Individuals may experience periodic joint pain that is usually responsive to medical therapy. This form is generally mild, although some people will develop disabling disease. Sometimes it is confused with osteoarthritis, but nail changes are usually prominent. In about 5 percent of individuals, inflammation of the spinal column is the predominant symptom. Inflammation with stiffness of the neck, lower back, sacroiliac or spinal vertebrae are common symptoms in a larger number of patients, making motion painful and dificult.
Peripheral disease can be present in the hands, arms, hips, legs and feet.
Spondylitis, when severe, may be associated with generalized symptoms. This is a severe, deforming and destructive arthritis that affects fewer than 5 percent of people with psoriatic arthritis. It principally affects the small joints of the hands and feet, though there is frequently associated neck or lower back pain. This type can progress over months and years. Arthritic flares and remissions tend to coincide with skin flares and remissions.