by Wendy McBrair, MS, BSN, CHES
Use cold or warmth. If one or two joints flare up, putting ice packs or running cool water on the joints a few times a day can help reduce pain and swelling. Some people find it uncomfortable to use cold and prefer warm moisture instead. Hot packs, heating pads, paraffin wax baths (for the hands), warm tub baths, showers, or warm-water pools can all help the joints feel better.
Rest the body. During a flare-up, getting plenty of rest will help the medicines you are taking do their job. Doctors usually recommend a good night’s sleep — at least eight hours — and an additional rest in the afternoon, if possible. Alternating rest and work is also a good plan, as long as you stop working before you get too tired. In general, a flare-up is a good time to put off any projects you’re working on and be extra good to yourself.
Rest the joint. If one of your joints is swollen, be careful about overusing it. In particular, avoid aggressive or repetitive activities. That includes some kinds of exercise. It is best to suspend more strenuous exercise programs during an RA flare-up. As the swelling subsides, you can return to your normal activities.
Do range-of-motion exercise. Although strenuous exercise is out during a flare-up, light range-of-motion exercises can be helpful. In range-of-motion exercise, you simply put a joint through its normal range of motion, without stretching or forcing it. This is especially important for swollen joints. You should not force a swollen joint to bend too much and should stop if you experience a lot of pain. However, making sure the joint stays as flexible as possible during a flare-up will help preserve the joint’s range of motion and prevent long-term stiffness.
Pace yourself. Take your time when you do activities during a flare-up. Save your energy. Do a little every day rather than doing a lot on one day and nothing the next. The art of pacing can be difficult to master, but its rewards are less pain and stiffness.
Consider a joint injection. If, during a flare, one or two joints are very painful and swollen, you may be a candidate for a cortisone injection into the joint(s). Cortisone injections can reduce swelling, relieve pain, and allow for more normal range of motion. Your doctor can determine whether you would benefit from a joint injection and then administer the injection in his or her office. After the injection the doctor can decide if changes to your drug regimen are also needed.
Ask for help. When you are worried that you are having a flare-up, it may be time to ask for help with projects or even everyday tasks that are overwhelming and possibly harmful to swollen joints. Of course, asking for help is not as easy as it sounds. But remember that most family and friends would rather have you ask for help than have you do harm to your body and joints.
Avoid “catastrophizing.” Despite your flare-up, try your best to remain calm and not to worry. Just because your joints are swelling again, it does not mean that the flare-up represents a permanent change. It will probably be short-lived, so avoid imagining “worst-case” scenarios. Negative thinking can bring you more stress and can make the flare-up worse. Remind yourself that you are doing all you can do to improve the situation and live with RA.
Manage stress. As I’ve noted before, stress can be a major contributor to an RA flare-up. Of course, it is not so easy to eliminate stress from your life. But even a small reduction in stress can have an impact. One way to get started is to try to change how you think about the stressors in your life. For example, you may become stressed at the first sign of an RA flare-up (which only makes the situation worse). But once you realize that RA has its ups and downs and that you can sometimes have an impact on the flare-up, your confidence in your and your doctor’s ability to manage flares will increase. As it does, your stress will decrease.
Another way to combat stress is through stress-management activities, such as yoga, deep breathing, and meditation. These activities are most effective when you practice them regularly.
Use assistive devices. To avoid causing a swollen joint more pain and discomfort, use assistive devices that make it easier to do painful chores or activities. There is a wide range of available assistive devices, from devices that make it easy to hold a pencil, to “reachers” that allow you to get to items on high shelves, to simple canes and crutches. (These devices and many more can be found on Web sites such as Sammons Preston and Aids for Arthitis.) You may not need these assistive devices all the time, but they can be helpful 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.