares and cause them to occur more often. Talk to your healthcare provider about the safest ways to quit smoking.

Alcohol

Research shows alcohol consumption interferes with the effect of PsA medications and causes more flare-ups.⁴ Additionally, it can weaken the immune system and cause problems in the brain, heart, liver, and pancreas.

Talk to your healthcare provider about whether it is safe for you to consume alcohol and how alcohol may affect PsA and the medications you take to treat it.

Not Getting Enough Sleep

Your body needs sleep to stay healthy. But PsA pain and disease flares can keep you up at night.⁵ To reduce the effects of PsA on your sleep, follow some good sleep habits, such as keeping electronics out of the bedroom, taking a warm bath before retiring to bed, or nighttime meditation.

Signs of a Flare

The symptoms and intensity of PsA flares vary from person to person. But there are some red flags to look out for with a flare. You may experience some of these or all of them during a flare-up.

Malaise

The term malaise is used to describe a feeling of discomfort, illness, or a lack of well-being.6 When a PsA flare-up starts, you will feel very off. Malaise may come on gradually or it may appear suddenly. For some people, this feeling comes and goes throughout a flare-up, while others may experience it for the entire length of the flare.

Malaise ranges from mild to severe, and for some people, malaise is so severe it interferes with work performance, family life, and other aspects of their life.

Fatigue

Your body needs sleep to heal so you can wake up refreshed and rested. But PsA can make you feel exhausted even after 8 hours of sleep. While fatigue is one of the most common and debilitating symptoms of a PsA flare, it tends to be an underestimated symptom^.7

Skin Symptoms

It is not uncommon for a psoriasis flare-up to happen alongside a PsA flare. For people who don’t have psoriasis they may still experience skin symptoms, including rashes. Anytime you feel you are starting to experience a PsA flare, be on guard for skin symptoms.

Asymmetrical Joint Swelling and Pain

If you are experiencing asymmetrical joint pain and swelling, it means you have stiffness, pain, and throbbing in a joint or multiple joints on one side of the body only. For example, you may experience knee and hip pain on the left side and wrist and elbow pain on the right side.

Other types of inflammatory arthritis may cause symmetrical joint pain or pain that affects the joints on both sides (i.e., both hands or both knees). Each person with PsA will have different joints affected by a PsA flare.

Sacroiliac Joint and Back Pain

Your sacroiliac (SI) joint is located between the sacrum and the ilium bones of the pelvis. This joint is strong and supports the entire weight of the upper body. With a PsA flare, the sacroiliac joint and the back can become inflamed, causing stiffness, swelling, and pain.

Knee Pain

Many people with PsA complain of knee pain. Chronic inflammation can cause pain, swelling, redness, and warmth in the knee joints, and for some, knee pain is a key sign of an impending flare.

Hand and Finger Pain

Tenderness, pain, and swelling can affect the joints of the hands. Often people with PsA experience a condition called dactylitis, or sausage fingers, where the small joints fingers swell, resembling sausages.

Foot and Toe Pain

You can also experience dactylitis in your toes. Additionally, you may also have foot, heel, and ankle pain. If you experience skin symptoms with PsA, you may have red, scaly skin on the soles of your feet and between your toes.

Eye Problems and Other Symptoms

A PsA flare may cause you to experience blurred vision, and/or redness and pain in the eyes. These symptoms should prompt a visit to an eye doctor, as they may be signs of a condition called iritis, in which there is inflammation of the iris.

It is possible to experience additional symptoms with a PsA flare, including joint pain in the jaw, elbows, or shoulders. You might experience anxiety or digestive issues.

It is a good idea to write down symptoms you experience during a flare so you can prepare before a flare gets worse and it takes you days or weeks to recover.

Treating a PsA Flare

Sometimes, it may be impossible to avoid a flare-up of your psoriatic arthritis. Even then, there are things you can do to keep a flare from getting worse and to manage its effects.

Hold and Cold Therapy

Cold and hot packs can make a difference in how you feel. Cold packs have a numbing effect, so they can dull pain. A heating pad can relieve pain and swelling in joints by relaxing the muscles.

You don’t have to use an ice pack or a heating pad for relief. For cold therapy, you can use a bag of frozen veggies wrapped in a towel, or for heat, try a warm bath. If you are applying heat or cold for a long period, wrap the ice or heat source in a towel before applying it to your body.

Cut the Junk Food

Avoid foods that are high in fat, sugar, and salt when you are flaring. Instead, eat foods that fight inflammation, including fresh produce, lean proteins, and whole grains.

Manage Stress

You manage stress during a flare by relaxing your mind and body. A 2015 report in the American Journal of Public Health finds by simply taking several deep breaths and letting go of tension, you can regain calmness.⁸

Ways to relax your mind include breathing exercises, soaking in a warm bath, listening to calming music, or writing about your feelings. You can relax your body with yoga, progressive muscle relaxation, a walk, or massage.

Take an NSAID Pain Reliever

Taking a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, can help relieve inflammation, pain, and discomfort. If pain persists or a flare-up seems to be severe, talk to your healthcare provider about a prescription-strength NSAID or a corticosteroid drug to shorten and reduce the effects of the flare.

Incorporate Gentle Exercise

Exercise is key to keeping your joints and tendons loose, strengthening muscles, and maintaining a healthy weight. During a flare-up, try gentle exercises, such as walking, swimming, or yoga. If you are struggling with exercise outside of flare-ups, ask your healthcare provider about a referral to a physical therapist to help you get active again.

Rest

It is important to get proper rest when your PsA is flaring. Of course, you don’t want to get too much or will end up with more joint stiffness and swelling. It is also important to pace yourself with a flare.

Put the most important activities at the top of your to-do list and leave other activities for when you are feeling better. Ask for help if you need it and focus on taking care of yourself.

Call Your Healthcare Provider

Sometimes, a flare-up requires more than self-management. If you are experiencing severe flares often, your rheumatologist can adjust a medication dose, add a new medication, or switch you to a different drug. They can also prescribe a more powerful NSAID or a corticosteroid to help you get through the flare.

It is important to be proactive and have open communication with your healthcare provider about the intensity and frequency of flares.

Prevention

Part of better disease management is working towards preventing flares in the first place. This starts with knowing and avoiding triggers.

Keeping track of PsA symptoms and what you are doing daily—how you are eating, sleeping, and managing stress—can help you figure out what triggers you may have and how to avoid those. Explore some ways to prevent flare-ups of PsA.

Incorporating arthritis-friendly exercise: Proper exercise is important for strengthening muscles, managing stiffness in joints, and keeping you at a healthy weight.

Reducing stressors: Since stress is a PsA trigger, it can make you more sensitive to pain. Find ways to reduce daily stress to keep PsA symptoms at bay, including stress relief techniques, such as mindfulness meditation or yoga. Or you could consider talking to a therapist to help you learn to manage daily stressors and find a balance to avoid flares in the first place.

Getting plenty of rest: Make sure you are practicing good sleep habits, including maintaining a consistent sleep schedule, limiting daytime naps, and making sure your sleep environment is pleasant.

Protecting your joints: You may think you have to give up favorite activities to avoid flares. You don’t; you just have to find ways to take the stress off your joints. The way you walk, stand, sit, and carry things needs to change. Mobility aids and assistive devices can also help, including grab bars, a cane, or sit/stand stools.

Looking at your diet: Since PsA is an inflammatory condition, following an anti-inflammatory diet can help you control symptoms and prevent flare-ups. Any balanced diet heavy in fruits, vegetables, lean proteins, whole grains, fish, nuts, and plant-based fats is considered an anti-inflammatory diet.⁹

Additionally, you should avoid foods considered pro-inflammatory, such as fatty red meats, foods high in sugar (i.e., sweet snacks and soda), and refined carbs (like white bread, rice, and pasta). If dairy triggers PsA symptoms, try to limit your daily intake.

A Word From Verywell

Without proper treatment, symptoms of psoriatic arthritis will get worse over time and chronic inflammation can cause permanent damage and deformity of affected joints. But treatment can manage inflammation and reduce your risk for flares.

In fact, the newest medications for treating PsA—called biologics—can actually reduce your risk for flares and minimize the severity of a flare should it occur. Follow your healthcare provider’s advice and treatment plan, and tell your practitioner about any problems or concerns that may impact your willingness or ability to take your PsA medications. 

SOURCES

1. Thorarensen SM, Lu N, Ogdie A, et al. Physical trauma recorded in primary care is associated with the onset of psoriatic arthritis among patients with psoriasis. Ann Rheum Dis. 2017;76(3):521-525. doi:10.1136/annrheumdis-2016-209334
2. Arthritis Foundation. Healthy lifestyle habits when you have PsA.
3. Pezzolo E, Naldi L. The relationship between smoking, psoriasis and psoriatic arthritis. Expert Rev Clin Immunol. 2019;15(1):41-48. doi:10.1080/1744666X.2019.1543591
4. Wu S, Cho E, Li WQ, Han J, Qureshi AA. Alcohol intake and risk of incident psoriatic arthritis in women. J Rheumatol. 2015;42(5):835-840. doi:10.3899/jrheum.140808
5. Arthritis Foundation. Psoriatic arthritis and sleep.
6. Medline Plus. Malaise.
7. Krajewska-Włodarczyk M, Owczarczyk-Saczonek A, Placek W. Fatigue - an underestimated symptom in psoriatic arthritis. Reumatologia. 2017;55(3):125-130. doi:10.5114/reum.2017.68911
8. Adeniyi PO. Stress, a major determinant of nutritional and health status. American Journal of Public Health Research. 2015;3.1:15-20. doi:10.12691/ajphr-3-1-3
9. National Psoriasis Foundation. What’s the deal with the anti-inflammatory diet?

Inflammation is part of your body’s natural defenses—when a cut swells up and turns red, that’s inflammation at work healing you. But when inflammation goes into overdrive, sparked by factors like poor diet and smoking, it can cause a host of health problems including cardiovascular disease, diabetes, arthritis (including psoriatic arthritis), cancer and even depression. But how can you reduce inflammation in the body? Try these strategies.

1. Try turmeric.

Turmeric is having a moment, thanks largely to curcumin—a compound that gives the sunny spice its anti-inflammatory powers. According to a recent review, curcumin reduces the production of a protein that makes your immune system work overtime. These studies used high doses of curcumin (up to 1,500 milligrams/day), so it may be worth asking your doctor about supplements. You may not be able to get that much from food (5 teaspoons ground turmeric or 2 ounces fresh has 500 mg of curcumin). But the spice’s anti-inflammatory potential is still a good reason to sprinkle it liberally on roasted veggies or sip those trendy golden lattes.

2. Eat your greens.

Here’s yet another reason not to skimp on green leafy vegetables: they are rich in magnesium, a mineral that about half of us don’t consume enough of. “I encourage anyone who’s susceptible to inflammation to assess their magnesium intake,” says Forrest H. Nielsen, Ph.D., a research nutritionist at the USDA’s Grand Forks Human Nutrition Research Center in North Dakota. (Ask your doctor to check your magnesium levels with a blood test.) “There's a lot of evidence that people with high inflammatory markers often have low magnesium levels. Plus, people who have conditions associated with inflammation, like heart disease and diabetes, also tend to have low magnesium levels,” Nielsen says.

3. Eat your reds, blues and purples, too.

Speaking of color, green isn’t the only one that’s good for you. Women who regularly consume roughly 40 mg per day of anthocyanins—the compounds that give produce its deep red and purple hues—have 18% lower levels of C-reactive protein, a measure of inflammatory activity, compared to those who eat minimal amounts of them, U.K. researchers found. You can get that daily dose of anthocyanins from 1/3 cup of blackberries, 18 red grapes or 1 cup of shredded red cabbage.

4. Grab a handful of nuts.

People who noshed at least five 1-ounce servings of peanuts, almonds, walnuts or cashews each week had lower levels of inflammatory biomarkers compared to those who didn’t eat them regularly, found a study in the American Journal of Clinical Nutrition. Nuts’ anti-inflammatory effects are due to their combo of fiber, antioxidants and omega-3 and omega-6 fatty acids.

5. Get more exercise.

Obesity—or even just an expanding waistline—is a major cause of inflammation. But you can offset this by amping up your activity. A study published in Medicine & Science in Sport & Exercise found that the least- sedentary people had the lowest inflammation, even if they didn’t lose weight. While they got about 2 1/2 hours of moderate-to-vigorous activity per day, it included regular life activities like yardwork and household chores. (Yes, running around your house scooping up Legos counts!) Even a small increase in activity tames the flames compared to being totally couch-bound.

6. Keep stress at bay.

Frequently frazzled? A study in the journal Brain, Behavior, and Immunity found that people who have a strong emotional reaction to stressful tasks (you bite your nails when you have to make a presentation at work, or get tense when someone presses your buttons) experience a greater increase in circulating interleukin-6 (a marker of inflammation) during times of stress than those who take stressful tasks in stride. While stress harms your body in many ways, Christopher P. Cannon, M.D., a professor at Harvard Medical School, puts it like this: “Stress increases blood pressure and heart rate, making your blood vessels work harder. Essentially, you’re pounding on them more often and creating damage. If that damage happens over and over, inflammation persists.”

7. Up your yoga game.

Women who had regularly practiced 75 to 90 minutes of Hatha yoga twice-weekly for at least two years had markedly lower levels of interleukin-6 and C-reactive protein, two key inflammatory markers, compared to those who were new to yoga or practiced less frequently, according to a study in the journal Psychosomatic Medicine. “A central tenet of yoga is that practicing can reduce stress responses,” explains Janice Kiecolt-Glaser, Ph.D., study co-author and professor of psychiatry and psychology at the Institute for Behavioral Medicine Research at Ohio State University College of Medicine. Researchers think that yoga’s benefit is that it minimizes stress-related physiological changes.

8. Get enough sleep.

It may be more than just a lack of sleep that causes inflammation. How you behave when you’re tired may be what’s stoking the flames. In a study from The Ohio State University, inflammation shot up when sleep-deprived couples started squabbling. When faced with a conflict, partners’ inflammatory markers jumped 6% for every hour of sleep they lost below seven hours. Inadequate rest may make you more sensitive to stress, which in turn causes inflammation. The good news: Using healthy conflict-resolution strategies protected both partners.

9. Enjoy a massage.

A massage isn’t just a treat—it can be part of staying healthy. Receiving a 45-minute Swedish massage can greatly lower levels of two key inflammation-promoting hormones, according to a study in the Journal of Alternative and Complementary Medicine. “Massage may decrease inflammatory substances by [appropriately] increasing the amount of disease-fighting white blood cells in the body,” says Mark Hyman Rapaport, M.D., co-author of the study. “It may also lower stress hormones. Either way, these results can be seen after just one massage.”

10. Drink green tea.

Even if coffee is your beverage of choice, you might not want to bag tea altogether—especially the green variety. Green tea is full of potent antioxidants that can help quell inflammation. In fact, researchers from Texas Tech University Health Sciences Center in Lubbock found that green tea can inhibit oxidative stress and the potential inflammation that may result from it. “After 24 weeks, people who consumed 500 mg of green tea polyphenols daily—that’s about 4 to 6 cups of tea—halved their oxidative stress levels,” says Leslie Shen, Ph.D., the study’s lead author.