People can develop reactive arthritis after COVID-19. Symptoms include sudden onset joint pain and swelling, often in multiple joints.

Reactive arthritis can occur after various infections, even if joint pain was not a symptom during the initial illness.

Alternatively, arthritis that develops after COVID-19 may be the result of long COVID, or it may be a temporary side effect of the COVID-19 vaccine.

According to a 2021 study, post-COVID-19 arthritis may occur as a result of inflammation, which is part of the body’s natural immune response. The symptoms of reactive arthritis include inflammation, swelling, and pain in the joints.

This article discusses arthritis after COVID-19, including the symptoms, treatment, and duration. It also examines joint pain with long COVID and flare-ups in preexisting arthritis.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Yes, COVID-19 can trigger arthritis in some people. Other viral infections can do so as well.

According to a 2022 review, reactive arthritis may occur in genetically predisposed individuals 1–4 weeks after a variety of infections, including the respiratory virus SARS-CoV-2 and some infections of the digestive or urinary tract.

In a 2021 study, researchers tried to gauge how common this is. They examined 100 people from Egypt who had recovered from COVID-19 several months prior. The incidence of post-COVID-19 arthritis was 37%. Smoking, older age, and preexisting joint pain had links to post-COVID-19 arthritis.

To determine the cause of arthritis after COVID-19, the authors tested for markers of inflammation and autoimmunity in the participants. Autoimmunity is when the body’s immune system mistakenly attacks healthy tissue.

They discovered a strong association between post-COVID-19 arthritis and inflammation but not between post-COVID-19 arthritis and autoimmunity. Based on this, they concluded that lingering inflammation is the cause.

The COVID-19 vaccine is safe and does not cause arthritis in the vast majority of people. However, a 2022 case report notes that some people have developed new or worse symptoms of autoimmune conditions after receiving the COVID-19 vaccine. One of these conditions is rheumatoid arthritis (RA).

The report focuses on a 53-year-old man with a family history of RA. Although he was healthy before he received the COVID-19 vaccine, he began having symptoms of RA 4 weeks after his final vaccination.

The authors of the case report suggest that the vaccine may have triggered an inflammatory response that led to the man’s symptoms. However, the report does not confirm that this happened. No studies have found a direct link between the vaccine and arthritis.

Arthritis can develop or flare up for many reasons. Factors that may contribute include:

  • older age
  • family history of arthritis
  • coexisting conditions

COVID-19 vaccines can also cause temporary side effects that feel similar to those of arthritis or RA, such as:

These effects usually last a few days but can last up to several weeks. People may mistake these symptoms for arthritis.

The COVID-19 vaccine may trigger an RA flare in people who already have the condition, but experts still strongly urge people with the condition to get vaccinated. The benefits usually outweigh the risks, as people with RA are more vulnerable to severe COVID-19.

The symptoms of reactive arthritis can range from mild to severe. Usually, they start 1–6 weeks after an infection.

Joint symptoms

Joint-related symptoms of reactive arthritis include:

  • pain and swelling in the joints, especially the large joints of the legs, such as the ankles and knees
  • symptoms that affect only one side of the body
  • nighttime pain or morning stiffness
  • foot or heel pain, which is a symptom of inflammation in a tendon or ligament attached to a bone
  • pain and swelling in fingers or toes

Eye inflammation

Reactive arthritis may also cause eye symptoms such as:

  • redness
  • burning
  • pain
  • itching
  • blurred vision
  • crusted eyelids
  • light sensitivity

Urinary tract inflammation

If reactive arthritis is the result of an infection in the genital or urinary tract, it can produce inflammation. In females, this can lead to inflammation in the genital and reproductive organs as well.

Symptoms may include frequent urination and burning pain while urinating.

Other symptoms

Other potential reactive arthritis symptoms include:

  • fever
  • abdominal pain
  • diarrhea
  • tiredness
  • unintentional weight loss
  • thickened nails
  • small ulcers in the mouth
  • rash
  • small ulcers on the penis

According to the National Library of Medicine, if a person still has the infection that led to reactive arthritis, treatment focuses on the infection.

If the infection is no longer active, this type of treatment does not help. In such cases, the goal of therapy is to relieve symptoms and prevent long-term complications.

Nonsteroidal anti-inflammatory drugs are the first-line treatment when reactive arthritis starts. Other possible treatments include:

  • Steroid cream or injections: A localized steroid may be an option for someone with arthritis in only one joint or in a few large joints. This could take the form of a cream, such as hydrocortisone, or an injection, such as triamcinolone.
  • Oral steroids: Systemic hydrocortisone may be appropriate for individuals with severe reactive arthritis that affects multiple joints and involves heart and eye symptoms.
  • Disease-modifying antirheumatic drugs: These medications help because they block inflammation, which helps protect joints. Sulfasalazine is one example.
  • Supportive devices: Insoles and orthotics, such as knee braces, may make people feel more comfortable.

In addition to taking medications, a person may benefit from:

  • using heat to ease pain
  • wearing joint braces
  • performing strengthening exercises, which prevent muscle wasting

Long COVID, or post-COVID syndrome, is a condition that causes long lasting symptoms after a person recovers from an initial COVID-19 infection.

These symptoms may last weeks or months. The symptoms may also disappear and recur. In most individuals, the symptoms slowly decrease over time.

One potential symptom of long COVID is joint pain. Other possible symptoms include:

  • tiredness
  • fever
  • shortness of breath
  • chest pain
  • difficulty concentrating
  • depression
  • diarrhea
  • muscle pain

Although long COVID is more common in people who have had a severe case of COVID-19, it can happen even in those with a very mild case.

If someone believes they may have long COVID, they should make an appointment with a doctor, who can create a medical management plan for them. This may help reduce symptoms and increase quality of life.

The symptoms of reactive arthritis usually go away within 3–5 months. However, 15–30% of people may develop long-term arthritis and other joint issues. Additionally, 15–50% may experience recurring episodes of arthritis.

If joint pain occurs as a result of long COVID, the symptoms could be unpredictable. Some people recover from long COVID in a few weeks, but others do not recover completely.

Learn more about long COVID recovery.

Arthritis after COVID-19 is a potential complication of the illness. It can happen if a person develops reactive arthritis due to the inflammation the infection causes.

This may lead to joint pain, eye inflammation, and symptoms that affect various parts of the body. Reactive arthritis usually disappears within 3–5 months.

Joint pain may also be present in long COVID. Additionally, the COVID-19 vaccine may cause arthritis-like side effects that can last weeks. In some cases, it may lead to arthritis flare-ups in people who already have RA.

Treatment for joint pain is available. If a person has persistent joint pain after any infection, they should contact a doctor.

Coronavirus data

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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