Reiter’s syndrome is also called as ‘Reactive arthritis’ or ‘Reiter’s arthritis’. It is an inflammatory reaction to an infection in other parts of the body, mainly reproductive system and digestive system. It causes inflammation of joints, urinary tract, eyes, skin and mucus membranes.
When an infection is caused due to bacterial contact, reactive arthritis is developed. Patients should enquire about the source of the infection. For example if the infection is acquired from STD, patients are advised to use condoms.
Treatment of Reiter’s Syndrome
Treatment is focussed on two things. Firstly the infection should be cleared and secondly the inflammation and joint pain should be treated.
According to studies, continuous use of ciprofloxacin for at least 4 months is effective and it acts on the infections causing reiter’s syndromes and it reduces the span of this disease. Doxycycline, azithromycin, levofloxacin and lymecycline are investigated for curing reactive arthritis associated with the Chlamydia. It has been proved successful in discouraging few symptoms.
NSAID refers to ‘Non Steroidal Anti Inflammatory Drugs’. Anti inflammatory drugs are commonly used for benefitting painful and swollen joints in reactive arthritis. The commonly used drugs are Aspirin, Ibuprofen and Azathioprine. For curing eye inflammations methotrexate eye drops is used.
The disadvantage of using this drug is the side effects caused by them. It causes cardiovascular and gastrointestinal complexities. Another restriction for this anti inflammatory drug is that it cannot be used for people with heart or peptic ulcer problems.
Corticosteroids are capable of controlling inflammation and stimulate the immune system against the infection. They are injected directly on the affected joints, if only very few joints are affected. For swelling and severe joint pain, oral corticosteroids are used for a short term. Except for this treatment, swelling does not respond well to any other treatment.
Corticosteroid cream may be applied for inflammation on eyelids and skin abrasions. Treatment is not required for mild conjunctivitis. For inflammations on deep areas of eyes, corticosteroid drops are prescribed after examining the eyes. Though corticosteroid is used for a short term, it has its own side effects. Side effects include mood swings and rise in appetite level.
DMARD refers to ‘Disease Modifying Anti Rheumatic Drugs’. Most of the Reiter’s syndrome cases respond to NSAID therapy. DMARD is used as an alternative if NSAID is not effective in treating this disease even after three months.
DMARD dampens the attack of immune system and reduces pain and inflammation. Azathioprine and Sulfasalazine are prescribed for peripheral joint pain. Methotrexate is advised for spinal pain. Side effects include gastrointestinal complexities.
Biologics refers to ’Biologic response modifiers’. For the extremely intense reiter’s syndrome cases, biologics is prescribed. TNF alpha inhibitors are widely biologic response modifier.
Physiotherapist teaches mild exercises to improve the flexibility and to support the muscles around the joints.
Strenuous exercises are not advised for the initial few months after resolution of reactive arthritis. Exercise should be done to strengthen the muscles around the joint. If there is no activity related to sore joints, it weakens the muscles around the joints and causes more pain.