Reactive arthritis

Reactive arthritis is pain, swelling, stiffness in a joint following a viral or bacterial infection in another part of the body. The infection is most commonly in the bowel (like food poisoning), or genital tract, though other types of bacterial infections can also cause reactive arthritis. The immune system (the body’s defence against infection) appears to overreact in response to the infection and starts attacking healthy tissue in the joints, causing them to become inflamed.

Symptoms develop a few weeks after an infection. The infection might even have been almost unnoticeable. 

• Most common symptoms are pain, stiffness and swelling of joints, and sometimes the tendons and ligaments
• The knees, ankles or toes are common sites of inflammation
• Other areas include the wrists, elbows, spine and ankles
• Some people develop swollen, sausage-like fingers
• There can be irritation of the eyes, causing redness and possible blurred vision
• Inflammation may spread to the genital tract and urethra, causing an urgency to urinate and a burning sensation while urinating (peeing) 
• Other symptoms might include extreme tiredness (fatigue), weight loss, mouth ulcers or scaly rash on hands or feet
• While symptoms of this condition usually last 3 to 5 months, a small number of people experience symptoms for longer. It is possible to have a recurrence of the symptoms or develop a long-term inflammatory condition as a result of their reactive arthritis

There is no specific test for this condition. 

Before making a diagnosis, your doctor will ask you questions about recent infections. They will check your joints for swelling, warmth, tenderness. They may check how flexible your back and affected joints are. Show your doctor any rash you might have on your hands or feet.  

The doctor might do a blood test, urine test, or urogenital swab to check for past or current infections. They will also look for signs that could indicate a different diagnosis (like another type of arthritis).

Lifestyle choices are an important part of managing symptoms and improving well-being. 

• Fatigue can impact every aspect of your life. Make sure those around you understand your condition. You might need to work shorter hours for a while so you get enough rest 
• Rest the joint while experiencing symptoms 
• Swimming in warm water allows you to exercise while your body weight is supported by the water 
• Gentle stretching helps keep your muscles and tendons stay strong so they can support your joints 
• Stay healthy with a good diet  

Reactive arthritis is not contagious, but it’s caused by some infections that are contagious. The best way to avoid getting reactive arthritis (or having a relapse) is by protecting yourself against STIs (sexually transmitted infections) and bowel infections. 

• Store your food at appropriate temperatures and cook it thoroughly 
• Wash your hands regularly especially before preparing or eating food 
• To reduce the chance of sexually transmitted infections, use condoms

It can affect anyone, including children but is most common in men between the ages of 20 and 40 years. It starts as a result of an infection. There is a specific inherited gene (HLA-B27) that makes it more likely that you could develop reactive arthritis, though having the gene doesn’t cause the condition. Most people with this gene actually never develop reactive arthritis.

Antibiotics may be prescribed to treat any bacterial infection that triggered reactive arthritis. Inflammation can be treated with non-steroidal anti-inflammatory drugs (NSAIDs).  

Treatment for later stages may include disease-modifying drugs (DMARDs) to control inflammation or steroid injections for swollen joints.

• See an eye specialist or go to A&E as soon as possible if one of your eyes becomes very painful and the vision becomes misty. This could be a symptom of uveitis – and the sooner you get treatment, the more successful it is likely to be. It could also be a symptom of other serious eye conditions, so always get these symptoms looked at as soon as possible
• See a doctor if you develop joint pain within a month of having diarrhoea or a genital infection

Clinically reviewed in 2025.