a woman with blond hair in her 40sPsoriatic arthritis (PsA) is a chronic condition that affects 30% of people who have psoriasis (a condition that shows up as red patches on the skin). Most people develop skin problems first but sometimes symptoms of arthritis can precede it or can develop without it.

PsA is an inflammatory disease which affects the joints and the places where tendons and ligaments connect to the bone.

Risk Factors

  • Psoriasis
  • Genetics - parent or sibling with the condition
  • Occurs most often in people between 30-50

Foot Symptoms

Because the feet have 26 bones and 33 joints, and over a hundred tendons, muscles, and ligaments they are a prime target for this condition.

Foot and ankle symptoms and conditions can include:

  • Swollen toes that resemble sausages
  • Pain and difficulty walking with first steps upon waking or after periods of inactivity
  • Stiffness pain, throbbing, swelling, and tenderness in one or more joints
  • Toenails that are pitted, discolored, crumbly, thickened, or lift off the nail bed.
  • Limited range of motion in the ankles
  • Painful calluses over joints
  • Achilles tendonitis and plantar fasciitis are two of the more common foot conditions experienced by patients with psoriatic arthritis.


  • Follow your medication regimen; rheumatologists are physicians that specialize in treating psoriatic arthritis.
  • Apply ice - ice can help reduce the inflammation and pain; apply ten minutes on, ten minutes off. In addition, if you have heel pain, roll a frozen water bottle on the bottom of your foot.
  • Participate in a low-impact exercise to reduce inflammation such as swimming, biking, or using an elliptical; check with your physician before starting any new exercise regimen.
  • Treat toenail fungus - one-third of patients with this condition will develop a fungal nail infection. If you already have a fungal toenail infection get it treated through our comprehensive treatment program.
  • Prevent toenail fungus - the following actions will help prevent toenail fungus:
    • wear shower shoes in public facilities
    • buy shoes that fit well that are made out of materials that breathe
    • wear synthetic socks that wick away moisture
    • alternate shoes on a daily basis to let them dry out
    • only use non-toxic nail polish with anti-fungal properties or none at all
    • keep toenails short and cut them straight across to prevent them from becoming ingrown
    • keep cuticles intact
  • Buy proper footwear
    • Wear shoes with good support and a wider toe box to reduce pressure on inflamed areas and swollen toes
    • Purchase shoes with extra cushioning
    • Avoid high heels as these will add pressure to the ball of your foot and your toes
    • Wear over-the-counter inserts for more support; in addition, your podiatrist may recommend custom orthotics to prevent heel pain and Achilles tendonitis
Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.
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