What Is Reactive Arthritis?
Reactive arthritis is a type of arthritis. It is triggered by another infection in the body. Typically, sexually transmitted infections (STIs) or bacterial infections in the intestines cause it.
People with reactive arthritis usually experience symptoms in their leg joints. A form of the condition called Reiter’s syndrome affects the eyes and the urinary tract.
The condition is not very common. According to the National Institute of Arthritis and Muscoskeletal and Skin Diseases (NIAMS), men develop reactive arthritis more often than women. The average age of onset is 30. Men also tend to experience more severe joint pain than women (NIAMS, 2011).
Causes of Reactive Arthritis
Bacterial infection of the urinary tract or intestines is the most common cause of reactive arthritis. The most common bacteria associated with reactive arthritis is chlamydia trachomatis (chlamydia), which is spread through sexual contact.
Bacteria that cause food poisoning can also produce reactive arthritis symptoms. Examples of these bacteria include shigella and salmonella.
Genetics may be a factor in whether or not you develop reactive arthritis. According to NIAMS, about 80 percent of people who have reactive arthritis also have a gene called HLA-B27. However, not everyone who has the HLA-B27 gene will develop reactive arthritis if he or she contracts an infection (NIAMS, 2011).
Symptoms of Reactive Arthritis
There are three distinct sets of symptoms associated with reactive arthritis:
Musculoskeletal symptoms include joint pain and swelling. Reactive arthritis most often affect joints in the knees and ankles. You may also experience joint pain, tightness, and swelling in your fingers, back, buttocks, or heels.
A condition called urethritis causes urinary symptoms. The urethra is the tube that carries urine from the bladder to the outside of your body. Urethritis is the inflammation of this tube. Symptoms can include pain or burning with urination and a frequent urge to urinate.
Men may develop prostatitis as part of reactive arthritis. Prostatitis is the inflammation of the prostate gland. Cervicitis is the inflammation of the cervix in females. It can be a sign of reactive arthritis.
Eyes and Skin
Eye inflammation is the main symptom of reactive arthritis when the eyes, skin, and mouth are involved. Conjunctivitis is the inflammation of the eye membranes. Symptoms include pain, itching, and discharge.
Mouth sores and skin rashes are less common. However, they can accompany other symptoms of reactive arthritis.
Diagnosing Reactive Arthritis
Your doctor will evaluate your medical history, perform a physical examination of your symptoms, and run blood tests to check for infection or inflammation. A blood test can also determine if you carry the HLA-B27 gene that increases your likelihood of developing reactive arthritis.
Your doctor may run additional tests to rule out other STIs if your symptoms indicate chlamydia infection. He or she will swab the urethra in men and will perform a pelvic exam and cervical swab on women.
Treating Reactive Arthritis
Treatment for reactive arthritis depends on the cause of the condition. Your doctor will prescribe antibiotic medications to treat an underlying infection. He or she may prescribe additional medications for conjunctivitis, mouth ulcers, or skin rashes if needed.
The goal of treatment once the underlying infection is under control turns to pain relief and management. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen help relieve pain and reduce inflammation.
Your doctor may prescribe stronger anti-inflammatories if over-the-counter medications do not relieve your pain. Corticosteroids are man-made drugs that mimic cortisol, a hormone that the body produces naturally. These drugs work by fighting off white blood cells and other chemicals in the body that can cause inflammation.
You can take corticosteroids orally or inject them directly into the affected joints.
Incorporate exercising into your daily routine to promote joint health. Exercise keeps your joints flexible and helps you retain your range of motion. Range of motion is the extent to which you can flex and extend your joints.
Talk to your doctor if stiffness and pain limit your range of motion. He or she might refer you to a physical therapist. Physical therapy is a gradual treatment process. The goal is to return to your healthy range of motion without pain.
Long-Term Outlook for Reactive Arthritis
The outlook for patients with reactive arthritis is positive. Most people make a full recovery. However, recovery time can range from a few months to almost a year in some cases. Nearly 50 percent of people with reactive arthritis experience a relapse of symptoms after initial treatment (NIAMS, 2011).