Treatment - Reactive arthritis

Reactive arthritis is usually temporary, but treatment can help to relieve your symptoms and clear any underlying infection.

Most people will make a full recovery within a year, but a small number of people experience long-term joint problems.

Treatment usually focuses on:

• clearing the original infection that triggered the reactive arthritis – usually using antibiotics in the case of sexually transmitted infections (STIs)
• relieving symptoms such as pain and stiffness – usually using painkillers such as ibuprofen
• managing severe or ongoing reactive arthritis – usually using medications such as steroids or disease-modifying anti-rheumatic drugs (DMARDs)

Antibiotics

Antibiotics will not treat reactive arthritis itself but are sometimes prescribed if you have an ongoing infection – particularly if you have an STI. Your recent sexual partner(s) may also need treatment.

Non-steroidal anti-inflammatory drugs

Anti-inflammatory painkillers (NSAIDs), such as ibuprofen, can be taken to reduce inflammation and relieve pain.

Steroid medication

If you have severe inflammation, or you can't take NSAIDs or they didn't work for you, you may be prescribed steroid medication to reduce inflammation.

Steroids may be given as tablets if several of your joints are affected. If only one or two joints are affected, steroids may be injected directly into the affected joint or tendon.

Disease-modifying anti-rheumatic drugs (DMARDs)

If your symptoms don't get better after a few weeks with other treatment or are very severe, you may be prescribed a DMARD, which also work by reducing inflammation. They may be prescribed on their own but can also be prescribed in combination with steroids or NSAIDs, or with both.

The most commonly used DMARDs are methotrexate and sulfasalazine.

It can take a few months before you notice a DMARD is working, so it's important to keep taking it even if you don't see immediate results.

Common side effects of methotrexate and sulfasalazine include feeling sick, diarrhoea, loss of appetite and headaches, although these usually improve once your body gets used to the medication.

DMARDs may also cause changes in your blood or liver, so it's important to have regular blood tests while taking these medicines.

Other drugs

If your reactive arthritis is very severe, even stronger drugs, known as biologics, may be prescribed.

These have to be given regularly by injection and may increase your risk of getting infections.

Self-care

There are also things you can do yourself to relieve your symptoms.

When you first start getting symptoms of reactive arthritis, you should try to get plenty of rest and avoid using the affected joints.

As your symptoms improve, you should begin to do exercises to stretch and strengthen the affected muscles, and improve the range of movement in your affected joints.

Your GP or specialist may recommend exercises for your arthritis. Alternatively, you may be referred for physiotherapy.

You might also find ice packs and heat pads useful in reducing joint pain and swelling. Wrap them in a clean towel before putting them against your skin.

Place the pack against the affected area for up to 20 minutes.

Splints, heel pads and shoe inserts (insoles) may also help.

How to stop reactive arthritis coming back

There is a risk you could develop reactive arthritis again if you get another infection. The best way to avoid this is by protecting yourself against STIs and bowel infections.

The most effective way of preventing STIs is to always use a barrier method of contraception, such as a condom, during sex with a new partner.

Read advice about STIs and contraception.

Ensuring good standards of hygiene when preparing and storing food can help to prevent bowel infections.