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What is reactive arthritis?

* Reactive arthritis is caused by bacteria. The bacteria cause a person to get sick, and then later travel through the body to the joints between bones. The joints swell and become stiff and painful. This is called inflammation.
* Reactive arthritis most often affects the joints of the knees, ankles or toes.
* It can also affect the eyes or skin or muscles. When it affects areas besides the joints, reactive arthritis is then called Reiter's (pronounced rIt-erz) syndrome.

How common is reactive arthritis?

* Both men and women can get reactive arthritis.
* It usually affects people between the ages of 20 and 50.
* Some people may be more likely to get reactive arthritis. These are people who have a certain type of body tissue. This type of tissue, called HLA-B27, occurs in only a small number of all people. People get their tissue type from their parents, just as they do hair colour and blood type.

What are the warning signs of reactive arthritis?

* If you have reactive arthritis you will probably develop the warning signs within a few weeks after you've had an infection.
* The infection may have been food poisoning or another illness of the intestine. It could also have been chlamydia (pronounced clam-i-dee-a), which is a disease passed on by an infected person during sex. Reactive arthritis cannot be passed from one person to another.
* Stiffness, pain and swelling in a joint that seems to have come on for no reason. The area may also be red and hot.
* There may be pain in the lower back, or on the heel or bottom of the foot.
* Pain and stiffness may be worse in the morning.
* The eyes may feel sore or sensitive to sunlight.
* Sores may appear in the mouth or on the genitals. These may be painful or painless.

The symptoms of reactive arthritis vary, but they usually appear one to three weeks (rarely months) after an episode of an intestinal infection caused by:

* Salmonella
* Shigella (pronounced shi-jel-la)
* Campylobacter (pronounced cam-puh-lo-bac-ter)
* Yersinia

What causes reactive arthritis?

*
Certain types of bacteria cause reactive arthritis. If you have reactive arthritis one of these types of bacteria may have already made you sick.
*
The bacteria that cause reactive arthritis are some of those that cause food poisoning or other illness of the intestine. The names of these bacteria are Salmonella, Shigella, Campylobacter and Yersinia
*
The bacteria that cause the disease chlamydia can also lead to reactive arthritis.
*
After the bacteria cause you to get sick they can travel through your body to other areas, where they then cause inflammation.
*
Reactive arthritis cannot be passed from one person to another.

What can you do about reactive arthritis?

* If your doctor thinks you have reactive arthritis he or she may refer you to a rheumatologist (pronounced room-a-tol-o-jist). A rheumatologist is a doctor who has received special training in the diagnosis and treatment of problems with joints, muscles and bones.
* Your doctor may perform a physical examination, and order x-rays and other tests. Your doctor will probably also ask questions about whether you have been sick from other illnesses.
* Sometimes reactive arthritis goes away on its own in a few days or weeks. Sometimes it can last longer. Treatment is done to get rid of the infection that has caused the arthritis and to reduce pain and inflammation.
* Learn as much as you can about this disease. Speaking with people who are specialists in arthritis care can provide you with the information you need.

Medicine

* Antibiotics are often used to treat the initial infection. However they may not stop reactive arthritis from developing.

* Non-steroidal anti-inflammatory drugs (NSAIDs - pronounced en-seds) are often used to treat the pain and inflammation of reactive arthritis. These are a type of medication that helps reduce pain and swelling of the joints and decrease stiffness. However, they do not prevent further joint damage. A common type of NSAID called ASA, which is found in medicines such as Aspirin or Anacin, is not used in the treatment of reactive arthritis.

* Occasionally a cortisone injection into an infected joint or tendon brings short-term relief. Cortisone is a steroid that reduces inflammation and swelling.

* People with reactive arthritis that lasts longer than a few months are often given disease modifying anti-rheumatic drugs (DMARDs). DMARDs try to stop the arthritis from getting worse. They can take about two to six months before they make a difference in the pain and swelling.

Exercise

* Exercise helps keep the muscles strong around a joint. Not using a sore joint will cause the muscles around it to become weak, resulting in pain.
* Exercise can also help you maintain a healthy weight, which puts less strain on your joints.
* Do stretching exercises every day to help keep your muscles and joints moving.
* If your muscles have become weak you may need to do strengthening exercises.
* Low impact exercises such as swimming, bicycling, water aerobics and walking will give you energy, strengthen your heart and help you control your weight.

Heat/Cold

* Applying heat helps relax aching muscles, and reduces pain and soreness. For example, take a hot shower.
* Applying cold helps to lessen the pain and swelling. For example, put an ice pack on the area that is sore.

Protect Your Joints

* Be kind to your body. After doing heavy work, or doing the same task over and over, stop. Slow down by doing an easy task, or by taking a rest.
* Use your back, arms and legs in safe ways to avoid putting stress on joints. For example, carry a heavy load close to your body.
* Use helpful devices such as a cart to carry your grocery bags, or an enlarged handle that fits over a knife handle so you can hold it easily. A cart will help you to walk more safely. A grab bar, which attaches to a shower, will help you to get in and out of the tub more easily.
* Maintain a healthy weight to avoid putting extra stress on your joints.

Relaxation

* Relaxing the muscles around an inflamed area reduces pain.
* There are many ways to relax. Try deep breathing exercises. Listen to music or relaxation tapes. Meditate or pray. Another way to relax is to imagine or visualize a pleasant activity such as lying on a beach, or sitting in front of a fireplace.

Additional Tips for Living Well

* The Arthritis Society offers a variety of programs and services that can be helpful.
* You can reach the Society at 1-800-321-1433 from anywhere in Canada.
* You can also reach us through our Web site at http://www.arthritis.ca

Source:
Arthritis Society
http://www.arthritis.ca