Reactive Arthritis (ReA): Symptoms, Causes & Treatment

Reactive arthritis (ReA) is an inflammatory condition that develops after certain infections. It usually affects the joints, and the eyes and skin may also be involved. It can also affect the urinary system and tendons. The joint inflammation is a reaction to an infection elsewhere in the body, not a direct infection of the joint itself.

The condition typically causes sudden joint pain, often without an obvious cause. At Njinsky Medical Centre, we understand this condition and offer the most effective treatments to patients. This brief guide is designed to help you understand this post-infectious condition. Read on to learn more about ReA and how to get the right treatment if needed.

Defining ReA in Medical Terms

It is a type of inflammatory arthritis that occurs after an infection. By the time joint symptoms appear, the infection has often already cleared, which can make the condition hard to diagnose. Certain gastrointestinal infections and sexually transmitted infections are common triggers of ReA. Besides infection, genetic factors (particularly the HLA-B27 gene) and environmental factors may also influence susceptibility to the condition. When inflammation affects the sites where tendons and ligaments attach to bone, the condition is called enthesitis, which can cause significant heel or foot pain. ReA most commonly affects the following parts of the body:

•         Knees
•         Ankles
•         Feet
•         Lower limb joints

Common Causes and Triggers

The following infections are the most common triggers of ReA:

• Chlamydia trachomatis
• Salmonella
• Shigella
• Campylobacter
• Yersinia
• Certain other gastrointestinal bacteria
• Some urinary or genital infections

Reactive Arthritis Symptoms

Reactive arthritis symptoms can vary considerably from person to person. The most common symptoms include:

The Professional Way to Diagnose ReA

1. Medical history
   The doctor may ask about recent diarrhoea, abdominal illness, urinary symptoms, genital symptoms, or other infections.
2. Joint examination
   The doctor examines the joints for swelling and tenderness to assess inflammation and any restriction in movement.
3. Blood tests
   ESR and CRP may help identify inflammation. They are not specific to reactive arthritis.
4. HLA-B27 testing
   This may provide additional information but cannot confirm or exclude reactive arthritis.
5. Infection testing
   Stool, urine, or sexually transmitted infection testing may be considered when clinically appropriate.
6. Joint fluid analysis
   Fluid may be removed from a swollen joint to help exclude infection or crystal arthritis.
7. Imaging
   X-rays and ultrasound may be used depending on the symptoms and clinical findings. A CT scan or MRI may occasionally be needed.

Reactive Arthritis Treatment

The following are the main treatment options for reactive arthritis:

Anti-Inflammatory Medicines

NSAIDs are usually the first-line treatment to relieve pain and inflammation in the joints. The medication and dosage should be tailored to the individual patient’s medical history and risk factors. Long-term or improper use can cause side effects, including stomach irritation and kidney problems.

Corticosteroids

If the inflammation is severe, a corticosteroid may be considered. If a single joint is very swollen or the tendon attachment sites are affected, a steroid injection may be given directly into the area. In more widespread cases, corticosteroids may be taken by mouth. Treatment should be under medical supervision, as corticosteroids can cause important side effects.

Antibiotics

Reactive arthritis results from an immune response to a previous infection, so antibiotics do not treat the joint inflammation itself. However, if an active bacterial infection is still present, antibiotics may be needed to treat it. The choice of antibiotic depends on the infection and should be advised by a qualified healthcare provider.

Disease-Modifying Antirheumatic Drugs (DMARDs)

Medicines that suppress the underlying inflammation may be needed for persistent symptoms. In some patients, sulfasalazine, methotrexate, or other immune-modifying medications might be considered. When symptoms don’t go away with standard treatment, more advanced therapies such as TNF inhibitors might be tried. These medicines must be prescribed and monitored by a doctor. 

Physical Therapy and Exercise

Physical therapy can play an important role in recovery. Chronic inflammation of the joints may decrease mobility and muscle strength. A personalised programme can help keep the joints moving and gradually rebuild strength. Exercise should be modified depending on the patient’s symptoms and state of recovery. Supportive approaches that can be useful might include: 

• Gentle exercises
• Strengthening exercises
• Low-impact physical activity
• Appropriate stretching
• Heat or cold therapy
• Joint-support devices when recommended
• Gradual return to normal activities

Stem Cell Therapy for Arthritis

This advanced treatment option has attracted significant interest as a potential regenerative approach for different musculoskeletal conditions. At Njinsky Medical Centre, we recognise the growing interest in regenerative medicine. Stem cell-based approaches are being studied for their potential to support tissue repair and regulate inflammation. However, stem cell therapy is not an established or approved treatment for reactive arthritis, and current evidence for its use in inflammatory arthritis remains limited and largely experimental. Depending on the arthritis type and treatment approach, potential areas of interest include:

• Supporting tissue repair.
• Modulating inflammation.
• Supporting joint function.
• Managing pain and stiffness.
• Potentially improving quality of life.
• Exploring options for cartilage-related damage.
• Offering personalised treatment assessment.

Explore our Stem Cell Treatment for Arthritis options to learn more.

Wrapping Up the Whole Discussion

Arthritis care should begin with an understanding of the individual patient. ReA may persist differently from one person to another. At Njinsky Medical Centre, we make a careful assessment to distinguish it from other causes of joint inflammation. The experts’ approach is centered on appropriate diagnosis and effective ongoing patient care.

If you are experiencing persistent joint pain and swelling along with heel pain and stiffness, don’t ignore these signs. Approach healthcare professionals without any delay. Connect with the experts at Njinsky Medical Centre. Share your symptoms and get the most advanced and effective treatment for the disease.

The Most Common Queries

Can ReA become chronic?