What is Reactive Arthritis? Symptoms, Causes, & Treatment

What is Reactive Arthritis?

Reactive arthritis is joint inflammation that develops after your body fights off an infection somewhere else in your body. Your immune system, while doing its job to clear the infection, mistakenly attacks healthy joint tissue in the process.

This condition typically affects your knees, ankles, and feet, though it can involve other joints too. The infection that triggers reactive arthritis is usually completely gone by the time joint symptoms appear, which is why it's called "reactive" rather than infectious arthritis.

Most people with reactive arthritis recover completely within several months to a year. However, some may experience recurring episodes or develop chronic symptoms that require ongoing management.

What are the Symptoms of Reactive Arthritis?

Reactive arthritis symptoms usually develop within one to four weeks after the original infection. The main signs involve joint pain and swelling, but this condition can affect other parts of your body too.

The most common joint symptoms include:

• Pain and swelling in knees, ankles, and feet
• Stiffness that's worse in the morning or after sitting
• Lower back pain, especially in the sacroiliac joints
• Heel pain or Achilles tendon inflammation
• Swollen fingers or toes that look like sausages

Beyond joint symptoms, you might also experience eye inflammation called conjunctivitis, which causes redness and irritation. Some people develop skin rashes, mouth sores, or genital sores as well.

In rare cases, reactive arthritis can affect your heart, lungs, or nervous system. These complications are uncommon but require immediate medical attention if symptoms like chest pain, shortness of breath, or neurological changes occur.

What are the Types of Reactive Arthritis?

Doctors typically classify reactive arthritis based on what triggered the initial infection. The two main types relate to where the original infection occurred in your body.

Sexually acquired reactive arthritis develops after infections of the urogenital tract, commonly from chlamydia or gonorrhea. This type often affects younger adults and may include symptoms like urethritis or cervicitis along with joint inflammation.

Enteropathic reactive arthritis follows gastrointestinal infections from bacteria like Salmonella, Shigella, Campylobacter, or Yersinia. This type typically occurs after food poisoning or gastroenteritis episodes.

Some medical professionals also recognize a classic triad called Reiter's syndrome, which includes arthritis, eye inflammation, and urethritis occurring together. However, most doctors now simply use the term reactive arthritis since not everyone experiences all three symptoms.

What Causes Reactive Arthritis?

Reactive arthritis happens when your immune system overreacts to an infection. After successfully fighting off bacteria, your immune system continues attacking healthy tissue, particularly in your joints.

The most common bacterial triggers include:

• Chlamydia trachomatis (sexually transmitted)
• Salmonella species (food poisoning)
• Shigella (dysentery)
• Campylobacter (food poisoning)
• Yersinia (food poisoning)

Genetics play a significant role in who develops reactive arthritis. People with a gene called HLA-B27 are much more likely to develop this condition after certain infections, though having this gene doesn't guarantee you'll get reactive arthritis.

In rare cases, other infections like those caused by Clostridium difficile or certain viral infections might trigger reactive arthritis. The exact mechanism isn't fully understood, but it appears to involve molecular mimicry where your immune system confuses your own tissue with bacterial proteins.

When to See a Doctor for Reactive Arthritis?

You should contact your doctor if you develop joint pain and swelling within a few weeks of having an infection. Early diagnosis and treatment can help prevent complications and reduce your recovery time.

Seek immediate medical attention if you experience severe symptoms like high fever, intense joint pain that prevents movement, or signs of serious complications. Eye pain with vision changes, chest pain, or difficulty breathing all require emergency care.

Don't wait to see your doctor if you notice multiple joints becoming swollen and painful, especially if you recently had food poisoning or a sexually transmitted infection. Even if your original infection seemed minor, reactive arthritis can develop into a more serious condition without proper treatment.

What are the Risk Factors for Reactive Arthritis?

Several factors can increase your likelihood of developing reactive arthritis after an infection. Understanding these risk factors can help you recognize when to seek medical care more quickly.

The most significant risk factors include:

• Having the HLA-B27 gene (found in about 8% of the population)
• Being between ages 20-40 years old
• Male sex, especially for sexually acquired forms
• Recent bacterial infection of the intestines or urogenital tract
• Family history of reactive arthritis or related conditions

Certain lifestyle factors can also increase your risk. Having multiple sexual partners or engaging in unprotected sex raises your chance of getting triggering infections like chlamydia.

Rarely, people with compromised immune systems or those taking immunosuppressive medications may be at higher risk. However, reactive arthritis can affect anyone who encounters the triggering bacteria, regardless of their overall health status.

What are the Possible Complications of Reactive Arthritis?

Most people with reactive arthritis recover completely without lasting problems. However, understanding potential complications can help you recognize when to seek additional medical care.

The most common complications include:

• Chronic arthritis that persists for months or years
• Recurrent episodes of joint inflammation
• Permanent joint damage if left untreated
• Chronic eye inflammation that could affect vision
• Persistent back pain and stiffness

Serious complications are rare but can include heart problems like aortic valve inflammation or rhythm abnormalities. Some people might develop lung inflammation or neurological complications, though these occur in less than 5% of cases.

The good news is that with proper treatment, most complications can be prevented or managed effectively. Regular follow-up with your healthcare provider helps catch any developing problems early when they're most treatable.

How Can Reactive Arthritis be Prevented?

Preventing reactive arthritis focuses on avoiding the infections that trigger it. While you can't completely eliminate your risk, several strategies can significantly reduce your chances of developing this condition.

Practice safe sex by using condoms and getting regular STI screenings. If you're sexually active with multiple partners, discuss testing schedules with your healthcare provider to catch and treat infections before they can trigger reactive arthritis.

Food safety is equally important for preventing gastrointestinal infections. Cook meat thoroughly, wash fruits and vegetables, avoid cross-contamination in your kitchen, and be cautious with food from questionable sources when traveling.

If you do develop a bacterial infection, complete your entire course of antibiotics as prescribed. This ensures the infection is fully cleared and may reduce the risk of your immune system developing the prolonged response that leads to reactive arthritis.

How is Reactive Arthritis Diagnosed?

Diagnosing reactive arthritis involves piecing together your recent infection history with your current symptoms. Your doctor will ask detailed questions about any infections you've had in the past few months, including stomach bugs or sexually transmitted infections.

Your doctor will perform a physical examination, checking for joint swelling, tenderness, and range of motion. They'll also examine your eyes, skin, and genital area for signs of inflammation that commonly accompany reactive arthritis.

Blood tests can help support the diagnosis by checking for inflammation markers and the HLA-B27 gene. However, no single test definitively diagnoses reactive arthritis, so your doctor relies on the combination of symptoms, timing, and test results.

In some cases, your doctor might test fluid from swollen joints or order imaging studies like X-rays or MRI scans. These tests help rule out other types of arthritis and assess the extent of joint inflammation.

What is the Treatment for Reactive Arthritis?

Treatment for reactive arthritis focuses on reducing inflammation and managing symptoms while your immune system settles down. Most people start feeling better within a few weeks to months with appropriate treatment.

Your doctor will likely start with anti-inflammatory medications like ibuprofen or naproxen to reduce joint pain and swelling. These medications work well for most people and have fewer side effects than stronger options.

If over-the-counter medications aren't sufficient, your doctor might prescribe stronger anti-inflammatory drugs or disease-modifying medications. Sulfasalazine is commonly used for reactive arthritis and can help prevent joint damage in chronic cases.

For severe or persistent cases, your doctor might recommend injections of corticosteroids directly into affected joints. In rare situations where the condition becomes chronic and doesn't respond to other treatments, biological medications that target specific parts of the immune system might be considered.

If you still have an active infection, treating it with appropriate antibiotics is crucial, even though the antibiotics won't directly cure the reactive arthritis. Physical therapy can also help maintain joint flexibility and strength during recovery.

How to Take Home Treatment During Reactive Arthritis?

Managing reactive arthritis at home involves balancing rest with gentle activity to keep your joints moving. You can take several steps to support your recovery and ease discomfort while your body heals.

Apply ice packs to swollen joints for 15-20 minutes several times daily to reduce inflammation and pain. Heat can also help with stiffness, so try warm baths or heating pads when your joints feel tight rather than swollen.

Gentle exercises like walking, swimming, or stretching can help maintain joint flexibility without putting too much stress on inflamed areas. Listen to your body and rest when you need to, but try to avoid complete immobility which can make stiffness worse.

Take your anti-inflammatory medications with food to reduce stomach irritation, and stick to the schedule your doctor recommends. Good sleep and stress management also support your immune system's recovery process.

How Should You Prepare for Your Doctor Appointment?

Coming prepared to your appointment helps your doctor make an accurate diagnosis and develop the best treatment plan. Gathering information beforehand can save time and ensure you don't forget important details.

Write down all your symptoms, including when they started and how they've changed over time. Be specific about which joints hurt, when the pain is worst, and what makes it better or worse.

Make a list of any infections you've had in the past 6 months, including stomach bugs, sexually transmitted infections, or even minor illnesses. Include any antibiotics you've taken and whether you completed the full course.

Bring a list of all medications and supplements you're currently taking, including over-the-counter pain relievers. Also, prepare questions about your condition, treatment options, and what to expect during recovery.

What's the Key Takeaway About Reactive Arthritis?

Reactive arthritis is your body's immune response gone a bit overboard after fighting an infection. While it can be uncomfortable and concerning, most people recover completely with proper treatment and time.

The key to managing reactive arthritis successfully is early recognition and appropriate treatment. If you develop joint pain and swelling within weeks of an infection, don't hesitate to contact your healthcare provider for evaluation.

Remember that reactive arthritis is treatable, and with the right approach, you can expect to return to your normal activities. Stay committed to your treatment plan, practice good infection prevention, and maintain open communication with your healthcare team throughout your recovery.