Here are the three most common foot problems doctors see in patients with psoriatic arthritis.

• Plantar fasciitis:  This causes pain in the sole, in particular the first thing in the morning, due to tissue inflammation.
• Achilles tendonitis:  The patient will feel pain in the back of the lower leg near the heel.
• Dactylitis:  This appears as swelling and puffiness along the toes.

Not only can these foot problems trigger debilitating pain for many patients with psoriatic arthritis, but without proper treatment, these issues can progress and cause long-term damage in the form of clawed toes, overextension of the big toe, and rolling of the ankle.

While ensuring your psoriatic arthritis is well managed overall, such as by adhering to your medication regimen, specific lifestyle changes can also help relieve foot pain.  Here is what doctors recommend to cut down on foot pain caused by psoriatic arthritis:

• Get shoes that fit.  It starts by having your feet measured by a trained salesperson and finding the right size.  Consult with the salesperson to find shoes with proper arch and heel support.  If your shoes do not have this, consider buying orthotic inserts.
• Ice your foot.  For plantar fasciitis, you might find it soothing to roll the bottom of your foot back and forth across a cold or frozen water bottle.
• Cut your toenails.  If you keep them short, they're less likely to irritate the nail bed.
• Keep nails naked.  Covering up your toenails with colorful polish may mask potential signs of infection.  You may be tempted to hide a yellow nail, but that is not a symptom you should ignore.
• Ditch the heels.  Stilettos push feet forward and cramp the toes, which aggravates the symptoms of common psoriatic arthritis foot problems.

 
Even if you are following these lifestyle habits, it is wise to see a podiatrist to ensure you take proper care of your feet.  Every case is unique, and it is worth it to invest now to avoid long-term damage.
 

Understanding incidence beyond prevalence is critical to understanding how chronic pain manifests and evolves.  Data on pain progression stresses the need for increased use of multimodal, multidisciplinary interventions to change the course of pain and improve patient outcomes.  The study found that the rate of chronic and high-impact chronic pain (HICP) among adults is approximately 21% and 8%, respectively.  Chronic pain is pain experienced on most days or every day in the past three months, and HICP is pain that limits life or work activities on most days or every day during the past three months.  The links between the overall burden of chronic pain and the country's opioid epidemic emphasize the urgency to understand and address the pain issue.

The study offers several key findings:
New chronic pain cases were high, at 52.4 per 1,000 persons per year.  It was compared to other common chronic conditions, such as:

• diabetes (7.1 cases/1,000 per year)
• depression (15.9 cases/ 1,000 per year)
• hypertension (45.3 cases/1,000 per year)

Among those who reported non-chronic pain, about 1 in 6 (14.9%) said they had chronic pain, pointing to the importance of early pain management.
​
This study does not just demonstrate the country's terrible burden of pain.  But, we have an urgent scientific imperative to expand our tools to fight pain to restore people to a pain-free life.  The onset of any chronic condition is pivotal, and early intervention can significantly affect the situation's toll on an individual.
 
References
Nahin RL, Feinberg T, Kapos FP, Terman GW. Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020.  JAMA Netw Open.  2023. doi: 10.1001/jamanetworkopen.2023.13563

Suppose you have conditions such as high blood pressure and diabetes.  In that case, you are at greater risk for kidney failure, meaning you can eventually require treatment like a kidney transplant or dialysis.  Dialysis will remove the excess fluid from the body, helping to control blood pressure.  Working with your doctor to control blood sugar and blood pressure may help keep your kidneys working longer.

Doctors use several kidney function tests to determine kidney health.  Most people begin dialysis treatment with a GFR of <15, meaning they have lost about 85 to 90 percent of their kidney function.  Early diagnosis of CKD and regular monitoring may help you keep your kidneys functioning for as long as possible and allow you and your doctor to plan for ESRD treatment when necessary.