Reactive arthritis - Treating reactive arthritis

There's no cure for reactive arthritis, but the condition is usually temporary and treatment can help to relieve your symptoms.

Most people will make a full recovery in about six months, although around one in five cases lasts a year or more, and a small number of people experience long-term joint problems.

There is also a risk you could develop the condition again after another infection.

Self-care

In the initial stages of reactive arthritis, it's recommended that you get plenty of rest and avoid using affected joints.

As your symptoms improve, you should begin a gradual programme of exercise designed to strengthen affected muscles and improve the range of movement in your affected joints.

Your GP or specialist may recommend a suitable exercise programme for your arthritis. Alternatively, you may be referred to a physiotherapist for physical therapy. 

You might also find ice packs and heat pads useful in reducing joint pain and swelling, although these should not be directly placed on your skin.

Antibiotics

Antibiotics may not help to treat reactive arthritis itself, but they are sometimes prescribed if you have an ongoing infection – particularly if you have a sexually transmitted infection (STI). Your recent sexual partner(s) may also need treatment.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the main medication used for reactive arthritis, as they can help to reduce inflammation and relieve pain.

However, taking a regular dose of a NSAID on a long-term basis can increase your risk of problems such as stomach ulcers. If you are at an increased risk of developing stomach ulcers, your GP may recommend an additional medication known as a proton pump inhibitor (PPI), which can protect your stomach by reducing the production of stomach acid.

Rarely, long-term use of NSAIDs can also slightly increase your risk of having a heart attack or stroke. Read more about the side effects of NSAIDs.

Steroid medication

Steroid medication (corticosteroids) may be recommended if your symptoms don't respond to NSAIDs, or you're unable to use NSAIDs.

Steroids work by blocking the effects of many of the chemicals the body uses to trigger inflammation.

A corticosteroid called prednisolone is usually the preferred choice. Prednisolone can be given as an injection into a joint or as a tablet. Eye drops are also available if you have inflamed eyes (conjunctivitis).

Around 1 in 20 people who take prednisolone will experience changes in their mental state, such as depression or hallucinations. Contact your GP as soon as possible if you notice any changes in your thoughts or behaviour.

Other side effects can include weight gain, acne, stomach ulcers and osteoporosis, although these should improve as your dose is decreased. Read more about the side effects of corticosteroids.

Disease-modifying anti-rheumatic drugs (DMARDs)

If your symptoms persist despite treatment with NSAIDs and/or corticosteroids, you may be prescribed a medication known as a disease-modifying anti-rheumatic drug (DMARD).

Like corticosteroids, DMARDs work by blocking the effects of some of the chemicals your immune system uses to trigger inflammation.

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

A DMARD called sulfasalazine is usually the preferred option. Common side effects of sulfasalazine include feeling sick, 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.