- Causes of reactive arthritis
- Symptoms of reactive arthritis
- Diagnosis of reactive arthritis
- How the treatment is done
- Remedies for reactive arthritis
- Physiotherapy for reactive arthritis
Reactive arthritis, formerly also known as Reiter's Syndrome, is an inflammatory disease that develops soon after or during a bacterial infection, usually or gastrointestinal. Due to the fact that it happens as a result of an infection, this type of arthritis is called reactive.
Reactive arthritis is composed of the clinical triad: post-infectious arthritis, urethritis and conjunctivitis. This disease is more common in young adults with a history of infection in the last 4 weeks.
In most cases, people diagnosed with reactive arthritis get better after a few months without the need for treatment, however there are chances of it happening again. The treatment for this type of arthritis is established by the general practitioner or rheumatologist according to the symptoms presented by the patient and the cause of the disease, and the use of anti-inflammatories, analgesics, corticosteroids or antibiotics may be recommended.
Causes of reactive arthritis
Reactive arthritis usually arises as a result of a urogenital or intestinal bacterial infection. In the case of urogenital infection, it may be due to sexually transmitted diseases, such as chlamydia, for example, which is caused by the bacterium Chlamydia trachomatis . When due to intestinal infections, it may be due to infection by Campylobacter sp , Shigella sp or Salmonella sp , for example.
These infections can occur because of unprotected intimate contact, in the case of Sexually Transmitted Infections (STIs), be associated with urethritis or cervicitis, which can be asymptomatic, although in most cases it leads to pain and burning in the urine, in addition to urethral or vaginal discharge, or due to food poisoning, in the case of intestinal bacterial infections. In addition, reactive arthritis can be caused by viral infection. There are also reports of reactive arthritis after immunotherapy for bladder cancer.
Symptoms of reactive arthritis
Reactive arthritis is characterized by a triad of symptoms (arthritis, urethritis and conjunctivitis), that is, the disease shows signs of infection, inflammation of joints and eye problems. Thus, the main signs and symptoms related to reactive arthritis are:
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Infection symptoms:
- Polyuria, which is the production of large amounts of urine during the day; Pain and burning when urinating; Presence of blood in the urine; Urgent desire to urinate; Signs and symptoms related to prostatitis in men, such as difficulty maintaining an erection, pain when ejaculate and presence of blood in the semen; Signs and symptoms related to cervicitis, salpingitis or vulvovaginitis in women.
- Joint pain; Difficulty moving the affected joint; Pain in the back; Swelling in the joints; Inflammation of the tendons and ligaments associated with the joint.
- Redness in the eyes; Excessive tearing; Pain or burning in the bones; Swelling; Burning of the eyes; Increased sensitivity to light, called photophobia.
In addition, other more general symptoms may also appear, such as excessive tiredness, back pain, fever above 38ºC, weight loss, thrush, abdominal pain or diarrhea, for example. When these symptoms appear, it is recommended to consult a general practitioner to assess the problem and indicate the need to consult a rheumatologist to start the appropriate treatment.
Diagnosis of reactive arthritis
The diagnosis of reactive arthritis is basically clinical, in which the doctor assesses whether there are signs and symptoms characteristic of the triad, that is, the presence of signs and symptoms related to infection, inflammation of the joints and eye problems.
In addition, the doctor may request that a genetic test be performed in order to identify HLA-B27, which can be considered a marker that is positive in patients with reactive arthritis. In isolation, HLA-B27 has little diagnostic value and is not indicated in the routine care of these patients.
How the treatment is done
The treatment for reactive arthritis is done according to the symptoms presented by the person and the cause of the disease, and the use of anti-inflammatory and analgesic remedies, such as Paracetamol or Ibuprofen, is usually indicated by the rheumatologist. In some cases, the use of corticosteroids, such as Prednisolone, may also be recommended to reduce inflammation in various parts of the body and relieve symptoms.
The rheumatologist can also indicate the use of antibiotics, if the reactive arthritis is caused by bacterial infection and the body is not able to eliminate the bacteria, however the use of antibiotics has no impact with regard to the development of the disease. In addition, in the case where the joints are affected, physical therapy may also be indicated, which is done with exercises that help to recover the movement of the limbs and relieve pain.
However, it is not always possible to completely relieve all the symptoms of reactive arthritis, developing a chronic condition that causes the symptoms to recur for a few weeks.
Remedies for reactive arthritis
In most cases of reactive arthritis, the doctor recommends the use of non-steroidal anti-inflammatory drugs (NSAIDs) in order to relieve symptoms, and the use of Ibuprofen or Diclofenac may be recommended to reduce pain and facilitate joint movement. In case the use of NSAIDs is not sufficient, the use of other medications, such as:
- Corticosteroids, such as Prednisolone or Betamethasone, to decrease the symptoms of inflammation when anti-inflammatory drugs are not enough; Antibiotics, which varies according to the infectious agent responsible for the infection and the sensitivity profile of the microorganism.
The treatment of reactive arthritis usually lasts about 6 months, but in some cases it can reach 1 years depending on the severity of the symptoms and the person's response to treatment.
Physiotherapy for reactive arthritis
Physiotherapy treatment is important in the treatment of this type of arthritis to avoid stiffening the joint. Thus, physical therapy indicates and performs some exercises to relieve joint symptoms, increase the range of motion and prevent deformations that can happen as a result of the disease.
Check out the following video for some arthritis exercises:
