Reactive arthritis

Reactive arthritis is where your joints become sore and swollen after you've had an infection. It usually goes away within 6 months, but it can last longer.

Symptoms of reactive arthritis

The symptoms of reactive arthritis usually start around 1 to 4 weeks after an infection, such as food poisoning or a sexually transmitted infection (STI).

Common symptoms of reactive arthritis include:

• sore, stiff and swollen joints
• skin around painful joints might feel hot and look red (but redness can be harder to see on black and brown skin)
• feeling very tired

It usually affects knees and feet, but your hands, elbows, spine and tendons around joints might also be affected.

Other symptoms can include:

• mouth ulcers
• pain when peeing
• flaky skin, usually on your soles or palms, which might have yellow pus underneath
• a grey or white patchy rash on your penis
• sticky, watery eyes (conjunctivitis)
• sore, red eyes with sensitivity to light and blurry vision

See a GP if:

• you have swollen, painful joints, which is unusual for you

How reactive arthritis is diagnosed

Reactive arthritis can be difficult to diagnose because several other conditions can have the same symptoms.

You'll usually need a range of tests to find out what's causing your symptoms.

Tests might include:

• a blood test
• tests on a sample of your pee or a swab of your genitals
• tests on a small amount of fluid removed from a painful joint using a needle (needle biopsy)
• an X-ray, MRI or ultrasound scan

You might be referred to a doctor who specialises in joints and inflammation (a rheumatologist) for tests and treatment.

If reactive arthritis is affecting your eyes, you might also be treated by an eye specialist (ophthalmologist). If it's affecting your skin, you might also see a skin specialist (dermatologist).

Treatment for reactive arthritis

Treatment for reactive arthritis might include:

• medicines that reduce inflammation, such as NSAIDs (non-steroidal anti-inflammatory drugs) or steroids
• DMARDs (disease-modifying anti-rheumatic drugs) or biological therapies which reduce inflammation by changing the way your immune system works
• physical therapy, such as physiotherapy
• antibiotics, if you still have the infection that may have caused the reactive arthritis

Reactive arthritis usually goes away after 6 months. For some people it can come back, or lead to another type of arthritis which needs long-term treatment, such as osteoarthritis or ankylosing spondylitis.

Things you can try to help reactive arthritis

There are things you can do to ease the symptoms of reactive arthritis.

Do

• get plenty of rest, but try to move around every day to stop your joints getting stiff

• do stretching and strengthening exercises when your joints are not swollen

• use cold packs, wrapped in a towel, on sore, swollen joints

• use heat packs, wrapped in a towel, on sore, stiff muscles

• take painkillers that are recommended by your doctor

• follow your care team's advice on what do to if joint pain suddenly gets worse (a flare-up)

Causes of reactive arthritis

Reactive arthritis can happen after having an infection that's usually in your stomach (such as food poisoning), or a sexually transmitted infection (STI), such as chlamydia.

Your joints later become swollen because your immune system begins to attack them by mistake.

If the infection that causes reactive arthritis was very mild, you might not remember having it before your joint pain began.