Reactive Arthritis
What is Reactive Arthritis?
Reactive arthritis is a condition that causes inflammation in your joints, eyes, skin, and urinary tract. It develops as a reaction to an infection in another part of your body. Most commonly, the infection starts in your intestines or urinary tract.
The condition typically affects your knees, ankles, and feet. It usually appears within one to four weeks after the initial infection. Most people recover fully within three to twelve months, though some experience symptoms that last longer or return over time.
Reactive arthritis was previously called Reiter's syndrome. It most often affects adults between 20 and 40 years old. Men and women can both develop this condition, though men are more likely to get it from sexually transmitted infections.
Symptoms
- Joint pain and swelling, especially in knees, ankles, and feet
- Stiffness in joints that worsens in the morning
- Pain and inflammation in the heels or Achilles tendon
- Eye redness, pain, or blurred vision
- Painful urination or increased urge to urinate
- Skin rashes or mouth sores
- Lower back pain and buttock pain
- Swelling of fingers or toes that makes them look like sausages
Some people experience only mild symptoms that come and go. Others may have severe symptoms that affect their daily activities. The symptoms can appear suddenly and may affect multiple parts of the body at once.
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Causes and risk factors
Reactive arthritis develops when your immune system overreacts to an infection elsewhere in your body. The most common trigger infections include food poisoning from bacteria like Salmonella, Shigella, or Campylobacter. Sexually transmitted infections, particularly chlamydia, can also trigger the condition. Your immune system attacks the infection but then mistakenly targets your own tissues, causing inflammation.
People who carry the HLA-B27 gene are at much higher risk of developing reactive arthritis. About 75% of people with reactive arthritis test positive for HLA-B27. However, having this gene does not mean you will definitely develop the condition. Other risk factors include being between 20 and 40 years old and having a family history of reactive arthritis or related conditions.
How it's diagnosed
Your doctor will diagnose reactive arthritis by reviewing your symptoms and medical history, especially recent infections. They will perform a physical exam to check for joint swelling, tenderness, and range of motion. Blood tests can help identify inflammation markers and check for the HLA-B27 antigen, which is present in many people with reactive arthritis.
Additional tests may include checking for signs of recent or current infections through urine tests or swabs. Your doctor might also order joint fluid tests to rule out other forms of arthritis. X-rays or other imaging tests can help assess joint damage. Talk to a doctor about specialized testing options for reactive arthritis and autoimmune markers.
Treatment options
- Nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen to reduce pain and inflammation
- Corticosteroid injections directly into affected joints for severe inflammation
- Antibiotics if an active infection is still present, though they do not treat the arthritis itself
- Disease-modifying antirheumatic drugs for persistent or severe cases
- Physical therapy to maintain joint flexibility and strengthen muscles
- Rest and elevation of affected joints during flare-ups
- Cold or warm compresses to reduce swelling and pain
- Gradual return to normal activity as symptoms improve
- Eye drops or medications if eye inflammation is present
- Anti-inflammatory diet rich in omega-3 fatty acids and vegetables
Frequently asked questions
Reactive arthritis is caused by your immune system's response to an infection in another part of your body. The most common triggers are bacterial infections in your intestines from contaminated food or sexually transmitted infections like chlamydia. Your immune system fights the infection but then mistakenly attacks your joints and other tissues, causing inflammation.
Most people recover from reactive arthritis within three to twelve months. Symptoms often improve gradually over this time. However, about 20% of people experience recurring symptoms or chronic arthritis that lasts longer. Early treatment and physical therapy can help speed recovery and prevent long-term joint damage.
Reactive arthritis itself is not contagious. However, the infections that trigger it can be spread to others. For example, sexually transmitted infections like chlamydia can be passed to partners, and food poisoning bacteria can spread through contaminated food. Once someone develops reactive arthritis, the arthritis itself cannot be transmitted to another person.
HLA-B27 is a protein found on the surface of cells in some people. About 75% of people with reactive arthritis carry this genetic marker. Having HLA-B27 increases your risk of developing reactive arthritis if you get certain infections. However, many people with HLA-B27 never develop any arthritic conditions.
Yes, reactive arthritis commonly affects the eyes in a condition called conjunctivitis or uveitis. Your eyes may become red, painful, and sensitive to light. You might experience blurred vision or excessive tearing. Eye inflammation requires prompt medical attention to prevent complications and preserve your vision.
Focus on reducing foods that promote inflammation, such as processed meats, refined sugars, and fried foods. Some people find relief by limiting dairy products and nightshade vegetables. Eating more anti-inflammatory foods like fatty fish, leafy greens, berries, and nuts may help reduce symptoms. Keep a food journal to identify any personal triggers.
Yes, reactive arthritis can recur in some people. About 15 to 50% of people experience repeated episodes over several years. Recurrences are more likely if you have the HLA-B27 gene or if you get another triggering infection. Taking steps to prevent infections and maintaining overall health can help reduce the risk of future episodes.
Reactive arthritis is triggered by an infection and often resolves within months, while rheumatoid arthritis is a chronic autoimmune disease without a clear trigger. Reactive arthritis typically affects fewer joints and often includes eye and urinary symptoms. Rheumatoid arthritis usually affects multiple small joints symmetrically and requires long-term management.
Gentle exercise is beneficial for reactive arthritis once acute inflammation subsides. Low-impact activities like swimming, walking, and cycling help maintain joint mobility and muscle strength. Physical therapy exercises can prevent stiffness and improve range of motion. Avoid high-impact activities during flare-ups and always listen to your body to prevent injury.
While you cannot eliminate your risk entirely, you can reduce it by preventing trigger infections. Practice safe sex to avoid sexually transmitted infections and use proper food handling to prevent food poisoning. Wash hands frequently and cook meat thoroughly. If you do develop an infection, seek prompt treatment to reduce the chance of triggering reactive arthritis.