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Symptoms of Reactive Arthritis (Reiter’s Syndrome)

Posted on February 22, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sarah Winfrey

Reactive arthritis — previously known as Reiter’s syndrome — is a type of inflammatory arthritis caused by exposure to certain bacteria, including chlamydia trachomatis, salmonella, shigella, yersinia, campylobacter, and more. This bacterial infection usually causes symptoms in the genitals, urinary tract, or intestines. It is often contracted via sexually transmitted infection (like chlamydia) or by ingesting spoiled food.

Understanding the characteristic symptoms of reactive arthritis can be useful. If you experience any of them, you should speak with your doctor. Ultimately, they will be the one to diagnose the condition, taking into account your signs and symptoms, as well as the results of any necessary lab tests, like X-rays and blood tests.

Common Symptoms of Reactive Arthritis

Reactive arthritis symptoms usually begin between one and four weeks after exposure to the infection that triggers it. Most people diagnosed with reactive arthritis find that their symptoms come and go and usually disappear within a year of onset. However, some people experience symptoms longer than that. In fact, in a small number of cases, reactive arthritis may become a chronic condition.

People with reactive arthritis may experience the following symptoms. Keep in mind that some of these symptoms are also shared by other conditions, including rheumatoid arthritis and psoriatic arthritis — two other forms of inflammatory arthritis.

Joint Pain and Stiffness

People diagnosed with reactive arthritis usually have pain and stiffness in the joints of their knees, feet, and ankles. In some people, the affected joints may also include those in the hands, elbows, heels, buttocks, and lower back. This pain often mimics the pain traditionally associated with other types of arthritis.

The pain and stiffness felt in reactive arthritis may be accompanied by redness and swelling, symptoms that often lead a person to go to their doctor. However, these characteristics aren’t always present in reactive arthritis and thus aren’t essential for an accurate diagnosis.

Why spondyloarthritis symptoms differ between women and men:
Read article.

Members of MySpondylitisTeam have shared how the pain, swelling, and stiffness can impact daily life. “I have lost mobility due to reactive arthritis,” one member wrote.

Another member described having “extreme pain and severe inflammation due to reactive arthritis,” as well as difficulty walking and limited mobility in their forearm, wrist, and hand.

Inflammation in the Eyes

Eye inflammation caused by reactive arthritis may involve inflammation of a mucous membrane surrounding the eyeball and eyelid (referred to as conjunctivitis or “pink eye”). It may also involve inflammation in the inner eye (called uveitis). Affected eyes usually appear red and irritated. The swelling often causes pain and can blur the vision, as well.

Urinary Issues

Many people diagnosed with reactive arthritis have significant urinary tract involvement, too. These genitourinary (affecting the genitals and urinary tract) symptoms can come and go before any other symptoms of reactive arthritis are experienced.

In men, symptoms can include:

  • Increased urine output
  • Pain and burning during urination
  • Discharge from the penis
  • Inflamed prostate gland (in only the most severe cases)
  • Small ulcers on the penis

Urinary involvement is less likely for females diagnosed with reactive arthritis. However, women may experience inflammation in the cervix, fallopian tubes, vulva, or vagina. Like men, women may also experience inflammation in the urethra (the opening through which urine passes out of the body), which causes a painful burning sensation when urinating.

Soft Tissue Inflammation

Reactive arthritis is associated with a certain kind of inflammation in the soft tissue, right where the tissue enters into a bone. This inflammation, referred to as enthesitis, can occur in the muscles, ligaments, or tendons (muscles used to hold the bones together). The presence of enthesitis may indicate that a person has a genetic marker for the condition, called the HLA-B27 genetic marker.

Tendonitis, or inflammation of a tendon, is also common in those diagnosed with reactive arthritis.

Swollen Toes and Fingers

Some people with reactive arthritis may experience swelling in their toes and fingers. These digits may even become so swollen that they resemble sausages.

Lower Back Pain

Spondylitis — inflammation in the spine — often develops in those diagnosed with reactive arthritis. This can cause significant pain throughout the spinal area, though most people with the condition experience lower back pain. This pain is often worse at night, in the morning, or at both times. Sacroiliitis (inflammation of the sacroiliac joint) may also cause lower back pain.

New Skin Problems

Reactive arthritis can cause several skin problems. People with reactive arthritis may experience rashes, especially on the palms of their hands and the soles of their feet. These rashes may sometimes be mistaken for the skin condition psoriasis, especially if they are given time to become severe before a person seeks a diagnosis. In addition to rashes, reactive arthritis may also cause some people to develop mouth sores.

Heel Spurs

People diagnosed with reactive arthritis may experience painful heel spurs more often than the general population. Heel spurs are bony growths on the heel that may develop after episodes of enthesitis. The heel spurs may persist long after the reactive arthritis bout is over, causing chronic pain. It’s important to keep in mind that there are many causes of heel spurs, so their presence alone is not enough to diagnose reactive arthritis.

Treatments for Reactive Arthritis

Regardless of which symptoms you have, you should seek out a health care provider’s advice as soon as possible if you believe you have reactive arthritis. Your doctor will diagnose you properly, then help you seek out the treatments you need to manage the condition until your symptoms subside.

There are many treatments available for reactive arthritis. Your doctor will help you find the best treatment for you based on your symptoms and your medical history.

  • Antibiotics — If your reactive arthritis was triggered by a bacterial infection and you seem to be experiencing a persistent infection, your doctor may prescribe antibiotics.
  • Over-the-counter and prescription pain relievers — Nonsteroidal anti-inflammatory drugs, commonly referred to as NSAIDs, can help relieve pain and inflammation caused by reactive arthritis. They include ibuprofen — such as Advil or Motrin — as well as Indocin (indomethacin).
  • Steroid creams and injections Corticosteroids can be injected directly into the affected joints to reduce inflammation and increase mobility. Topical steroids may be used for skin rashes caused by reactive arthritis.
  • Drugs for rheumatoid arthritis — Evidence has suggested that antirheumatic drugs, including Trexall (methotrexate) and Enbrel (etanercept), can help relieve symptoms like joint pain and stiffness in some people with reactive arthritis.

Get Support Today

MySpondylitisTeam is the social network for people with spondylitis and reactive arthritis. Join MySpondylitisTeam today to ask questions, give advice, and connect with others who understand life with the symptoms of reactive arthritis.

What symptoms have you experienced with reactive arthritis? Share your story in the comments below, or start a conversation on MySpondylitisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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