by Wendy McBrair, MS, BSN, CHES
If you have rheumatoid arthritis (RA), you take medicines to help keep symptoms such as joint pain and inflammation under control. Even when RA is well-controlled, however, it’s possible to have a flare-up, or flare, of the condition. During a flare-up, RA symptoms get temporarily worse after being quiet or less severe for a period of time. If you experience a flare-up, a joint or joints may swell or become more swollen; you may feel more pain and stiffness, especially in the morning; and your body may feel more fatigued. When all of these things happen at the same time, the flare-up is considered more serious.
Fortunately, there are ways to deal with a flare-up. Here are three important steps you can take to help yourself if your RA ever flares.
The first step to managing a flare-up is to realize that you are having one. By identifying a flare-up early, you can get an early start on managing it. This is easier for the individual who is very aware of his or her body and how it feels. Learn to pay attention to how RA affects your body so that if something changes, you recognize it. When you realize there’s been a change, acknowledge it — don’t go into denial and hope that everything will just get better on its own.
Once you’ve recognized that you are having a flare-up, it’s important to try to identify why the flare-up is occurring. While in many cases flare-ups have no known cause and are just part of the natural ups and downs of RA, sometimes they have triggers. How you manage the symptoms of the flare-up may be determined by what you think the cause is. For instance, you may recognize that your flare-ups are often triggered by stress. By identifying the stressors in your life, you may then be able to change them and thus diminish the severity of the flare-up (or prevent future flare-ups). This sort of information can be very important for both you and your doctor.
Other possible triggers for flare-ups may include not taking your medicines properly, overdoing activity and not getting enough rest, overusing certain joints, or experiencing a general worsening of your condition. Some people also think changes in the weather provoke their flare-ups. Let’s take a closer look at some of these flare-up triggers.
Medicine. A flare-up can occur when you are not taking your medicine regularly or not taking it as prescribed by the doctor. Some people are afraid of the side effects of medicines and try to reduce the amount they are taking or even stop taking the medicine entirely, even when they’re still experiencing symptoms. Others begin to feel better and either stop taking or forget to take their medicine. In both cases, not taking the medicines as prescribed can have serious consequences. It increases the risk of permanent damage to the joints.
Overdoing it. Overdoing activities and becoming severely tired may also bring about a flare-up. Let’s say you’re feeling better and trying to get a particular project done, such as hosting a big party. In the excitement of the event, you can push yourself too hard and wind up paying for it later. That’s why it’s important to have a clear idea of what is too much for your body to handle. While exercise and activity are important, it is also important to balance them with rest. Avoiding tiredness as much as possible is a key part of your RA treatment.
Overusing it. Overusing a joint can cause your RA to flare up. You can overuse a joint or joints in a number of ways. For example, if you have RA in your hands, doing an activity that is too hard for your hands, such as hammering, opening a tricky jar, or washing all your home’s windows in one day, can bring about a flare-up in the hands. If you have RA in your knees, you might flare up after spending several hours on your knees planting your garden. In each case, the swelling may occur any time from soon after the activity to a few days later. When swelling occurs in a particular joint, think back to what you’ve done over the last few days.
Other triggers. As already mentioned, stress can contribute to a flare-up. In addition, some people find that certain weather conditions, such as humidity, can cause increased joint pain. The weather does not necessarily make the joint inflammation worse but may make the joint discomfort more obvious. Finally, a flare-up may be a sign that your condition is getting worse. If you have a flare-up that just won’t go away, you should see a doctor for more effective ways to treat your RA.
The third step to managing flare-ups involves actions you can take to relieve the pain and inflammation. The following are known to be effective.
Do a medicine check. If you haven’t been taking your medicines as prescribed, it’s time to get back on track. If you stopped taking your medicine because you think it is causing undesirable side effects, make sure to tell your doctor. The doctor may be able to change your dose or prescribe a new medicine for you. If you are having trouble paying for your medicines, your doctor may be able to help you find ways to pay for them or to prescribe less expensive ones. Whatever your reason for stopping your medicine, it’s best not to allow this situation to continue for too long. The hope is that getting back on a regular schedule with your medicines will cause the RA to again respond and calm down quickly.
Check in with your doctor. You may want to check in with your doctor. You should already have worked out with your doctor the best way to get in touch should you have a flare-up. Some doctors prefer that you visit, especially if you are newly diagnosed. Others would prefer you to e-mail or phone. To treat your flare-up, the doctor may change the dose of your medicine, give you a new medicine, or advise you on other techniques to reduce your symptoms. You and your doctor can also work out a plan for changing or adding medicines or making other changes to your program that you can do yourself at home before checking in with the doctor. For example, your doctor may advise you to increase the dose of a pain-relief drug temporarily when you are having a flare-up.
Last Reviewed on May 19, 2010
Get the latest arthritis news and the most useful self-management tips delivered to your inbox twice a month! Sign up for our free e-mail newsletter today.
Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.