If you experience pain and swelling in your joints after an infection, you may have reactive arthritis. This form of arthritis causes inflammation and sometimes severe pain in the knees, ankles and feet, but it can also affect the heels, toes, back and fingers.
According to the American College of Rheumatology, reactive arthritis typically occurs as a short episode; however, for some it can become a chronic condition. Generally, reactive arthritis symptoms come and go, with symptoms disappearing within a year. (1, 2)
Treatment isn’t typically necessary except in severe or persistent cases. If the underlying infection that caused the reactive arthritis is still present or reoccurs, it will need to be treated.
Some research points to this disease being an autoimmune disorder. In the case of reactive arthritis, it may be caused by the immune system continuing to fight even after an infection is gone, according to Harvard Medical School. (3)
While the bacteria that cause this disease are very common, reactive arthritis is fairly uncommon. Research continues to determine how genetics play a role.
Conventional reactive arthritis, or Reiter’s syndrome, treatment includes over-the-counter NSAIDs to relieve inflammation and reduce pain. More severe cases may require more aggressive treatment. Fortunately, there are natural remedies to help manage symptoms and improve the overall quality of life. (1)
What Is Reactive Arthritis?
Reactive arthritis causes inflammation, swelling and pain in the joints. Knees, ankles and the feet are the joints most often affected.
Caused by an infection, reactive arthritis is not contagious, but if the underlying infection is still active, the infection itself may be contagious.
Once referred to as Reiter’s disease or Reiter’s syndrome, this inflammatory form of arthritis now belongs to a particular arthritis group called “spondyloarthritis.” Arthritis in this group causes inflammation, pain, stiffness and sometimes deformities of the spine. Under this classification, axial spondyloarthritis, peripheral spondyloarthritis, psoriatic arthritis and enteropathic arthritis are included along with reactive arthritis. (4)
When arthritis, urethritis and conjunctivitis occur concurrently, it is referred to as the Reiter’s syndrome triad. In addition to the joint pain, infection in the eye and infection in the urethra (urethritis), the disease may manifest on the skin. Lesions, pus-filled sores and rashes are possible.
Reiter’s syndrome in women is less common, accounting for approximately one-fifth of the cases. In addition to adults, children have been diagnosed, but this is considered rare. (5)
Signs & Symptoms
Symptoms, and their severity, can vary quite widely from person to person and depending upon the stage of the infection. If you experience any of the following symptoms one to four weeks after an infection, you may have reactive arthritis. (6, 7)
Pain and Inflammation Symptoms
- Joint pain and inflammation in the knees, ankles and feet
- Heel pain caused by enthesopathy (inflammation of the tendon attached to the bone)
- Thickening of fingers caused by enthesopathy
- Heel spurs or bony growths on the heels
- Inflammation and pain in the spine
- Inflammation and pain in the lower back
- Swollen toes or fingers
- Skin conditions
- Redness near the iris
- Blurry vision
- Painful and irritated eyes, particularly when exposed to light
- Discharge from the eyes, or conjunctivitis
- Keratoderma blennorrhagicum, also known as Reiter’s syndrome rash, presents as pus-filled sores on the palms and soles
- Oral lesions including shiny patches on the tongue or palate as well as ulcerations in the mouth
- Changes in fingernails and toenails
- Circinate balantis, inflammatory lesions affecting the glans of the penis
- Ulcerative vulveritis, lesions of the vulva
Reactive Arthritis Symptoms in Men
- Increased urinary output
- Burning sensation during urination
- Abnormal discharge from the penis
- Prostatitis (inflamed prostate gland)
Reactive Arthritis Symptoms in Women
- Inflammation of the cervix
- Inflammation of the fallopian tubes
- Inflammation of the vagina and vulva
- Burning sensation during urination caused by inflammation of the urethra
Causes & Risk Factors
Reactive arthritis is caused by a bacterial infection. Your genetic code also plays a role in the disease, according to the American College of Rheumatology, and research continues to look for answers as to why some people get it and others don’t. (1)
Infections in the urinary tract, genitals and intestines can trigger reactive arthritis. Foodborne bacteria, as well as those transmitted through sexual contact, can also trigger reactive arthritis. These infections most often occur in the urinary tract, digestive tract and the genitals. Offending bacteria include:
- Campylobacter: Likely transmitted through undercooked poultry, contaminated water, contact with animals (or their feces) and unpasteurized milk. (8)
- Chlamydia tracomatis: The most common cause of reactive arthritis is also responsible for the most common sexually transmitted disease, chlamydia. (9)
- Clostridium difficile: Also called C. Diff, this bacteria lives in the colon and can cause severe diarrhea. It is most often associated with health care, long-term care facilities or in persons that have recently completed a round of antibiotics. This bacteria is passed through the feces and spread to surfaces and food due to poor hand-washing. (10)
- Salmonella: One of the most-recognized bacterium, it is spread in undercooked or raw foods including meats, eggs and raw cheeses as well as raw fruits and vegetables. Handling of certain reptiles including turtles, iguanas, snakes and lizards can also spread salmonella. (11)
- Shigella: Easily spread from one person to another, this bacteria travels through the colon and infects the stool. Contamination occurs when the feces is transmitted to the mouth. This is generally caused by improperly washing of hands; however, it can be spread through sexual contact too. (12)
- Yersinia: This foodborne bacteria is passed to humans who have eaten undercooked or raw pork that is contaminated with the bacteria. In more rare cases, the bacteria has been spread through contact, drinking contaminated milk or water, contact with feces or even through a blood transfusion. (13)
- Being male
- Being between the ages of 20 and 40
- Having a certain genetic marker, HLA-B27 (3)
- Previous or current diagnosis of a sexually transmitted disease
Diagnosing reactive arthritis symptoms after an infection may require certain imaging tests to check for inflammation and fluid retention.
Treatment will depend on specific symptoms, as well as their severity. Your care plan may include: (3)
- Antibiotics if the infection is still present
- Corticosteroid injections into painful joints
- Certain rheumatoid arthritis mediations including methotrexate, sulfasalazine, adalimumab or infliximab
- Joint replacement, for extreme arthritis symptoms
- Ointments for rashes
- Drops for the eyes
7 Natural Remedies for Reactive Arthritis Symptoms
Balancing rest with exercise is essential with reactive arthritis. Don’t over-stress your body; focus on exercises to extend range of motion, as they are known to increase flexibility while reducing stiffness. Some of the best activities according to Harvard Medical School include biking and swimming: (3)
- Biking: When your knees, ankles and feet hurt, biking may not seem like a good idea, but it actually can be. According to the Arthritis Foundation, cycling is a great workout for people with arthritis because the knee moves through a full range of motion, producing more lubricating fluids. (14)
- Swimming: Swimming is a great whole-body, non-impact exercise that helps to strengthen the muscles surrounding the joints. Swimming includes full range-of-motion movements, and it helps to strengthen the body while being an aerobic activity. (15)
- Stretching: Much like cycling and swimming, stretching helps to strengthen the muscles surrounding joints and helps to increase joints’ flexibility while reducing stiffness. Foam roller exercises can work on the full range of motion, producing more lubrication in the joints that may help relieve reactive arthritis symptoms. (16)
2. Epsom Salt Bath
One of the top remedies for bone and joint pain, an Epsom salt bath, may help relieve pain — particularly heel pain. Epsom salt baths are proven to relieve pain, including arthritis pain and inflammation, psoriasis, sore muscles and tired and swollen feet.
If your feet and ankles hurt, soaking them in a deep pan or bucket may help. If your arthritis pain is more widespread, a warm bath with Epsom salt can help relax muscles and relieve pain.
Reactive arthritis is known to cause skin reactions, including lesions and other rashes. To affected areas, applying a DIY rash cream may help to ease the discomfort, including pain and itching. In this recipe, aloe and lavender essential oil are used to help relieve the discomfort while aiding in the healing.
4. Low-Inflammation Diet
Arthritis symptoms and inflammation go hand-in-hand. While you are experiencing reactive arthritis or Reiter’s syndrome symptoms, eating a diet low in inflammatory foods is essential. Fill your diet with the top anti-inflammatory foods like green leafy vegetables, celery, beets, broccoli, blueberries, wild-caught salmon, bone broth, coconut oil and turmeric.
Known for improving skin health and reducing joint pain, collagen is essential for those with reactive arthritis. In a clinical trial of patients with rheumatoid arthritis, type II collagen was shown to decrease swollen and tender joints after three months.
The Arthritis Foundation explains that collagen supplements include a form of predigested collagen that make the essential amino acids more available to your tissue. In a recent study published in Nutrition Journal, researchers found that individuals with osteoarthritis taking type II collagen experienced less pain, less stiffness and better functioning than those taking the placebo. (17)
It is important to note that type II collagen should be taken in smaller doses (20 mg to 40 mg) as it is not intended to be used as a collagen builder, but as an element to train the immune system to stop attacking the existing collagen in the body. (18)
For centuries, massage has been used to treat a wide range of ailments and diseases. From deep tissue massage, to the more gentle hot stone massages, massage can relax the muscles, improve flexibility and reduce joint pain.
According to the Arthritis Foundation, moderate pressure massage should help relieve arthritis pain. It should be noted that research has found that light pressure causes the heart rate and blood pressure to rise while moderate pressure causes the heart rate and blood pressure to fall. (19)
Reactive arthritis can cause moderate-to-severe pain and inflammation in the joints. This pain and discomfort can affect the quality of life. Meditation, in the form of guided meditation, visualization exercises or other forms can help ease both acute and chronic pain. (20)
The Arthritis Foundation states that arthritis symptoms aren’t just physical; this disease takes a toll emotionally as well. A clinical trial — the results of which were published in the Annals of Behavioral Medicine — found that meditation practice improves pain and depression symptoms, as well as quality of life. If you are new to meditation, you may want to find a coach in your area to help you develop your personalized practice, or you can also try one of several apps that are now available to help you get started.
Unfortunately, there is no clear way to prevent reactive arthritis after an infection. Research shows that certain genetic factors do increase the risk for developing this disease. While you can’t control your genetics, there are ways you can protect yourself from this painful inflammatory disease.
- Practice safe sex. The most common cause of reactive arthritis is chlamydia.
- Wash hands properly. After handling any raw meats, going to the bathroom, cleaning up after your pet or changing diapers, wash your hands thoroughly.
- Eat foods cooked to the proper temperature. Consuming undercooked or raw seafood, pork, poultry, beef, cheese, eggs and milk can transmit one of the bacterium that causes reactive arthritis.
Key Points About Reactive Arthritis
- Reactive arthritis, known previously as Reiter’s syndrome, is a disease that causes pain and inflammation in the joints.
- The onset of this disease occurs one week to one month after an infection caused by a foodborne bacteria or chlamydia.
- The reactive arthritis duration can vary from a few weeks to a year. Symptoms may come and go or be more persistent. While rare, reactive arthritis can become a chronic condition.
- Conventional reactive arthritis treatment focuses on treating the infection if it is still present, as well as NSAIDs to reduce pain and swelling. In severe cases, other medications including eye drops, rash creams and corticosteroid injections into affected joints may be recommended.
- You can’t prevent reactive arthritis after an infection, but you can practice safe sex, proper hand- washing and only eat foods that are cooked to recommended temperatures to lessen your risk.
7 Natural Remedies for Reactive Arthritis Symptoms
1. Exercise: Try exercises that work the full range of motion of joints, like swimming, biking and stretching.
2. Epsom Salt Bath: Soak your feet and ankles or take a warm Epsom salt bath to help relieve pain, inflammation and relax your muscles.
3. Natural Rash Remedy: Apply a natural rash remedy to ease the itching, pain and discomfort of dermatologic symptoms.
4. Eat a Low-Inflammation Diet: Include top anti-inflammatory foods in your diet like green leafy vegetables, beets, blueberries, broccoli, wild-caught salmon, bone broth, turmeric and coconut oil.
5. Collagen: Take a high-quality type II collage supplement to help decrease swollen and tender joints.
6. Massage: Enjoy regular, moderate-pressure massages to help relieve joint pain, improve flexibility and relax muscles.
7. Meditation: Practice meditation daily to help relieve inflammation and pain in the joints.
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