RA flares are inevitable, but these tips can help you feeling like yourself again.
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.
Dr. Blazer is a rheumatologist and instructor in the department of medicine at NYU Langone Health.
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An RA flare feels a lot like
the first diagnosis of RA.
00:00:07,620 --> 00:00:12,150
So patients start to develop pains,
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The stiffness is especially in
the morning, and it can last hours,
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to maybe several hours,
or even a whole day
00:00:19,349 --> 00:00:22,880
00:00:22,880 --> 00:00:27,479
A rheumatoid arthritis flare is an acute
activation of the immune system,
00:00:27,479 --> 00:00:32,520
such that the joints become inflamed,
painful, and difficult to move.
00:00:32,520 --> 00:00:36,870
Flares can go on for
several weeks without appropriate therapy.
00:00:36,870 --> 00:00:38,810
The immune system is very mysterious,
00:00:38,810 --> 00:00:42,570
so a person can have a flare
without any sort of trigger,
00:00:42,570 --> 00:00:47,800
but there are certain things that trigger
flares, such as stress and infections.
00:00:47,800 --> 00:00:51,010
Sometimes patients get frustrated if
they're taking their medications as
00:00:51,010 --> 00:00:54,560
prescribed, and they still have flares,
but it's important to note
00:00:54,560 --> 00:00:58,780
that flares can happen even in
patients who are completely compliant.
00:00:58,780 --> 00:01:02,090
Unfortunately, some patients will
break through their treatment and
00:01:02,090 --> 00:01:05,520
end up having flares, but
we like to tailor the treatment
00:01:05,520 --> 00:01:09,060
plan such that we minimize the number
of flares as much as possible.
00:01:09,060 --> 00:01:12,210
So if someone is diagnosed
with rheumatoid arthritis, and
00:01:12,210 --> 00:01:16,200
they believe they're experiencing a flare,
they should certainly see their physician
00:01:16,200 --> 00:01:20,930
as early as possible in order to get
therapy and get the flare under control.
00:01:20,930 --> 00:01:24,260
The first thing is to assess
how bad the flare is, so
00:01:24,260 --> 00:01:28,630
we tend to use medications that work
quickly to reduce inflammation, so
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steroids are one of our tools, but
some flares are a little bit milder, and
00:01:32,330 --> 00:01:37,290
we can get away with non-steroidal
anti-inflammatories, such as ibuprofen or
00:01:37,290 --> 00:01:41,140
Aleve, and then, it's important not
to try to push through a flare.
00:01:41,140 --> 00:01:44,370
So, take some time out,
if you need to take some time off work,
00:01:44,370 --> 00:01:49,130
or maybe reducing the numbers of
obligations you have in your life,
00:01:49,130 --> 00:01:55,130
to really care for yourself and have that
rest in order to improve your flare.
00:01:55,130 --> 00:01:57,810
Because these disorders tend to come and
00:01:57,810 --> 00:02:01,760
go, it's very tempting to stop taking
the medication when you feel well,
00:02:01,760 --> 00:02:06,150
and if you wanna avoid having flares,
you really need to take it all the time.
00:02:06,150 --> 00:02:10,246
Adequate sleep, adequate exercise,
not over-exertion, and
00:02:10,246 --> 00:02:13,606
stress-management are keys
to preventing flares.
00:02:13,606 --> 00:02:21,524
Arthritis flares. Arthritis Foundation. (Accessed on May 11, 2018 at https://www.arthritis.org/living-with-arthritis/pain-management/flares)