What Should You Know About Reactive Arthritis?

Reactive arthritis involves painful swelling in the joints that is caused by an infection in another part of the body, most often the urinary tract, genitals or intestines. The joints in the knees, ankles and feet are typically the prime target for the disease. It’s common for the inflammation to affect the skin, eyes and urethra as well.

What Causes The Disease?

This bacteria induced arthritis is the result of an infection that distorts the body’s defenses and genetic environment. It is not known how these factors play into how someone develops reactive arthritis, but it is a focus of ongoing research.

What Are The Symptoms Of Reactive Arthritis?

Normally, within one to three weeks after exposure to a triggering infection, the signs and symptoms of reactive arthritis will appear. They may include the following:

• Stiffness and discomfort: The joint pain that is associated with reactive arthritis happens most often in the feet, knees and ankles. A person could also experience pain in the lower back, buttocks and/or heels (balls of feet).
• Swelling in fingers and/or toes: In some instances, a person’s fingers or toes could become so swollen that they appear like stuffed sausages.
• Urinary difficulties: It is common to have increased urinary output and discomfort during urination, because the disease can cause an inflammation in the cervix or prostate gland.
• Eye inflammation: A lot of people with reactive arthritis develop conjunctivitis, which is an inflammation of the eyes.

What Kind of Bacteria Can Cause It?

Usually, the symptoms of reactive arthritis will begin within two to four weeks after an infection. The bacteria most commonly associated with the disease is chlamydia trachomatis which is usually acquired through sexual contact with an infected person. Some evidence has also shown respiratory infections due to chlamydia pneumoniae may also trigger reactive arthritis.

Physicians do not know exactly why some individuals exposed to these bacteria’s will develop reactive arthritis and others do not, but they have identified a genetic factor the human leukocyte antigen HLA B27, which can increase a person’s risk factors. However, inheriting this gene does not necessarily mean the disease will occur.

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How Is Reactive Arthritis Diagnosed?

Sometimes it can be very hard for a doctor to diagnose reactive arthritis because there is no specific scientific or laboratory test to confirm it is what a person has. A physician may order a blood test to detect the genetic factor HLA B27, but even if this result is positive, the presence of the gene alone does not mean the person has the disease.

Reactive Arthritis: What Else Happens During A Doctor Visit?

At the start of an exam, a doctor will more than likely take a complete medical history and take down a person’s symptoms, as well as note any infections or previous medical issues. Before and after a doctor’s visit, it is sometimes helpful for a patient to keep a record of symptoms that occur, when they occur and how long they last. It is particularly important for a person to report any flu-like symptoms like diarrhea, vomiting and fever, because these issues could be evidence of a bacterial infection.

Some doctors might order an HLA B27 test, while other physicians may order antinuclear antibody testing or a rheumatoid factor test to see if a person has arthritis. Most individuals with reactive arthritis will come up negative when tested, and even if the results are positive, it may be related to some other type of arthritis or rheumatic disorder.

What Type Of Physician Treats Reactive Arthritis?

A person who has reactive arthritis will more than likely need to see several types of physicians because the disease attacks different parts of the body. However, it may be a good idea to have a rheumatologist because this is a specialist that can coordinate treatments and monitor the side effects of different medications a person may need to take. Other physicians that a person may need include:

• Physiatrist: to manage and supervise exercise regimens
• Ophthalmologist: to treat diseases of the eyes
• Orthopedist: to perform surgery on badly damaged joints
• Gynecologist: to treat genital symptoms in women
• Urologist: to treat genital issues in males and females
• Dermatologist: to treat skin symptoms and issues

How is Reactive Arthritis Treated?

Although there is no cure for reactive arthritis, there are many ways of treating the symptoms and giving a person some relief from the pain. A physician could recommend one or more of the following treatments:

• Early stage: The early stages of inflammation can be treated with nonsteroidal anti-inflammatory medications. These medicines will stop pain and swelling and the exact dose recommended will vary from patient to patient.
• Late stage: Chronic reactive arthritis could require treatment using antirheumatic drugs such as methotrexate or sulfasalazine. Sulfasalazine may be more beneficial when this disease is triggered by a gastrointestinal infection. In some situations, joint inflammation may benefit from corticosteroid infection.

Prognosis

While there is no cure for reactive arthritis, most patients find relief of the painful symptoms through a combination of different treatments. Physical therapy, nonsteroidal anti-inflammatory medications and cortisone injections can be helpful for painful joints and tendons and fascial inflammation. People with reactive arthritis usually do not require hospitalization, but inpatient care may be necessary for those who are unable to manage oral administration of medications.

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No dietary changes are necessary, unless a person is receiving steroidal therapy. Physical therapy may be helpful at relieving pain in many instances, but the symptoms of reactive arthritis will usually inhibit someone’s activities to some extent.