Reactive arthritis
What is Reactive arthritis?
Reactive arthritis is a condition where your immune system attacks your own joints and tissues after an infection. The infection itself may be gone, but your body keeps fighting. This causes inflammation in your joints, eyes, and urinary tract.
The condition usually develops 1 to 4 weeks after a bacterial infection. Common triggers include gastrointestinal infections from food poisoning or sexually transmitted infections like Chlamydia. Most people recover within 3 to 12 months, but some experience ongoing symptoms.
Reactive arthritis is rare, affecting about 1 to 3 people per 100,000 each year. It most often occurs in adults between ages 20 and 40. Men and women are equally affected, though men are more likely to develop it after sexually transmitted infections.
Symptoms
- Joint pain and swelling, especially in knees, ankles, and feet
- Lower back pain and stiffness, particularly in the morning
- Heel pain or inflammation of the Achilles tendon
- Eye redness, pain, or blurred vision
- Painful urination or increased urinary frequency
- Skin rashes or mouth sores
- Inflammation of fingers or toes, making them appear sausage-like
- Fatigue and fever
Some people experience mild symptoms that resolve quickly. Others may develop severe joint inflammation that lasts for months. Symptoms typically appear in the order of urinary or digestive issues first, followed by joint and eye problems.
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Causes and risk factors
Reactive arthritis is triggered by bacterial infections in other parts of your body. The most common triggers are sexually transmitted infections like Chlamydia or gastrointestinal infections from bacteria such as Salmonella, Shigella, Campylobacter, or Yersinia. Your immune system responds to these infections by creating inflammation that mistakenly targets your own tissues.
Certain genetic factors increase your risk. People who carry the HLA-B27 gene are more likely to develop reactive arthritis and tend to have more severe or longer-lasting symptoms. Having a family history of reactive arthritis or related conditions like ankylosing spondylitis also raises your risk. Men are more likely to develop reactive arthritis after sexually transmitted infections, while gastrointestinal infections affect men and women equally.
How it's diagnosed
Doctors diagnose reactive arthritis through a combination of your medical history, physical exam, and laboratory tests. Your doctor will ask about recent infections, particularly digestive illnesses or sexually transmitted infections in the past month. They will examine your joints, eyes, skin, and check for inflammation.
Blood tests and urogenital swabs help identify the triggering infection. Rite Aid offers testing for Chlamydia Trachomatis, one of the most common triggers of reactive arthritis. Your doctor may also order tests to check for inflammatory markers like C-reactive protein and erythrocyte sedimentation rate. Joint fluid analysis and imaging studies like X-rays or MRI may be needed to rule out other types of arthritis.
Treatment options
- Nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen to reduce pain and swelling
- Corticosteroid injections directly into affected joints for severe inflammation
- Antibiotics to treat underlying bacterial infections like Chlamydia
- Disease-modifying antirheumatic drugs for persistent or severe cases
- Physical therapy to maintain joint flexibility and muscle strength
- Rest and ice application during flare-ups
- Eye drops for conjunctivitis or medications for more serious eye inflammation
- Proper sexual health practices to prevent sexually transmitted infections
- Food safety measures to avoid gastrointestinal infections
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Frequently asked questions
Reactive arthritis is caused by your immune system overreacting to a bacterial infection elsewhere in your body. The most common triggers are sexually transmitted infections like Chlamydia and gastrointestinal infections from contaminated food or water. Your body continues to produce inflammation even after the original infection is gone.
Most people recover from reactive arthritis within 3 to 12 months. Symptoms typically improve gradually over this period. However, about 15 to 30 percent of people experience chronic symptoms or recurring episodes that last longer than a year.
There is no cure for reactive arthritis, but most cases resolve on their own within a year. Treatment focuses on managing symptoms and treating the underlying infection if still present. Some people experience complete recovery with no lasting joint damage, while others may have occasional flare-ups.
Reactive arthritis itself is not contagious. However, the infections that trigger it can be spread from person to person. Chlamydia is transmitted through sexual contact, while gastrointestinal bacteria spread through contaminated food or water.
Diagnosis involves testing for the triggering infection through blood tests, urine tests, or urogenital swabs. Your doctor may test for Chlamydia, stool cultures for gastrointestinal bacteria, and blood tests for inflammatory markers. Joint fluid analysis or imaging studies may be needed to rule out other conditions.
You can reduce your risk by preventing the infections that trigger it. Practice safe sex to avoid sexually transmitted infections like Chlamydia. Follow proper food safety guidelines, including thoroughly cooking meat and washing fruits and vegetables, to prevent gastrointestinal infections.
Yes, reactive arthritis commonly affects the eyes. About 20 to 40 percent of people develop conjunctivitis, which causes redness and irritation. Some develop more serious eye inflammation called uveitis, which can cause pain, blurred vision, and sensitivity to light and requires immediate medical attention.
Reactive arthritis is triggered by an infection and usually resolves within months to a year. Rheumatoid arthritis is an autoimmune disease that is chronic and progressive, typically affecting both sides of the body symmetrically. Reactive arthritis often affects larger joints in the lower body, while rheumatoid arthritis commonly starts in smaller joints.
Reactive arthritis most commonly affects adults between ages 20 and 40. People who carry the HLA-B27 gene have a higher risk and may experience more severe symptoms. Men are more likely to develop reactive arthritis after sexually transmitted infections, while gastrointestinal infections affect both sexes equally.
Yes, you should see a doctor if you develop joint pain, swelling, or stiffness within a few weeks of having an infection. Early diagnosis and treatment can help manage symptoms and prevent complications. Seek immediate care if you have severe eye pain, vision changes, or intense joint inflammation.