Whole body

What It Is

Reactive arthritis is a form of arthritis where the joints become sore and swollen after an infection, usually in the gut (such as food poisoning) or a sexually transmitted infection (STI) such as chlamydia (NHS, 2024a). As well as the joints, it can affect the eyes, skin and urinary tract. The symptoms might or might not appear at the same time, and not everyone gets all of them (NIAMS, 2024a). Symptoms usually start around 1 to 4 weeks after the infection (NHS, 2024a). It occurs most often in people between the ages of 20 and 40. Men are more likely to develop it after a sexually transmitted infection, but men and women are equally affected when it follows a gut infection (NIAMS, 2024a). For those who have HIV, the risk of getting reactive arthritis is higher (NIAMS, 2024a).

The condition happens because the immune system begins to attack the joints by mistake after the infection (NHS, 2024a). Genes also play a part: people who have a gene called HLA-B27 have a higher risk of getting it, and of having more severe and longer-lasting symptoms (NIAMS, 2024a). Between about half and 80 percent of people with the condition test positive for HLA-B27 (Bentaleb et al., 2020), but people without the gene can still get it. If the infection was very mild, you might not remember having it before your joint pain began (NHS, 2024a).

If you suspect reactive arthritis, or have been diagnosed with it, then there is a good possibility you have already seen a rheumatologist (a doctor for joint and inflammatory conditions). The rheumatologist may do blood tests, tests on a sample of joint fluid, scans or X-rays, or advise on physiotherapy treatment if appropriate (NHS, 2024a; NIAMS, 2024b).

This condition is sometimes known by its older name, Reiter's Syndrome.

Reactive Arthritis Anatomy

The joints most commonly affected are the knees, ankles and feet, but the hands, elbows, spine and the tendons around joints can also be affected (NHS, 2024a). Many people have pain in the sacroiliac joints in the lower back. Heel or foot pain is often caused by inflammation where a tendon or ligament attaches to the bone (enthesitis), and fingers or toes can become swollen (NIAMS, 2024a). In addition, the eyes can become inflamed (conjunctivitis, or uveitis, which affects the middle part of the eye), and inflammation of the urinary tract can cause pain when peeing (NHS, 2024a; NIAMS, 2024a). Some people get flaky or scaly skin, usually on the soles of the feet or palms of the hands (NHS, 2024a).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Reactive Arthritis

There is no cure, so treatment aims to relieve the symptoms, and your doctor will tailor treatment to you (NIAMS, 2024b).

1. Anti-Inflammatory Medication

The NHS lists anti-inflammatory medicines called non-steroidal anti-inflammatory drugs (NSAIDs) as a treatment that can help reduce inflammation in the joints, and NIAMS says over-the-counter or prescribed anti-inflammatory and pain medicines can help reduce pain and swelling (NHS, 2024a; NIAMS, 2024b). Take painkillers that are recommended by your doctor (NHS, 2024a). (This medicine information comes from the NHS and NIAMS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Exercise and Physiotherapy

I can help you keep your joints moving and build strength, with gentle hands-on work and exercises adapted to how your joints are on the day. See the My Approach tab for how I work.

Get plenty of rest, but try to move around every day to stop your joints getting stiff. Do stretching and strengthening exercises when your joints are not swollen (NHS, 2024a). A physiotherapist can help ease pain, improve how your joints work, and teach you exercises to strengthen the muscles around a joint (NIAMS, 2024b).

3. Cold and Heat

Use cold packs, wrapped in a towel, on sore, swollen joints, and heat packs, wrapped in a towel, on sore, stiff muscles (NHS, 2024a).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Antibiotics: these are only used if you still have the infection that may have triggered the arthritis; they treat the infection rather than the joint inflammation itself (NHS, 2024a; NIAMS, 2024b).
Steroids: steroid medicines, injections into a joint, creams for skin symptoms or eye drops for eye inflammation may be used to reduce inflammation, and are managed by your doctor (NIAMS, 2024b).
Disease-modifying medicines: DMARDs (disease-modifying anti-rheumatic drugs) or biological therapies, which change the way the immune system works, may be used if other treatments have not worked (NHS, 2024a; NIAMS, 2024b).

How I can help (see the My Approach tab)

Gentle hands-on work adapted to flares and calmer spells
Stretching and strengthening exercises for when your joints aren't swollen
Pacing and joint protection advice

Tips

Reactive arthritis usually goes away within 6 months (NHS, 2024a). For some people it can come back, and around 10 to 30 percent of people develop a longer-lasting (chronic) form (Bentaleb et al., 2020).
In some people it can lead to another type of arthritis that needs long-term treatment, such as ankylosing spondylitis (inflammation that causes stiffening of the spine) (NHS, 2024a).
Some sexually transmitted infections that can trigger the condition, such as chlamydia, are often passed on through sex without a condom, so using condoms helps avoid getting and spreading them (NHS, 2024b).
If you start noticing painful urination or a discharge from the penis or vagina, you need to seek medical attention (NHS, 2024a).
Patches of flaky or scaly skin on the soles of the feet or palms of the hands are often associated with this condition (NHS, 2024a; NIAMS, 2024a).
Follow your care team's advice on what to do if your joint pain suddenly gets worse (a flare-up) (NHS, 2024a).

Treatment

My Approach

Your doctor or rheumatologist manages reactive arthritis, and I work alongside their plan. My aim is to ease pain and stiffness, keep your joints moving, and rebuild strength as the inflammation settles. If you can manage your normal daily tasks, we can usually start; if you have a fever, feel unwell or are still being treated for the infection, check with your doctor first.

I assess how your back, hips, knees, ankles and feet move and how strong they are, and check every session whether you're in a flare.

During a Flare

I still treat, with extra care: gentler, shorter sessions, avoiding the most inflamed joints apart from cool applications
Soothing massage for unaffected areas and for muscles overworking because you're limping
Gentle joint movement within comfort, with no stretching or forceful work on inflamed joints

Calmer Spells

Warm applications, massage and gentle joint mobilisation for stiff joints, sore heels and the lower back
Work around the buttocks and hips only with your informed consent and a written consent form
Stretching and strengthening when joints aren't swollen, building towards low-impact and gym-based exercise
Pacing your day and protecting your joints

I avoid rashes, flaky skin and sores. If pain lasts more than about an hour after treatment or exercise, we scale back.

What to Expect

Typical Course

Typical course: Usually, visits are once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often. Reactive arthritis usually goes away within about 6 months, following your doctor's treatment plan; if it lasts longer or comes back, occasional visits can help you manage flares.

What I Focus On

Flare-Aware Care

Compensation Relief

Joint Mobility

Strength When Joints Settle

Pacing & Joint Protection

Please read

When to See a Doctor First

When to get urgent medical advice

Ask for an urgent appointment with your family doctor or nurse practitioner if (NHS, 2024a):

you have severe pain and swelling in just one joint that started suddenly
your pain is not controlled with simple painkillers
the skin around a joint feels hot or looks red
you have sore joints with a high temperature, or you feel hot, cold or shivery
you have sore joints with sore eyes or problems with your vision
you have sore joints with pain when you pee, discharge from your penis or vagina, or a rash or sores on your genitals

Sources

References

NHS (2024a) Reactive arthritis. Available at: https://www.nhs.uk/conditions/reactive-arthritis/ (Accessed: 7 October 2026).
National Institute of Arthritis and Musculoskeletal and Skin Diseases (2024a) (2024) Reactive Arthritis. Available at: https://www.niams.nih.gov/health-topics/reactive-arthritis (Accessed: 7 October 2026).
National Institute of Arthritis and Musculoskeletal and Skin Diseases (2024b) (2024) Reactive Arthritis: Diagnosis, Treatment, and Steps to Take. Available at: https://www.niams.nih.gov/health-topics/reactive-arthritis/diagnosis-treatment-and-steps-to-take (Accessed: 7 October 2026).
Bentaleb, I. et al. (2020) 'Reactive Arthritis: Update', Current Clinical Microbiology Reports, 7(4), pp. 124–132. doi: 10.1007/s40588-020-00152-6. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7519381/ (Accessed: 7 October 2026).
NHS (2024b) Chlamydia. Available at: https://www.nhs.uk/conditions/chlamydia/ (Accessed: 8 October 2026).

Massage therapy · Kitchener–WaterlooReactive Arthritis

What It Is

Reactive Arthritis Anatomy

Self-Care & Treatment

How to Treat Reactive Arthritis

1. Anti-Inflammatory Medication

2. Exercise and Physiotherapy

3. Cold and Heat

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

During a Flare

Calmer Spells

Typical Course

When to See a Doctor First

When to get urgent medical advice

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooReactive Arthritis

What It Is

Reactive Arthritis Anatomy

Self-Care & Treatment

How to Treat Reactive Arthritis

1. Anti-Inflammatory Medication

2. Exercise and Physiotherapy

3. Cold and Heat

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

During a Flare

Calmer Spells

Typical Course

When to See a Doctor First

When to get urgent medical advice

References

Related Conditions

Chronic Fatigue Syndrome

Juvenile Rheumatoid Arthritis (now called Juvenile Idiopathic Arthritis)

Benign Hypermobility Joint Syndrome

Osteoarthritis

Book a session