How psoriatic arthritis (PsA) progresses will depend on various factors, including the type of PsA, its stage at diagnosis, the treatment a person receives, and how they respond to it.

• In the early stages, there may be few or no symptoms. Tissue damage might be present, but bone damage may not show on an X-ray.
• When symptoms appear, they include inflammation of the joints, which causes pain, swelling, redness, and warmth in the surrounding tissues.
• In time, the spaces between the joints narrow, and bone erosion occurs. Osteoporosis may develop in some areas.
• Bone erosion can affect the joints on one or both sides of the body, and it can vary in severity from causing mild pain to resulting in changes that make it difficult to continue with daily activities.
• In time, erosions worsen, and bone spurs develop, as in other types of arthritis. The bones can become deformed.

Will symptoms worsen over time?

For some people with mild symptoms, these symptoms may not worsen over time.

Symptoms that follow a cycle of flares and remissions can sometimes get worse over time, but an effective treatment plan can usually prevent progressive damage from occurring.

If symptoms are severe, however, or the person does not receive effective treatment, symptoms can get progressively worse, and this can affect an individual’s ability to carry out their daily tasks.

In the early stages, it can be difficult to predict the course of the disease.

Progression of psoriasis and PsA

Most people who develop PSA will already have had psoriasis for around 10 years, but this is not always the case.

In 2016, researchers noted that among people who have both PsA and psoriasis, 70% experience skin changes before the symptoms of PsA appear, while 15% develop skin changes after having symptoms of PsA for about 2 years. The other 15% develop both at the same time.

Early diagnosis and treatment can help a person manage their symptoms and reduce the risk of flares and future complications.