The Center for Podiatric Care and Sports Medicine

I’m Experiencing Pain in My Foot. Do I Have Reactive Arthritis?

Posted by on Monday, May 14th, 2018

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Wondering what’s causing the pain and stiffness in your knees, ankles, and feet? Maybe you have conjunctivitis in the eyes, increased frequency and discomfort with urination, inflammation of soft tissues, swollen toes or fingers, rashes on the soles and palms, mouth sores, and back pain that worsens at night and first thing in the morning. You were treated for a bacterial infection within the last four weeks, but you thought that was clearing up. If this sounds like what you’re experiencing, you may be asking yourself: “Do I have reactive arthritis (also called Reiter’s Syndrome)?”

do i have reactive arthritis
If you’ve recently suffered from foot pain and a bacterial infection, you may have reactive arthritis. [Image Source: Unsplash user Lindsay Henwood]

Reactive Arthritis Case Study

The UK Express tells the story of a patient who landed in the hospital after waking up in the middle of the night “screaming in agony.” In addition to his high fever, his toes were turning blue, despite feeling hot to the touch, and he was covered in a rash. According to celebrity doctor Ranj Singh, immediate infection is the first thing medical practitioners look for with a patient presenting with rash, fever, foot swelling, and skin peeling. If the tests come back negative, their attention should turn to an ongoing inflammatory condition or underlying arthritis.

What is Reactive Arthritis?

One in 30,000 Americans come down with reactive arthritis following a certain type of bacterial infection. Most commonly, the culprit is Chlamydia trachomatis, a sexually transmitted disease. Diarrhea-producing gastrointestinal and bowel bacteria like Campylobacter, Salmonella, Shigella, or Yersinia from eating contaminated food are another common source. Prevalence is greater among men than women, by a 3:1 ratio. Most sufferers are relatively young, between 20 and 50 years of age, which sets this type of arthritis apart from others, which tend to afflict the elderly. What exactly triggers chronic arthritis symptoms in some but not others is mysterious, but research shows people with the HLA-B27 gene have more sudden, severe, and long-lasting symptoms. Patients with weakened immune systems due to AIDS or HIV also commonly develop reactive arthritis following bacterial exposure.

Do I Have Reactive Arthritis? If So, How Is It Treated?

Most people will fully recover from their symptoms when treated properly. Two-thirds of patients are treated for some residual back pain or enthesopathy—a disorder involving the attachment of a tendon or ligament to a bone. Reactive arthritis treatment will depend upon the stage of inflammation. Early acute inflammation can be treated by NSAIDs that suppress pain and swelling, such as Aleve, Voltaren, Indocin, or Celebrex. Doses vary from patient to patient. Unwanted side effects from long-term use, such as gastrointestinal bleeding, will need to be evaluated relative to the individual as well.

Late stage or chronic reactive arthritis may require treatment with an anti-rheumatic DMARD drug like sulfasalazine or methotrexate. These drugs are also useful in patients who have previously suffered from gastrointestinal infections. We give cortisone shots in the office that immediately relieve pain in extremely inflamed joints as the other medication improves the underlying condition. Immune-lowering biologic medications like Enbrel or Humira are used in severe cases. Chlamydia-induced reactive arthritis can benefit from a prolonged course of two or more antibiotics. With proper care, symptoms resolve in one to six months.

Other Possible Causes of Foot Pain

If not reactive arthritis, similar symptoms and foot pain could result from:

  • Nerve disorder (particularly if there is intense burning, numbness, or tingling sensations)
  • Broken foot bones and stress fractures
  • Ingrown toenails
  • Gout arthritis (especially if agonizing pain and extreme redness/inflammation are present)
  • Bunions
  • Achilles tendinitis
  • Raynaud’s Syndrome

Pain so bad you have trouble walking should not be taken lightly. Early treatment yields much better results. If you’re in the New York City area, you can be seen by foot and ankle specialists at The Center for Podiatric Care and Sports Medicine without delay. We have all the necessary tools in-office to diagnose you for illnesses or injuries pertaining to the lower limbs. Our doctors accept all major forms of insurance and you won’t need a referral. Contact us today.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.