Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body, most often intestines, genitals or urinary tract. Reactive arthritis usually targets knees, ankles and the joints of the feet. Inflammation also can affect eyes, skin and urethra.
The infection usually occurs days to weeks before the onset of joint pain. In some cases, a preceding infection may only be identified with laboratory testing. Previously, reactive arthritis was sometimes called Reiter’s syndrome, which was characterized by eye, urethra and joint inflammation.
Signs and symptoms
- Pain and stiffness in joints, especially knees, ankles and feet
- Eye inflammation like conjunctivitis
- Urinary problems like increased frequency and discomfort during urination
- Inflammation of soft tissues like muscles, tendons and ligaments
- Swollen toes or fingers
- Skin problems including a rash on the soles and palms and mouth sores
- Low back pain
Causes
Infection by certain bacteria. Most often, these bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella, Shigella and Yersinia).
Physiopathologie
The bacteria induce (cause) arthritis by distorting body’s defence against infections, as well as the individual’s genetic environment
Reactive arthritis is an immune-mediated syndrome triggered by a recent infection. It is hypothesized that T lymphocytes are induced by bacterial fragments such as lipopolysaccharide and nucleic acids when invasive bacteria reach the systemic circulation. These activated cytotoxic-T cells then attack the synovium and other self-antigens through molecular mimicry. This is supported by the evidence of Chlamydia trachomatis and C pneumoniae ribosomal RNA transcripts, enteric bacterial DNA, and bacterial degradation products in the synovial tissue and fluid. It is believed that anti-bacterial cytokine response is also impaired in reactive arthritis, resulting in the decreased elimination of the bacteria. It is, however, unclear why such localization of inflammation occurs.
The prevalence of HLA-B27 in reactive arthritis is estimated at 30% to 50% in patients with reactive arthritis, although values range widely. In hospital-based studies with more severely affected patients, frequencies as high as 60% to 80% have been reported. HLA-B27 should not be used as a diagnostic tool for a diagnosis of acute reactive arthritis. The presence of HLA-B27 is believed to potentiate reactive arthritis by presenting bacterial antigens to T cells, altering self-tolerance of the host immune system, increased TNF-alpha production, promoting the invasion of microbes in the gut, and delayed clearance of causative organisms.
Initially, the dermal histopathological features of reactive arthritis are similar to psoriasis. Examination of the synovial fluid reveals large macrophages, Reiter cells with phagocytosed neutrophils, lymphocytes, and plasma cells. Extensive pannus formation is very rare.
Diagnostic
Diagnosis is largely based on symptoms of the inducing infections and appearance of typical musculoskeletal (joint and muscle) involvement.
Blood tests are done for any infection and all types of arthritic conditions.
If indicated, doctors might order a test for Chlamydia infection or test for the HLA-B27 gene
Traitements
Treatment for the infection consists mainly of antibiotics. Other medications used to treat reactive arthritis include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Corticosteroids
- Topical steroids
- Rheumatoid arthritis medications such as sulfasalazine (Azulfidine), methotrexate (Trexall) or etanercept (Enbrel)
Physical therapy is found beneficial in the management of reactive arthritis to improve the flexibility of joints & to reduce stiffness.
Pronostic
Follows a typically self-limited course, with resolution of symptoms by 3-12 months.
Complications
- Recurrent arthritis (15-50%)
- Chronic arthritis or sacroiliitis (15-30%)
- Ankylosing spondylitis (30-50% of HLA-B27–positive patients)
- Urethral stricture
- Aortic root necrosis
- Secondary glaucoma
- Cataractes
- Cystoid macular edema
- Posterior and anterior synechiae
- Cyclitic membrane
- Vitreous opacification
- Ankylosing spondylitis
- Psoriatic arthritis
- Sacroiliitis
- Erythroderma (rare)
Maladies et Ayurveda
Considering the clinical features & presentation, the disease reactive arthritis can be compared with aamavata described in Ayurveda classic texts.
Nidana
Incompetent and unwholesome diet with opposite potency
Improper body postures & movements
Loss of appetite & digestive power
Exercise immediately after highly unctuous & oily food
Sedentary lifestyle
Purvaaroopa
Dourballya – Tiredness/Fatigue
Hrudayasya gauravam – Heaviness of chest
Samprapti
The ama produced due to defective digestion & sedentary lifestyle, gets lodged in the site of sleshma (Kapha) like joints with the help of Vaata and produce symptoms of Aamavaata.
Lakshana
Angamarda – bodyache
Aruchi – Loss of taste sensation
Thrishna – Excessive thirst
Alasyam – Lethargy/laziness
Gauravam – Heaviness of the body
Jwara – Fever
Apaaka – Indigestion
Soonata – Oedema
Divisions
It can develop by the vitiation of Vaata, Pitta, Kapha individually (ekadoshaja), or any two of them together(dwidoshaja) or all the three doshas vitiated together(tridoshaja).
Pronostic
Saadhya – only one dosha vitiated
Yaapya – two doshas involved
Asadhya – All doshas involved & the disease affected all over the body.
Chikithsa
Ayurveda treatment for Aamavaata is completely different from other joint diseases. Use of any snehadravya like oils/ghee will aggravate all the symptoms in this disease. So, only langhana(weight reducing therapy like fasting)and Rookshana(drying up therapies with medicines & treatment procedures) are recommended.
Samana
Lepana with rookshadravyas like kolakulathadi choorna
Parisheka with soolaharakwatha like dasmoolakwatha
Aamapachanam with shaddharanam choornam etc
Agnideepanam with gandharvahastadi kwatham etc
Vyadhivipareeta chikithsa
Sodhana
Langhana
Swedana
Virechana
Snehapanam
Vasti especially kshaaravasti
Médicaments couramment utilisés
Amruthotharam kashayam
Rasnasunthyadi kashayam
Yogarajaguggulu
Shaddharanam choornam
Guggulutiktakam ghrutam
Marques disponibles
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Remèdes maison
No home remedies are proven to cure reactive arthritis. But a healthy diet and lifestyle will be helpful to improve the quality of life.
Régime alimentaire
- À éviter
Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Boissons gazeuses - rendent l'estomac plus acide et perturbent la digestion
Aliments réfrigérés et congelés - provoquent une digestion faible et paresseuse en affaiblissant Agni (le feu digestif).
Milk and milk products – increase kapha and cause respiratory problems
Caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies
- A ajouter
Des repas légers et des aliments faciles à digérer
Green gram, soups, honey
Aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.
Comportement :
Protect yourself from cold climate.
Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.
Maintenir une alimentation et un sommeil réguliers.
Évitez de retenir ou de forcer les envies comme l'urine, les selles, la toux, les éternuements, etc.
Avoid sedentary lifestyle.
postures de Yoga
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Exercices simples pour la santé des poumons et du cœur
Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.
Articles de recherche
https://www.ncbi.nlm.nih.gov/books/NBK499831/#_article-28255_s5_
The objectives of this study were to investigate and validate individual variables and to develop a composite score for disease activity measurement in patients with reactive arthritis (REA). In the first cross‐sectional part, the clinical and laboratory evaluation of 45 patients was used to elaborate the most important individual disease activity measures. In the second prospective part, these variables as well as a composite score for disease activity measurement of REA were prospectively validated in 23 patients at two points in time.The following variables emerged as the most useful for the composite measure: number of swollen and tender joints, patient’s pain and global assessment, and C‐reactive protein. The score was calculated by simple addition of the individual figures.
It was concluded that DAREA constitutes a reliable score which can easily be assessed on a day‐to‐day office work basis.
Ces déclarations n'ont pas été évaluées par la Food and Drug Administration des États-Unis. Ce produit n'est pas destiné à diagnostiquer, traiter, guérir ou prévenir une quelconque maladie. Veuillez consulter votre médecin généraliste avant de prendre ce produit.
Rédacteur :
Rajesh Nair, cofondateur et consultant en chef d'Ayurvedaforall.Com, est diplômé du prestigieux Vaidyaratnam Ayurveda College (affilié à l'université de Calicut), au Kerala, en Inde. Il est également titulaire d'un diplôme de troisième cycle en thérapie par le yoga de l'université d'Annamalai.
Le docteur Nair propose des consultations dans deux cliniques très fréquentées à Haripad, Alleppey, Kerala, l'État du sud, célèbre dans le monde entier pour ses traitements ayurvédiques authentiques et ses médecins. Tout en offrant des consultations sur tous les aspects des traitements ayurvédiques, le Dr Nair s'intéresse tout particulièrement au Panchkarma, au yoga et aux massages.
Grâce à Ayurvedaforall, le Dr Nair propose des consultations en ligne à des patients du monde entier et a servi des centaines de patients au cours des 20 dernières années. En plus de sa pratique ayurvédique, il est le rédacteur en chef de ayurveda-amai.org, le portail en ligne de l'Ayurveda Medical Association of India, et le membre du comité d'État de l'Ayurveda Medical Association of India.
Le Dr Nair participe régulièrement à des conférences sur l'Ayurvéda et s'est rendu en Allemagne pour propager l'Ayurvéda. Vous pouvez lui écrire directement
rajesh@ayurvedaforall.com
Whatsapp - +91 9446918019, +91 8075810816
URLs : https://www.ayurvedaforall.com/
https://www.ayurvedaforall.co.uk/
Pour vous donner une idée rapide d'Ayurvedaforall, nous sommes un groupe de praticiens ayurvédiques engagés à propager l'Ayurveda dans sa meilleure tradition à travers le monde. Notre boutique en ligne vend des formules ayurvédiques authentiques accompagnées de conseils professionnels. Le site, qui en est à sa dix-septième année d'existence, nous a permis de nous constituer une clientèle dévouée qui utilise régulièrement nos produits et nos services et qui nous recommande d'autres personnes. Il va sans dire que nous y sommes parvenus grâce à notre adhésion aux normes les plus élevées en matière de service à la clientèle et d'éthique professionnelle.
Français 
English 
Русский 
Deutsch 
Türkçe 
Italiano 
Español