About reactive arthritis
Reactive arthritis usually develops after you've had an infection, particularly a sexually transmitted infection or food poisoning.
In most cases, it clears up within a few months and causes no long-term problems.
Men and women of any age can get it. But the condition is more common in men, and people aged between 20 and 40.
Symptoms of reactive arthritis
The symptoms of reactive arthritis usually develop shortly after you get an infection, such as a sexually transmitted infection or bowel infection.
The main, and sometimes only, symptom of reactive arthritis is pain, stiffness and swelling in the joints and tendons.
It can also affect the:
- genital tract
- eyes
Not everyone will get symptoms in these areas.
You should see your GP as soon as possible if you have any of these symptoms. This is especially if you have recently had diarrhoea or problems peeing.
Joint symptoms
Reactive arthritis can affect any joints. But it's most common in the knees, feet, toes, hips and ankles.
Symptoms include:
- pain, tenderness and swelling in your joints
- pain and tenderness in some tendons, especially at the heels
- pain in your lower back and buttocks
- sausage-like swelling of your fingers and toes
- joint stiffness – particularly in the morning
Genital tract symptoms
Sometimes, you can also have symptoms of a urinary tract infection. These include:
- needing to pee suddenly, or more often than usual
- pain or a burning sensation when peeing
- smelly or cloudy pee
- blood in your pee
- pain in your lower tummy
- feeling tired and unwell
Eye symptoms
Occasionally, you may get inflammation of the eyes (conjunctivitis or, rarely, iritis).
Symptoms can include:
- red eyes
- watery eyes
- eye pain
- swollen eyelids
- sensitivity to light
See an eye specialist or go to your nearest emergency department as soon as possible if one of your eyes becomes very painful and the vision becomes misty.
This could be a symptom of iritis – and the sooner you get treatment, the more successful it is likely to be.
Other symptoms
Reactive arthritis can also cause:
- flu-like symptoms
- a high temperature (fever)
- weight loss
- mouth ulcers
- a scaly rash on the hands or feet
When to see your GP
If you have symptoms of reactive arthritis, you should see your GP. This is especially if you have recently had symptoms of an infection – such as diarrhoea, or pain when peeing.
There's no single test for reactive arthritis. Blood and urine tests, genital swabs, ultrasound scans and X-rays may be used to check for infection and rule out other causes of your symptoms.
Your GP will also want to know about your recent medical history, such as whether you may have recently had a bowel infection or an STI.
If you think you might have an STI, you can also visit a local genitourinary medicine (GUM) clinic or other sexual health services. These clinics can often see you straight away, without a GP referral.
Causes of reactive arthritis
Typically, reactive arthritis is caused by a sexually transmitted infection (STI), such as chlamydia, or an infection of the bowel, such as food poisoning.
You may also develop reactive arthritis if you, or someone close to you, has recently had glandular fever or slapped cheek syndrome.
The body's immune system seems to overreact to the infection and starts attacking healthy tissue, causing it to become inflamed. But the exact reason for this is unknown.
People who have a gene called HLA-B27 are much more likely to develop reactive arthritis than those who don't, but it's unclear why.
If your GP thinks you have reactive arthritis, they may refer you to an arthritis specialist (rheumatologist). They may also refer you to an eye specialist (ophthalmologist) if you have problems with your eyes.
Treatment for reactive arthritis
Treatment usually focuses on:
- using antibiotics to clear any STI that may have triggered the reactive arthritis
- using painkillers such as ibuprofen to relieve joint pain and stiffness
- managing any severe or ongoing arthritis, usually using medications such as steroids or disease-modifying anti-rheumatic drugs (DMARDs)
Most people start returning to normal activities after 3 to 6 months. Symptoms don't usually last longer than 12 months.