There’s no cure for reactive arthritis, but the condition is usually temporary and treatment can help relieve your symptoms.
Self care
In the initial stages of reactive arthritis, it’s recommended 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. Instead, you should cover them – for example, with a towel.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the first type of medication used for reactive arthritis as they can help reduce inflammation and relieve pain.
Taking a regular dose of an NSAID on a long-term basis can increase your risk of getting stomach ulcers or bleeding. If you are at an increased risk of developing stomach ulcers, your GP may recommend an additional medication known as a proton pump inhibitor, which reduces the production of stomach acid.
Long-term use of NSAIDs may also slightly increase your risk of having a heart attack or stroke.
Steroid medications
Steroid medication (corticosteroids) may be recommended if your symptoms don’t respond to NSAIDs or you’re unable to use NSAIDs, for example because you have a history of stomach ulcers.
Steroids work by blocking the effects of many of the chemicals that 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.
Your dose will gradually be reduced over a period of weeks, depending on how well you respond to treatment.
Never stop taking your steroid medicines, unless you’re told by your doctor that it’s safe to do so. Suddenly stopping treatment with steroids can make you feel very ill.
Side effects
About one 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 change.
Other side effects include weight gain, acne, stomach ulcers and osteoporosis, although these should improve as your dosage is decreased.
If you’re over 65, your GP may also prescribe medication to strengthen your bones to avoid the effects of osteoporosis (see treating osteoporosis for more information).
You may also be referred for a type of X-ray known as a dual-energy X-ray absorptiometry (DEXA) scan, which can be used to assess how strong your bones are.
As with NSAIDs, stomach ulcers can also be a problem for people taking prednisolone on a long-term basis, so you may also be prescribed a proton pump inhibitor.
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).
DMARDs also block the effects of some of the chemicals that your immune system uses to trigger inflammation.
It can take four to six 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 is essential to have regular blood tests while taking these medicines.