If you have rheumatoid arthritis, you probably know that RA flare-ups tend to have a mind of their own. “The immune system is very mysterious,” says Ashira Blazer, MD, a rheumatologist at NYU Langone Medical Center. “A person can have a flare without any sort of trigger, but there are certain things that trigger flares.”
A flare is a period of increased RA activity (inflammation) or worsening rheumatoid arthritis symptoms. “An RA flare feels a lot like the first diagnosis of RA,” says Dr. Blazer. “So patients start to develop pain swelling, stiffness—especially in the morning—and it can last hours, maybe even all day.”
Predictable flares are ones that come about from a known trigger, like if you overexerted yourself from cleaning your house or had a stressful day at work. Unpredictable flares are ones that come about but don’t have a clear trigger.
“Sometimes patients get frustrated if they’re taking their medications as prescribed and they still have flares—but it’s important to know that flares can happen even in patients who are completely compliant,” says Dr. Blazer.
Flares are related to natural variations in the processes that cause inflammation. They can vary in intensity, duration, and frequency, but RA flares are usually reversible—if treated promptly. “Flares can go on for several weeks without appropriate therapy,” says Dr. Blazer.
Treating a Rheumatoid Arthritis Flare with Medication
“If someone is diagnosed with RA, and they believe they’re experiencing a flare, they should certainly see their physician as early as possible in order to get therapy and to get the flare under control,” says Dr. Blazer.
Depending on the severity of the RA flare, your doctor may give you medication to reduce the inflammation quickly. “Steroids are one of our tools, but some flares are a little bit milder and we can get away with non-steroidal anti-inflammatories, such as ibuprofen,” says Dr. Blazer.
Since flare-ups can come and go, Dr. Blazer says patients are often tempted to stop taking their meds when they feel well. Her advice: don’t. “If you want to avoid having flares you need to take [your medication] all the time,” she says.
Treating a Rheumatoid Arthritis Flare with Lifestyle Changes
When you’re experiencing an RA flare, it’s important to not try to just push through it—overexerting yourself can make the flare worse. “Take some time off work, or maybe reduce the number of obligations that you have in your life to really care for yourself and rest,” says Dr. Blazer.
Having trouble coping with RA emotionally? This little mindset shift will help change your outlook on rheumatoid arthritis.
It’s also important to prevent flares by managing your lifestyle. “Adequate sleep, adequate exercise (not overexertion), and stress management are keys to preventing flares,” says Dr. Blazer.