Reactive arthritis, also known as Reiter’s syndrome, is a type of inflammatory arthritis that occurs as a reaction to an infection elsewhere in the body. This condition can affect the joints, eyes, and urinary tract, leading to a range of painful and disruptive symptoms.
What is Reactive Arthritis?
Reactive arthritis is an autoimmune condition that develops in response to an infection, typically in the gastrointestinal or genitourinary tract. It is the inflammation of the joints, eyes, and sometimes the urinary tract. The condition is most common in young adults and can be triggered by bacterial infections, such as those caused by Chlamydia trachomatis, Salmonella, Shigella, Yersinia, or Campylobacter.
Symptoms of Reactive Arthritis
The symptoms of reactive arthritis usually appear within 1 to 4 weeks after the initial infection. They can vary in severity and may include:
Joint Pain and Swelling
- Peripheral Arthritis – Pain and swelling in the knees, ankles, feet, and wrists. Joints on one side of the body may be more affected than the other.
- Enthesitis – Inflammation at the sites where tendons or ligaments attach to bone, such as the Achilles tendon, leading to pain and tenderness.
Eye Inflammation
- Conjunctivitis – Redness, pain, and irritation in the eyes.
- Uveitis – More severe inflammation inside the eye, causing redness, pain, light sensitivity, and blurred vision.
Urinary and Genital Symptoms
- Urethritis – Inflammation of the urethra, leading to pain or discomfort during urination, and discharge.
- Cervicitis – Inflammation of the cervix in women, causing pelvic pain and vaginal discharge.
Skin and Mucous Membrane Symptoms
- Skin Rashes – Red, scaly, or pustular rashes, particularly on the palms and soles.
- Mouth Ulcers – Painless sores or ulcers in the mouth.
General Symptoms
- Fatigue – Persistent tiredness and lack of energy.
- Fever – Mild fever and general malaise.
Causes and Risk Factors
Reactive arthritis is triggered by an infection, but not everyone who experiences an infection will develop the condition. Several factors can increase the risk:
- HLA-B27 Gene – A significant genetic marker associated with an increased risk of developing reactive arthritis. About 60-80% of individuals with reactive arthritis carry the HLA-B27 gene.
- Bacterial Infections – Gastrointestinal infections caused by bacteria like Salmonella, Shigella, Yersinia, and Campylobacter, or genitourinary infections caused by Chlamydia trachomatis, can trigger reactive arthritis.
- Autoimmunity – The body’s immune system may mistakenly attack its tissues after an infection, leading to inflammation.
Diagnosis for Reactive Arthritis
Diagnosing reactive arthritis involves a combination of medical history, physical examination, and diagnostic tests:
- Symptom Inquiry – Your doctor will ask about your symptoms, their onset, duration, and any recent infections or illnesses, as well as your family history of arthritis or autoimmune conditions.
- Joint and Eye Assessment – Examining the affected joints for signs of inflammation, tenderness, and reduced range of motion, as well as checking for eye inflammation.
- Blood Tests – To check for markers of inflammation (e.g., C-reactive protein, erythrocyte sedimentation rate) and the presence of the HLA-B27 gene.
- Infection Screening – Testing for bacterial infections that may have triggered the condition, such as Chlamydia or gastrointestinal pathogens.
- X-Rays – To detect joint damage or signs of enthesitis.
- MRI or Ultrasound – To provide detailed images of the joints and soft tissues, helping to identify inflammation that may not be visible on X-rays.
Reactive Arthritis Treatment Options
The goal of treating reactive arthritis is to reduce pain, inflammation, and manage the underlying infection. Treatment options include:
Medications
- Antibiotics – To treat the underlying infection if it is still present.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – To reduce pain and inflammation.
- Corticosteroids – Oral or injectable steroids to provide rapid relief of severe inflammation and pain.
- Disease-Modifying Antirheumatic Drugs (DMARDs) – Such as sulfasalazine or methotrexate to control inflammation in persistent cases.
- Biologic Therapies – TNF inhibitors (e.g., etanercept, adalimumab) for patients who do not respond to traditional DMARDs.
Physical Therapy
- Exercise – Engaging in regular, low-impact exercises to maintain joint flexibility and strength.
- Joint Protection – Learning techniques to protect the joints during daily activities to prevent further injury.
Lifestyle Modifications
- Healthy Diet – Maintaining a balanced diet to support overall health and reduce inflammation.
- Weight Management – Achieving and maintaining a healthy weight to reduce stress on the joints.
Managing and Preventing Reactive Arthritis
Managing and preventing reactive arthritis involves a combination of medical treatment, lifestyle changes, and self-care strategies. Here are some tips:
- Follow Prescriptions – Take medications as prescribed by your doctor to control inflammation and prevent flare-ups.
- Stay Active – Engage in regular, low-impact exercises such as swimming, walking, or yoga to maintain joint function and overall health.
- Balanced Nutrition – Eating a balanced diet rich in fruits, vegetables, and whole grains to support overall health and potentially reduce inflammation.
- Maintain Healthy Weight – Achieving and maintaining a healthy weight to reduce stress on the joints and lower the risk of arthritis flare-ups.
- Reduce Stress – Practicing stress-reduction techniques such as meditation, deep breathing exercises, and mindfulness to help manage symptoms.
- Monitor Progress – Regular visits to your healthcare provider to monitor the progression of the disease, adjust treatment as needed, and manage any complications.
Reactive arthritis is a type of arthritis that can cause significant pain and discomfort, often triggered by a preceding infection. However, with the right knowledge, treatment, and management strategies, individuals can effectively manage their symptoms, reduce inflammation, and maintain an active and fulfilling life. If you suspect you have reactive arthritis, it’s important to seek medical advice early to manage symptoms and prevent joint damage. By staying informed, adhering to treatment plans, and making healthy lifestyle choices, you can take control of your condition and live well with reactive arthritis.
