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Diseases > Reactive Arthritis > What can I do about it?

What can I do about reactive arthritis?

The first thing is don’t panic. Take a deep breath. Although you might have been diagnosed with reactive arthritis, you are not alone. Luckily, there are effective treatments available. Even if they don’t cure reactive arthritis they can make living with the condition much more comfortable.

If you have reactive arthritis or think you may have it, your family doctor should refer you to a rheumatologist. A rheumatologist is a specialist who is an expert in treating arthritis. This type of doctor is in the best position to help you manage your condition.

Here are some recommendations:

  • Learn as much as you can about this disease. Knowledge is power and we’ve aimed to develop this RheumInfo website so it’s easy to understand
  • Attend your doctor and/or rheumatologist appointments regularly
  • Take it easy – identify activities that flare your joint pain and do your best to avoid them
  • Learn about the medications used to treat reactive arthritis. The RheumInfo website has many interactive and valuable tools to help you understand these medications and their impact on your disease

Treatment of reactive arthritis

Reactive arthritis is a serious disease. It must be treated early and aggressively. It can eventually damage the joints if it is not adequately controlled. Think of it like this: the inflammation caused by reactive arthritis is like a fire burning in your joints. If you were sitting in your living room and you noticed a fire on the stove, you would want to put it out right away before it spread. You wouldn’t say “let’s wait a little bit” until the fire spreads to the ceiling before trying to put it out. With reactive arthritis we want to put out the fire in your joints as quickly as possible, before there’s permanent damage. We don’t want to let it smoulder and get worse.

Medications for reactive arthritis

The first step is to treat your infection, if you haven’t already. Bowel and urinary tract infections are usually treated with antibiotics. Other types of medications might be required if you have a sexually transmitted infection (STI).

For acute attacks of reactive arthritis, corticosteroids can be very effective to control inflammation. These can be taken orally as pills (prednisone) or sometimes as cortisone injections directly into a joint. This type of treatment can reduce the pain and swelling in joints affected by reactive arthritis. It can take up to 24 or 48 hours before you feel the effects of a corticosteroid injection, but it provides the quickest relief. Once the effects set in, they can last for a few days up to a few months – it depends on the individual person and the joint. Usually, corticosteroid injections are limited to 2 or 3 in a single joint per year.

Non-Steroidal Anti-Inflammatory Drugs or NSAIDs are medications that can also be used to reduce the inflammation of joints caused by acute reactive arthritis. They also help to reduce pain. They may take a little longer to work than corticosteroids.

If a skin rash or oral ulcers are present, a topical steroid (applied to the surface) such as cortisone is used. Cortisone eye drops are usually used to treat conjunctivitis.

For chronic reactive arthritis, Disease Modifying Anti-Rheumatic Drugs (DMARDs) can be effective. Methotrexate is the most commonly used DMARD in people with reactive arthritis. Other types of DMARDs can also be used such as Sulfasalazine.

In cases where joint pain and stiffness caused by reactive arthritis aren’t relieved by anti-inflammatory drugs or DMARDs, there is a newer group of medications called anti-TNF biologics. Anti-TNF biologics are extremely effective and can make a big difference for people with reactive arthritis.

For more information about specific medications used to treat reactive arthritis, refer to the “pictopamphlets” in the Medications section of this website.

Exercises for reactive arthritis

For people with chronic reactive arthritis, physical therapy and exercise are an important part of treatment. The right exercises can actually improve the pain and stiffness in affected joints. They can also protect the joints by strengthening the muscles around them. You must be careful about the type of exercise and activities you do. It will depend on what joints have been affected and the severity of your disease.

Moderate stretching can help reduce pain and keep the joint flexible. Aerobic exercise such as walking, swimming or bicycling works your heart and increases your overall fitness. It is also an important part of keeping a healthy weight. A trained arthritis physiotherapist can help design an exercise program tailored to you and your needs.

Read these useful articles on exercising with arthritis – many of the tips can also be applied to people with reactive arthritis:

Natural or Home Remedies for reactive arthritis

There are no known natural remedies or complementary therapies that have been proven to help reactive arthritis in any significant way. However, it’s important to check with your doctor or rheumatologist to make sure that nothing interacts with your medication if you choose to use natural remedies or complementary therapies.

Diet for reactive arthritis

Questions about diet and reactive arthritis are very common. We all want to know what we can do to help ourselves. Can we change our diet to improve our immune system and help our condition? Changing our diet gives us a sense of control over a disease which often seems to have a mind of its own.

Unfortunately, there is no diet that has been proven to significantly alter the course of reactive arthritis. Eating well can help you keep a healthy weight, which helps to reduce the load on your weight-bearing joints including the hips, knees and feet.

Alcohol and reactive arthritis

Many of us like to share a glass of wine, a beer or a spirit from time to time. Unfortunately, due to the nature of reactive arthritis, some people may turn to alcohol to help cope with the distress. Alcoholic beverages are not an effective treatment for reactive arthritis. They can also interact with some of the medications you may be taking.

Smoking and reactive arthritis

Cigarette smoking, whether you have reactive arthritis or not, has no positive effects on any aspect of your health. Smoking can also make some of the medications you are taking less effective. So, if you are a smoker with reactive arthritis, quitting could be one of the best things you can do to improve your overall health.

Concluding Thoughts

Reactive arthritis is often acute. This means it comes on quickly and it can be quite debilitating. It is important to treat reactive arthritis early and aggressively. Reactive arthritis can become chronic. In either case, it’s important to treat reactive arthritis early before there’s any permanent damage to the joints. Don’t let the fire in your joints smoulder – if you put it out there will be far less damage