Do you also have other symptoms along with this type of joint pain? Let's learn about Reactive Arthritis!

Sometimes we can suddenly get joint pain, right? Along with that, other symptoms such as a body ache and red eyes may also appear. You might not even think about it, but this could be a side effect of a minor infection you had before. That's the kind of condition we're going to talk about today, called Reactive Arthritis.

What is Reactive Arthritis?

Simply put, reactive arthritis, sometimes called Reiter's Syndrome, is a temporary condition that causes the joints to swell and become painful. It's caused by a bacterial infection. Imagine that you have a bacterial infection somewhere in your body, perhaps in your urinary tract, genitals, or intestines, and after you've treated it, your immune system reacts in a strange way.

Normally, our immune system fights off infections and kills them. But what happens in this reactive arthritis is that even after the infection is gone, the immune system thinks, "The battle isn't over yet." So it causes inflammation in places where there was no infection, especially in your joints, eyes, and skin. It's like soldiers who are still shooting at each other after a war, but they can't just sit back and wait.

However, like most types of arthritis, this is not a lifelong condition. It often goes away in less than a year. Isn't that a great relief?

What are the symptoms?

Now let's see what symptoms we can expect in this reactive arthritis.

The most important and common symptoms are joint pain and stiffness , especially in the following areas:

• Your lower back is fine.
• Knees
• Ankle
• Feet

But in addition to this, various other symptoms may appear. Let's see what they are:

• Eye redness, swelling, and pain (it may feel like something is in the eye).
• Gastrointestinal symptoms such as stomach ache and diarrhea.
• The need to urinate frequently and feeling pain when urinating.
• Skin rashes and mouth sores .
• Heel pain, possibly Achilles tendinitis .
• Swelling of the fingers, especially the fingers and toes. Some people call this 'sausage fingers' because the finger itself swells up like a sausage.
• Flu-like symptoms such as fever, body aches, and extreme fatigue.

What is this 'Triad'?

Sometimes when doctors talk about reactive arthritis, they talk about a 'triad'. That is, a combination of three symptoms . This helps to quickly identify this disease. The three symptoms are:

1. Arthritis - This means inflammation of the joints.

2. Conjunctivitis - This means inflammation of the eyes, redness of the eyes.

3. Urethritis - This means inflammation of the urethra, burning during urination.

But remember, not everyone has all three of these symptoms at the same time. Some people never have all three at the same time. Different symptoms can come and go. So you may have other symptoms that are not in this 'triad'.

What causes it?

We've already mentioned that reactive arthritis starts with a bacterial infection . This is what can happen most often:

• Urinary Tract Infection (UTI) .
• A sexually transmitted infection (STI) .
• A gastrointestinal infection, such as food poisoning .
• A sore throat .

There are also some specific types of bacteria that can affect this:

• Chlamydia
• Gonorrhea
• Salmonella
• Shigella
• Campylobacter
• Yersinia
• Mycoplasma
• C. difficile
• Streptococcus

Reiter's Syndrome starts a few days or weeks after the initial infection. And it doesn't happen to everyone, only to a small percentage of people who get it. It seems to be caused by the infection triggering an autoimmune response in your immune system. That is, your immune system mistakenly starts attacking healthy parts of your body, causing inflammation.

But fortunately, unlike many autoimmune diseases, reactive arthritis is usually a temporary condition.

Reactive arthritis belongs to a group of inflammatory arthritis called spondyloarthritis. Many of these are autoimmune diseases. Scientists are still not sure why some people develop these diseases and others do not. Reactive arthritis does not require a major, severe infection to develop.

One factor that may influence this is a gene called HLA-B27 . Many people who develop spondyloarthritis and Reiter's syndrome have this gene.

Who is most likely to be affected by this?

Although anyone can develop reactive arthritis, some people are at higher risk of developing it. These include:

• Men under 40 years of age.
• If you have HIV infection .
• If you have another autoimmune disease .
• If you have the previously mentioned HLA-B27 gene in your body.

How do you recognize this?

If you have recently developed symptoms of arthritis, such as joint pain and swelling, you should tell your doctor. He or she will examine you. When certain symptoms come together, your doctor may suspect reactive arthritis. In particular, he or she will ask if you have recently recovered from an infection that could have caused it.

Various tests may be required to accurately diagnose this disease. For example:

• X-ray examinations.
• CT scan (Computed Tomography - CT scan) .
• MRI (Magnetic Resonance Imaging - MRI) scan.
• Joint aspiration/arthrocentesis: This is done to check for inflammation and other infections inside the joint.
• Taking a throat culture (if a throat infection is suspected).
• Urinalysis .
• Blood tests : These can check for inflammation, the presence of the HLA-B27 gene, and other infections.

How is it treated?

Doctors may recommend various treatments for reactive arthritis.

• Antibiotics: Depending on the underlying infection and whether it is still active, antibiotics such as doxycycline and rifampin may be prescribed. These can help stop or speed up the healing of reactive arthritis.
• NSAIDs (Nonsteroidal anti-inflammatory drugs): These are nonsteroidal anti- inflammatory drugs. A strong NSAID such as Indomethacin can be given in high doses temporarily. The dose is reduced when symptoms subside.
• DMARDs (Disease-modifying anti-rheumatic drugs): DMARDs, such as sulfasalazine, treat inflammatory arthritis by suppressing some of the activity of your immune system. These may help if NSAIDs are not well controlled.
• Corticosteroids:These are powerful anti-inflammatory drugs. Although oral steroids do not provide much benefit for most people with Reiter's Syndrome, they can sometimes be applied to the skin as creams or given as an injection directly into a painful joint.

Important: All of these treatments should be taken only under medical advice. Self-medication can make the condition worse.

Can this be cured completely?

Most of the time, Reiter's Syndrome is 'self-limited' . This means that it will resolve on its own over time (usually within 3 to 12 months). In the meantime, treatment can help control symptoms and help you recover more quickly.

However, because reactive arthritis is an autoimmune disorder, no autoimmune disease can truly be 'cured.' This means that there is always a chance that symptoms will return. For example, if you get another infection.

In a very small number of people, Reiter's syndrome can lead to a more serious, long-term form of arthritis called spondyloarthritis. They have long-term inflammation of the joints, which can eventually lead to joint damage. It's hard to say for sure whether this is chronic reactive arthritis or whether it's a result of another condition. One autoimmune disease can lead to another, and some people may have more than one.

What can you do while living with this condition?

Although it is temporary, reactive arthritis can have a significant impact on your daily life. Some people have mild, come-and-go symptoms, while others may experience extreme fatigue and discomfort. You may also need to make some changes to your daily routine and work schedule during this time.

Your doctor may recommend things like:

• Physical therapy: A physical therapist can teach you how to gently exercise the muscles and tendons that support your painful joints. This can help reduce joint stiffness and relieve pressure on the joints. Imagine that Sameera had difficulty walking because of knee pain. By doing simple exercises daily, the physical therapist gradually reduced her pain and allowed her to function normally again.
• Orthotics: An occupational therapist can advise you on how to support or modify the way you use your joints. You may benefit from using a brace, splint, or shoe insert.
• Hot/cold therapy: Ice packs and heat packs can help relieve pain in different ways. For example, your doctor may recommend applying ice to painful joints or heat to tight muscles.
• Power naps: Chronic fatigue can make you tired. But staying in bed for long periods of time isn't good for your aching joints or tight muscles. Instead, take a power nap and try to move around a bit during it.

Imagine, just when you think your infection is over, this stranger called reactive arthritis suddenly appears, bringing you back the symptoms of the original infection, as well as new symptoms, especially joint inflammation. Whether it affects you a little or a lot, it's very difficult to live with the uncertainty of when this will end. But, for many people, it does end, and until then, treatment can help.

Things to remember in brief

Okay, so let's summarize the things you need to remember about Reactive Arthritis.

• Reactive arthritis is a temporary inflammation of the joints that occurs after a bacterial infection.
• This can cause symptoms such as joint pain, swelling, red eyes, and urinary tract infections.
• Not everyone experiences the same symptoms, and symptoms can come and go.
• This is not a contagious disease, but the infections that cause it (e.g. STIs, food poisoning) can be contagious.
• This usually heals within a few months to a year.
• Treatment can control symptoms. Be sure to follow your doctor's instructions.
• Because this is an autoimmune condition, it can rarely recur or be long-lasting.
• If you have these symptoms, please consult a doctor for advice. Don't worry, this condition can be controlled with proper treatment and management.

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