Understanding Psoriatic Arthritis: What’s Happening to My Body?

A Canadian Spondyloarthritis Association (CSA) Webinar with Dr. Dafna Gladman

Living with psoriatic arthritis (PsA) can be overwhelming, especially in the early stages when symptoms may be confusing or unpredictable. To support those who are newly diagnosed—or searching for answers about their symptoms—the Canadian Spondyloarthritis Association (CSA) recently hosted an in-depth educational webinar titled “Psoriatic Arthritis: What’s Happening to My Body?”

This live session was led by Dr. Dafna Gladman, a world-renowned rheumatologist, researcher, and co-director of the Gladman Kremble Psoriatic Arthritis Program at Toronto Western Hospital. Dr. Gladman’s groundbreaking research has shaped how psoriatic arthritis is diagnosed and treated around the world.

What Makes Psoriatic Arthritis Different

Psoriatic arthritis (PsA) is more than “just joint pain.” It’s a chronic inflammatory disease that affects about 30% of people living with psoriasis. Unlike osteoarthritis or rheumatoid arthritis, PsA can involve the distal joints (fingers and toes), spine and pelvis (axial involvement), and can cause swelling, stiffness, and fatigue.

Dr. Gladman explained how PsA stands apart from other forms of arthritis:

• Inflammatory vs. non-inflammatory pain: PsA pain typically worsens with inactivity and improves with movement.

• Axial disease: About 50% of people with PsA develop inflammatory back pain and stiffness.

• Multi-system impact: PsA can affect skin, nails, eyes, tendons, and even increase the risk of cardiovascular disease.

• Variable course: Symptoms and disease progression are unpredictable, making early diagnosis and treatment critical.

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Recognizing Symptoms and Getting Diagnosed Early

Many people live with unexplained symptoms for years before receiving a diagnosis. Common early signs of psoriatic arthritis include:

• Persistent joint pain, stiffness, and swelling

• Back pain that improves with activity

• Nail changes such as pitting or separation

• Fatigue and reduced mobility

• Inflammation in fingers or toes (dactylitis)

Early diagnosis matters: Research shows that people who receive treatment within the first 6–12 months of symptom onset have significantly better outcomes, including reduced joint damage and improved quality of life.

“The earlier we see the patient, the earlier we treat the patient, the better their outcome.” — Dr. Dafna Gladman

Why Psoriatic Arthritis Is a Whole-Body Condition

PsA doesn’t stop at the joints. It can affect many parts of the body, including:

• Skin and nails: Psoriasis lesions and nail changes are common

• Tendons and ligaments: Inflammation can appear in areas like the Achilles tendon or plantar fascia

• Eyes and gut: Some patients develop uveitis or inflammatory bowel disease

• Heart and mental health: Increased risk of cardiovascular disease, anxiety, and depression

Controlling inflammation through appropriate treatment and lifestyle changes—such as regular exercise and good sleep—can improve both physical health and mental well-being.

The Power of Self-Advocacy

Dr. Gladman emphasized the importance of patient self-advocacy during medical appointments:

• Always mention any skin lesions—even if they’re not visible.

• Report any joint or back pain to your dermatologist or primary care provider.

• Request a referral to a rheumatologist if symptoms persist.

• Ask your care team about your risk of developing PsA if you already have psoriasis.