Why Psoriatic Arthritis May Make You Dizzy (and What to Do About It)

There’s nothing quite like vertigo—the sensation that the world is suddenly spinning around you and basically trying to knock you over (and maybe succeeding). It can be a frightening experience and, if you have psoriatic arthritis (PsA), not uncommon.

Elizabeth Madeiros, 27, vividly remembers her first vertigo spell. It hit her in the middle of a busy train station when she was heading home from a long work day—tired and already not feeling great because of a PsA flare. “I remember very specifically, I was looking up at the board with all the train numbers,” Madeiros tells SELF. “And as I moved my head down, that was the first time I got vertigo.”

It’s not completely clear why this happens. However, the autoimmune condition, which tends to strike people who have the skin condition psoriasis, may cause inflammation in the inner ear, and the result can be balance problems that disrupt your equilibrium. The good news is that there are ways of managing these symptoms and feeling more confident as you move around.

Your body’s balancing act

Standing and walking are typically skills you nail so early in life that it’s easy to take them for granted. But your body actually has an elaborate system to keep you steady on your feet, Jennifer Kelly, DPT, the director of vestibular rehabilitation at New York Eye and Ear Infirmary at Mount Sinai, in New York City tells SELF.

It all hinges on your brain integrating a constant stream of signals from three places: your muscles and joints, eyes, and a vestibular (balance) system in your inner ears. These tiny labyrinths of fluid-filled canals and “organs” feed your brain information on your movements and position (as in, are you making a beeline down the street, doing jumping jacks, or standing still?). If any part of this body-brain loop is disturbed—from an injury, disease, or simply aging—that can sometimes create that feeling that you’re about to slide off the planet.

Studies suggest that people with autoimmune conditions like lupus, thyroid disease, multiple sclerosis, and rheumatoid arthritis may be at increased risk of inner ear problems, including vertigo and hearing loss. Less is known about people with PsA, specifically. But in a 2022 research review, Habib Rizk, MD, an associate professor of otolaryngology-head and neck surgery at the Medical University of South Carolina, in Charleston, and colleagues found that 16% of people with psoriasis and/or PsA had test results that indicated problems with their inner-ear balance system, versus less than 1% of other people.

Oftentimes, Kelly says, people use the words “vertigo” and “dizziness” interchangeably. But they’re not the same, she explains, and knowing the difference might help you figure out what’s happening to you. As Madeiros experienced, vertigo is a false sense of motion: You feel like you’re moving when you’re actually still, or it might look like the world is whirling, which can make you feel sick to your stomach. With dizziness, you might feel lightheaded, faint, or unsteady—but without that false sense of movement. It can be a result of dehydration, medications, or a lot of other things.

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