What's the Difference Between Osteoarthritis and Psoriatic Arthritis?

Both conditions affect the joints, but they have different causes and different symptoms.

A bad back, trouble climbing stairs, an aching hip—these are all signs of getting older. Or at least that's what most people think. The truth is that, for some people, this kind of discomfort could be pointing to something much more serious than just aging. 

Osteoarthritis (OA) is the most common chronic joint condition in adults. It's a wear-and-tear type of arthritis that happens when cartilage breaks down in your joints, usually the hands, hips, knees and lower back. One of its biggest risk factors is aging, which is why this type of joint pain is associated with getting on in years. 

But for people with psoriasis, joint pain could have another name. Some people with psoriasis end up with a type of arthritis called psoriatic arthritis (PsA). This joint condition is an inflammatory disease that has to do with your immune system attacking your joints, not plain ol' wear and tear. 

Unfortunately, people with psoriasis tend to shrug off joint pain as they get older, making PsA hard to diagnose. A 2015 review of 12 different studies found that about 15 percent of people with psoriasis have undiagnosed PsA. This could be because when you're seeing your dermatologist, you're both focused on your skin, while your primary healthcare provider (HCP) might not be tuned into the signs of PsA. 

If you're not telling your HCP about your joint pain, PsA could go undetected and wreak havoc on your body. The sooner you talk to your HCP and explore your treatment options, the better. 

What's the difference between osteoarthritis and psoriatic arthritis symptoms? 
Telltale signs you should look out for with PsA: 

  • Pain and swelling that comes and goes (called flare-ups) 
  • Pain that usually gets better with exercise 
  • Tender spots where tendons and ligaments connect with bones, often around the heel, sole of the foot and elbows 
  • Fatigue or exhaustion 
  • Eye pain or redness 
  • Fingernails or toenails that look pitted and separated from the nail bed 
  • Painful, sausage-like swelling in the fingers or toes 

And OA: 

  • A cracking sound or a scraping or grating feeling when you bend your joints 
  • Pain that usually gets worse with activity and better with rest 
  • Bone spurs that can be felt under the skin 
  • Mild swelling, but this less common 

If you have psoriasis and joint pain, tell your HCP—soon. Early treatment can save your joints from permanent damage. Remember, just because you have psoriasis doesn't automatically mean your joint pain is PsA. Talking to your HCP will lead to the right diagnosis, and more importantly, the right treatment plan. 

Medically reviewed in February 2018. Updated in February 2021. 

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