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Reactive arthritis: Symptoms, risk factors, and treatment

Date: Jul-02-2017
Reactive arthritis, also known as Reiter's syndrome, is a painful form of inflammation that can cause swelling, heat, and redness in the feet, ankles, knees, and back.

It is considered a form of spondyloarthritis, which is a general term for inflammatory diseases that attack the places where ligaments and tendons connect muscles to the bones and joints.

One of the most notable characteristics of this condition is that it can also affect the eyes, bladder, and urethra.

Inflammation is the primary symptom of reactive arthritis, and most often it flares up in the urogenital tract, the joints, and the eyes.

Contents of this article:

What are the symptoms of reactive arthritis?

Risk factors and causes

How is reactive arthritis diagnosed?


What is the outlook for reactive arthritis?

Fast facts on reactive arthritis:

The condition is called "reactive" because it develops in response to a bacterial infection somewhere else in the body.

Although reactive arthritis is not contagious, the bacteria that cause the trigger diseases can spread.

Most people with reactive arthritis recover completely over time.

What are the symptoms of reactive arthritis?

Reactive arthritis may affect the joints, eyes,

and urogenital tract.

The symptoms of reactive arthritis usually appear 2-4 weeks after these triggering infections of the urogenital or digestive tracts.

The range of symptoms associated with reactive arthritis includes:

sore and swollen toes, fingers, knees, ankles, and other joints

pain in the lower back and buttocks, reported by roughly 50 percent of people

pain in the heels

blurry vision

irritated eyes

conjunctivitis, or inflammation of the eyes, seen in 20 percent of cases

urethritis, inflammation of the urinary tract

rashes or crusty sores on the hands, feet, and penis, experienced by 5-10 percent of people

frequent, painful urination

Urinary problems are often the first symptoms to appear for men, but they might not be seen in women at all. Arthritis symptoms are typically the last to appear and the last to go away, although they can be mild.

Symptoms recur in some people, and, in rare cases, reactive arthritis can become a chronic disease.

Risk factors and causes

Reactive arthritis is found most frequently among people 20-40 years old, and males are three times more likely to get the disease than females. Symptoms may also be more severe in men.

Chlamydia, which causes infections and usually spreads through sexual contact, is the bacteria most often associated with reactive arthritis.

The National Institute of Arthritis and Musculoskeletal and Skin Infections report that men are nine times more likely than women to develop reactive arthritis due to sexually transmitted diseases.

Infections in the digestive system or the bladder, urethra, or vagina can also cause these "trigger" diseases.

Eating contaminated food, or food that was poorly handled, can also trigger diseases of the digestive tract that result in reactive arthritis. The bacteria responsible are usually:





Men and women get reactive arthritis through digestive tract illnesses at about the same rate.

Not everyone exposed to these bacteria develops reactive arthritis. In fact, the condition is listed by the Genetic and Rare Diseases Information Center, which means that no more than 200,000 people in the United States are affected by it.

Genetics appears to be a factor in the disease. Reactive arthritis is also one of the first symptoms of HIV infection shown by people who are HIV positive.

How is reactive arthritis diagnosed?

Examining the eyes may enable a doctor to diagnose reactive arthritis.

Specific laboratory tests for reactive arthritis do not currently exist. Doctors base their decisions on their observations and experience. The process will involve:

taking a medical history, including past and current symptoms, especially symptoms like diarrhea or discharge from the genitals

examining inflamed areas, plus the pelvic area, genitals, eyes, and skin

inspecting joints for swelling, inflammation, and range of motion

doing blood tests for the HLA B27 gene, rheumatoid factor, antinuclear antibody, red blood cell sedimentation rate

testing for chlamydia

testing samples of throat, urethra, and cervix tissue for bacteria

analyzing urine and stool samples

studying the synovial fluid found in joints, such as the knee

taking X-rays of the spine, pelvis, and joints

Because reactive arthritis is difficult to diagnose, less severe cases might not be discovered and reported. Some researchers think the condition is more widespread than is commonly believed.


Medical care for reactive arthritis includes the following:

curing the triggering infection with antibiotics

treating genital symptoms

caring for eye symptoms

controlling skin symptoms

managing pain

Seeking medical treatment for reactive arthritis can involve working with many different doctors, starting with a rheumatologist, a specialist in arthritis. Other doctors may include a gynecologist or urologist, ophthalmologist (eyes), dermatologist (skin), and potentially an orthopedic surgeon.

Doctors have found that, if a case of reactive arthritis is due to chlamydia, early treatment can be particularly helpful and limit the progression of the disease.

Medications include:

Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen, to reduce swelling and discomfort.

Corticosteroids, which are powerful drugs used to reduce inflammation. The medication can also be injected into the joints or taken by mouth.

Disease-modifying anti-rheumatic drugs (DMARDs) for chronic cases or cases that are particularly severe.

Sulfasalazine, especially if a gastrointestinal infection kicked off the original episode.

Combination therapy, involving multiple antibiotics.

Home remedies and pain relief

Hydrotherapy and exercising in water may help to ease symptoms.

Maintaining a healthy level of physical activity is one of the most important things people with reactive arthritis can do.

Easing into exercise is very important for people with arthritis, as is incorporating a range of different activities. Many people with arthritis have found water exercise classes to be both accessible and beneficial.

Preventing repeat infections that can trigger reactive arthritis is also important for self-care. Patients should use condoms to reduce the risk of acquiring a sexually transmitted infection. Store and cook food at recommended temperatures to stop the spread of food-borne bacteria.

Both heating pads and ice, applied indirectly and never placed right on the skin, can provide relief from the pain associated with reactive arthritis.

What is the outlook for reactive arthritis?

The Genetic and Rare Disease Information Center report most people see their symptoms gradually disappear within 3 months to 1 year.

However, according to the Arthritis Foundation, 15-50 percent of people who have this disease may show symptoms again, usually involving pain in the low back and other arthritis symptoms. These flare-ups may be due to re-infection.

Some individuals may suffer long-term problems with arthritis after developing reactive arthritis.

Written by Danielle Dresden

Courtesy: Medical News Today
Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.