Frequent flares are a sign that your rheumatoid arthritis treatment is not the right fit.
Autoimmune diseases like rheumatoid arthritis often have ups and downs. You may have periods where you experience little to no symptoms (remission). Then, you may have periods where you have new or more severe symptoms (a flare).
“A rheumatoid arthritis flare is a period of time where you have an increase in symptoms of your rheumatoid arthritis,” says Elizabeth Schulman, MD, Rheumatologist at the Hospital for Special Surgery. “Flares can vary. Some can be mild. Some can be very severe, and oftentimes it's unpredictable.”
Do I need to tell my provider if I’m having a rheumatoid arthritis flare?
Not necessarily. “A mild flare may last only a couple of days, be treated with over-the-counter medications, and then go away on its own,” says Dr. Schulman.
Consider asking your doctor the following questions:
- What should I do when I’m having a flare?
- What are tips to cope with a flare at home?
- When should I contact you about a flare?
- What is the best way to contact you about a flare?
When do I need to tell my doctor about a rheumatoid arthritis flare?
If your flare is severe — or if at-home treatments aren’t helping — you may need to contact your doctor. Keep in mind that a mild flare can sometimes progress into a severe flare.
“A severe flare may involve multiple joints and symptoms may get worse, not better, over time,” says Dr. Schulman. “I always stress to patients that if they have a new red, swollen or painful joint, they should reach out immediately because it's important to identify infections or severe flares early.”
How will my provider treat a severe rheumatoid arthritis flare?
In some cases, your provider may give you instructions for how to manage your flare using your existing treatment options.
In other cases, you may need additional or more aggressive treatment. Your doctor may prescribe corticosteroids or prescription-strength NSAIDs to treat the flare. These are short-term treatments that you’ll only take in low doses for a short time.
If you are having frequent flares, your provider may consider changing your long-term treatment plan. Common options to treat moderate-to-severe rheumatoid arthritis include:
- Conventional DMARDs (disease-modifying antirheumatic drugs)
- Biologics (a subtype of DMARD)
- JAK inhibitors (a newer, non-biologic type of DMARD)
What are the benefits of telling my doctor about a flare?
Tweaking your treatment plan in this case may result in fewer flares. Staying in remission longer generally results in less disease progression and joint damage. Ultimately, this may have positive effects on your quality of life and long-term health.
Elizabeth Schulman, MD, is a rheumatologist at the Hospital for Special Surgery.
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- McWilliams, D. F., et al. (2019). Disease activity flares and pain flares in an early rheumatoid arthritis inception cohort; characteristics, antecedents and sequelae. BMC Rheumatology.