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What is reactive arthritis?

Reactive arthritis is a disorder that causes three seemingly unrelated symptoms: arthritis, eye redness and urinary tract problems.

Doctors sometimes call reactive arthritis spondyloarthropathy or seronegative arthropathy because it is one of a group of diseases that cause inflammation throughout the body, particularly in parts of the spine and other joints where tendons connect to b
ones.

Examples of other seronegative spondyloarthropathies include psoriatic arthritis, ankylosing spondylitis and inflammatory bowel syndrome.

The main features of reactive arthritis are inflammation of the joints, eyes, and ulceration of the skin and mouth.

What is the cause?

Reactive arthritis may develop in some people after an infection in the intestines or the genital or urinary tracts. When the primary condition is identified, symptoms of reactive arthritis appear 1 to 3 weeks later.

Bacteria commonly associated with this condition are Chlamydia, Salmonella, Shigella, Yersinia and Campylobacter.

Doctors do not know precisely why some people exposed to these bacteria develop this condition, and others do not. Still, they have identified a genetic factor (HLA-B27) that increases the risk of developing this disease.

About 80% of people with reactive arthritis are HLA-B27 positive. Only 6% of people who do not have this syndrome have this gene.

What are the symptoms?

Symptoms can affect many different parts of the body but mainly affect the urogenital tract, joints, and eyes. Less common symptoms include mouth ulcerations, skin rashes, and heart valve problems.

Symptoms may be so mild that patients do not notice them. These signs may come and go for several weeks or months.

Symptoms May Include:

Urogenital tract

Males may notice an increased need to urinate, a burning sensation when urinating, and a discharge from the penis. Some men may develop prostatitis (inflammation of the prostate).

Women with reactive arthritis may also show symptoms in the urogenital tract, such as inflammation of the cervix (cervicitis) or the urethra (urethritis), which may cause a burning sensation during urination.

In addition, some women may also develop salpingitis (inflammation of the fallopian tubes) or vulvovaginitis (inflammation of the vulva and vagina). These conditions may or may not cause symptoms.

Joints

Reactive arthritis typically affects knees, ankles and feet, causing pain and swelling. Wrists, fingers and other joints are less affected. People with reactive arthritis commonly show inflammation where tendons connect to bones, a condition called enthesopathy.

This can result in heel pain and shortening and thickening of the fingers. Some people with reactive arthritis also develop spurs and other growths on the bones of the feet that can cause chronic or long-lasting pain.

Eyes

Conjunctivitis, an inflammation of the mucous membrane covering the eye and eyelid, occurs in 50% of people with urogenital reactive arthritis and 75% of people with intestinal reactive arthritis. Some people may have uveitis, internal inflammation of the eye.

Conjunctivitis and uveitis can cause eye redness, eye pain and irritation, and blurred vision. The eyes are usually affected early in the disease, and symptoms may come and go.

Who is at risk?

Men between the ages of 20 and 40 are at the most significant risk for the disease. It is the most common type of arthritis affecting young men.

Among men under 50, 3.5 out of every 100,000 develop reactive arthritis each year. Three per cent of all men with venereal disease develop reactive arthritis.

Women may also present with this condition, although less frequently and with less severe characteristics.

The importance of lifestyle

While topical pain relievers can help ease the pain of arthritis, the health choices you make throughout your life will go a long way toward successfully managing OA.

Incorporating three types of exercise into your life can improve your overall fitness and health. Expressly, exercising can relieve pain, give you more energy, help you sleep better, strengthen your body and heart, as well as boost your self-esteem and sense of well-being.

Gentle, slow stretches can help you improve flexibility, range of motion and prevent joint stiffness. Your doctor or rehabilitation specialist can teach you stretches to do at home.

With your doctor’s approval, you may want to try tai chi or yoga classes. These types of exercise not only encourage flexibility but increase muscle strength and help you relax.

Participating in low-impact aerobic exercise is key to managing arthritis and decreasing pain. Water aerobics, walking and stationary cycling don’t put as much stress on your joints as other aerobic exercise types, but they give you a good workout.

You don’t have to lift weights like a bodybuilder, but doing specific exercises that maintain or increase muscle strength and endurance around the affected joints is essential.

Ask your healthcare provider to design a simple program that quickly becomes part of your daily routine.

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