What Is A Flare
Hopefully, you have achieved a fairly steady level of your RA, but you may still experience flares. This is a time when your RA temporarily becomes more active and can include increased disease activity, swelling and pain in your joints, fatigue, low-grade fevers, even loss of appetite. Flares may be intense, essentially stopping your life, or they can be smaller and only last a few days. How bad they are depends on how controlled your RA is, as well as possible triggers.
Ra Pain Vs Ra Flare: Whats The Difference
Everyday rheumatoid arthritis pain is different than the pain you feel during an RA flare. According to Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, RA pain is a constant, nagging pain that is typically worse in the morning, while an RA flare is a severe sudden onset of diffuse widespread pain that, if not treated, can put you in bed the whole day.
RA pain is a symptom of an RA flare, says Dr. Schulman. RA pain would be part of the evaluation that a rheumatologist would do to determine if a patient is having a flare.
In addition to joint pain, an RA flare can cause fatigue, irritability, aggressiveness, and depression.
Both RA pain and an RA flare can vary in intensity, duration, and frequency, but an RA flare can be alleviated if treated promptly and properly. Often a short course of steroids can be enough to stop the flare, and then you go back to a cycle of maintenance, says Dr. Domingues.
Its not uncommon for an RA patient who is on medication and in low disease activity or remission to have one or two RA flares per year, he continues.
However, if you find yourself getting flares that dont resolve or come back often, this may mean that your medications are no longer working as well as they should, says Dr. Schulman. This may mean it is time to discuss a medication change with your doctor.
Its important to recognize and avoid RA flare triggers, which include:
- Overexertion
Causes And Symptoms Of Arthritis Flares
If you have arthritis, you will likely have experienced a flare-up of symptoms at one time or another, often with no apparent cause. Depending on the type of arthritis you have, it may be related to a specific trigger or the ongoing progression of your disease. It is often hard to tell.
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What Is Rheumatoid Arthritis
Arthritis is a general term for inflammation in joints. Rheumatoid arthritis is a type of chronic arthritis that occurs in joints on both sides of the body , which helps distinguish it from other types of arthritis.
In addition to affecting the joints, rheumatoid arthritis may occasionally affect other parts of the body, including the skin, eyes, lungs, heart, blood, nerves, or kidneys.
Rheumatoid arthritis is an autoimmune disease, meaning that patients immune system is overreacting against itself. The result can cause some or all of the symptoms of rheumatoid arthritis.
What Causes Gout To Flare Up
Gout is a complex form of arthritis that can flare up suddenly and severely. It occurs as a result of having high levels of uric acid, which makes it easier for urate crystals to form. These sharp crystals can deposit in your joints, causing inflammation, swelling and pain.
“The most common trigger of gout is eating purine-rich foods, since high levels of purines can increase the amount of uric acid in your bloodstream,” explains Dr. Alam.
Gout-sufferers can help avoid flare-ups by avoiding foods rich in purines, including:
- Red meat
- Certain types of seafood, including tuna, scallops and trout
- Alcohol, particularly beer
- Fruit juices and other beverages that contain fructose
“Similar to rheumatoid arthritis, a flare-up of gout can be alleviated by using a cold compress on the affected joint, which helps reduce the inflammation that’s causing your pain, swelling and stiffness,” says Dr. Alam.
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What Do Ra Flare
You will know when you are in a flare, wrote one myRAteam member. The usual pain that we learn to live with multiplies by an unknown amount.
As this member stated, RA flare-ups are often apparent because they cause typical RA symptoms to worsen. This may not necessarily be excruciating as one member in flare described, Its not major inflammation or screaming pain, but enough to let me know things are not right.
Three of the most common symptoms that develop or worsen during RA flares are joint symptoms, fatigue, and fever. A person experiencing an RA flare may also feel generally unwell, as if they are coming down with an illness. Think I started a flare, wrote one myRAteam member. Serious fatigue, low-grade fever, and increased aching joints like Im coming down with something.
Some people with RA find that they experience less typical symptoms while in flare: one member wrote that they have increased ear fullness/ache, while another shared that they have had stomach upset This flare, Ive had tons of belly issues! The bloating is so uncomfortable!
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2. Try hot and cold packs. A heating pad or an ice pack can increase your pain threshold wherever you apply it, thus helping to decrease the sensation of pain, Dr. Ormseth says. Dr. Lee recommends cold therapy if joints are swollen because heat can worsen swelling. Apply a cold pack, like a bag of frozen vegetables, to swollen joints two to four times a day for 15 minutes each time. You can use heat if joints are painful but not swollen during your flare. Try a heating pad, warm compress, heat patch, or warm bath for the affected joints two or three times a day for 15 minutes at a time. Just make sure you dont overdo either treatment, hot or cold.
3. Soothe your body and mind. Give yourself some extra TLC to help your body recover from a flare. Though its not always easy, try to relax, Ormseth says. Practice relaxation techniques to help your mind and body calm down and recover. Engage in deep breathing, meditation, and visualization. Try a little pampering soaking in a warm bath, listening to soothing music, enjoying quiet time, or sipping on a steaming mug of tea the Arthritis Foundation suggests. Also, adds Smith, do your best to avoid physically and emotionally stressful situations.
4. Call for backup. The world doesnt stop when your RA flares, and neither do your responsibilities. When RA knocks you down, put a second action plan in place to address lifes other essentials work, family, and household chores.
How Does A Normal Joint Work
A joint is where two bones meet. Most of our joints are designed to allow the bones to move in certain directions and within certain limits.
For example, the knee is the largest joint in the body and one of the most complicated. It must be strong enough to take our weight and must lock into position, so we can stand upright.
It also has to act as a hinge, so we can walk, and needs to twist and turn when we run or play sports.
The end of each bone is covered with cartilage that has a very smooth, slippery surface. The cartilage allows the ends of the bones to move against each other, almost without rubbing.
The joint is held in place by the synovium, which contains thick fluid to protect the bones and joint.
The synovium has a tough outer layer that holds the joint in place and stops the bones moving too far.
Strong cords called tendons anchor the muscles to the bones.
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Relax With Yoga And A Massage
Stress is a major contributor to RA flares. Here are some ideas to get a better handle on your stressand your RA flares:
- Do yoga, including meditation and deep breathing.
- Try biofeedback-enhanced neuromuscular relaxation .
- Schedule regular gentle massages.
- Take a long, warm bath.
Even a small decrease in stress can have a major impact in your life. For the most benefit, add stress management techniques into your everyday routine.
What Happens In A Joint Affected By Rheumatoid Arthritis
If you have rheumatoid arthritis, your immune system can cause inflammation inside a joint or a number of joints. Inflammation is normally an important part of how your immune system works. It allows the body to send extra fluid and blood to a part of the body under attack from an infection. For example, if you have a cut that gets infected, the skin around it can become swollen and a different colour.
However, in the case of rheumatoid arthritis, this inflammation in the joint is unnecessary and causes problems.
When the inflammation goes down, the capsule around the synovium remains stretched and cant hold the joint in its proper position. This can cause the joint to become unstable and move into unusual positions.
The following can play a part in why someone has rheumatoid arthritis:
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Managing Rheumatoid Arthritis Flares
There are ways to manage rheumatoid arthritis flares. These include:
How Is An Ra Flare Defined
Although there is currently no set definition of what constitutes an RA flare, there is agreement that a flare is associated with a worsening of key RA symptoms and an impact on certain areas of daily functioning. Your doctor may use clinical tools including standard RA laboratory tests, counts of swollen and tender joints, and a global assessment of your condition to determine whether you are experiencing a flare.1
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Protect Your Aching Joints
These simple methods may work:
- Use canes, special jar openers, and padded handles.
- Make it easier to lift, carry, or bend. Use your bigger joints instead of your smaller ones. Use your whole arm to lift things, not just your hands and wrists.
- Wear safety gear like knee and elbow pads, or wrist guards when you play sports or do outdoor activities.
- Put your joints through their full range of motion. Use slow, gentle movements.
- Strengthen the muscles and ligaments around your joints. If you don’t have a physical therapist, ask your doctor to help you find one.
- Try to avoid extra weight, which puts pressure on your joints. Your doctor can tell you what your goal should be.
Rheumatoid Arthritis Flare Treatment
If your symptoms are revving up while youre on RA meds, your doctor may add an injectable or oral steroid to the mix. These drugs help to curb the inflammation quickly, says Saika Sharmeen, M.D., assistant professor in the division of rheumatology at Stony Brook Medicine in Stony Brook, NY. Beyond that, you might consider one of these home remedies or supplements to help ease your symptoms:
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Seeking Help When Symptoms Cannot Be Contained
The tipping point for seeking professional help is reached when multiple symptoms cannot be controlled by even increased self-management strategies, and patients cannot run their normal lives . They may be supported or prompted in this decision by family:
When its all over, along with the other symptoms that I know I get with inflammation, thats my personal tipping point
In such a place of despair I think I just cant go on with this anymore and Im trying this medication and Im trying to pace my working, Im trying to have so many hours sleep and Im still waking up in pain. and its still not working
The reason that I end up running back to crying is, Ive got 3 young children and I teach and its where it gets to the point where I cant function any more its got to the point where Im not coping, the household chores just arent being done and I just beat myself up because I cant be like all the other mums and do little things for the kids. If its not me its my husband, hell say You need to go and get some reinforcement and usually I go to the GP .
What Causes Rheumatoid Arthritis Flare Ups
October 19, 2017 by Edward Harrison
Occasionally people with rheumatoid arthritis experience a flare up. A flare up is when symptoms have been controlled, but then suddenly become worse. The RA sufferer experiences three or more days of increased joint pain, swollen joints, and stiffness. An understanding of what causes RA flare ups and what to do about them can help family members of older adults with RA to assist with managing them.
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Types of Flare Ups.
The Arthritis Foundation states that there are two kinds of flare ups:
- Predictable Flares: These types of flares have triggers that the RA patient is aware of. For example, if older adults with RA overexert themselves cleaning the house or engaging in other strenuous physical activity, they can expect to have a flare up. Predictable flares usually last a few days and resolve on their own.
- Unpredictable Flares: Unpredictable flares are ones that the RA patient cannot associate with a trigger. They simply feel worse, and dont know why. These types of flares sometimes require medical care to resolve.
Common Flare Up Triggers.
There are several things that may trigger flare ups. Some things to be mindful of in aging family members with RA are:
Managing RA Flare Ups.
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How To Prevent Ra Flares From Getting Worse
If you have RA, you can expect flares from time to time, but knowing how to identify the signs of a flare early on can help prevent it from becoming more severe. When a flare strikes, getting proper rest, taking anti-inflammatory medications and supplements, practicing stress-reducing techniques, and engaging in gentle, calming exercise can help your flare from getting worse.
- General Info on RA Flares: The Arthritis Foundation. What Triggers an Arthritis Flare?
- Diet and RA Flares:The Open Rheumatology Journal. . Role of Diet in Influencing Rheumatoid Arthritis Disease Activity.
- Omega-3 Fatty Acids and RA:Mediterranean Journal of Rheumatology. The Effects of Omega-3 Fatty Acids on Rheumatoid Arthritis.
- Frequency of Flares:The Journal of Rheumatology. Flares in Rheumatoid Arthritis: Frequency and Management. A Report From the BRASS Registry.
Measures To Reduce Bone Loss
Inflammatory conditions such as rheumatoid arthritis can cause bone loss, which can lead to osteoporosis. The use of prednisone further increases the risk of bone loss, especially in postmenopausal women.
You can do the following to help minimize the bone loss associated with steroid therapy:
- Use the lowest possible dose of glucocorticoids for the shortest possible time, when possible, to minimize bone loss.
- Get an adequate amount of calcium and vitamin D, either in the diet or by taking supplements.
- Use medications that can reduce bone loss, including that which is caused by glucocorticoids.
- Control rheumatoid arthritis itself with appropriate medications prescribed by your doctor.
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Going Through The Peak Of A Flare
A dramatic worsening of pain marks the peak of a flare. This pain may be characterized as burning or stabbing and may affect different muscles and joints simultaneously. During the peak of a flare, you may find it difficult or impossible to sleep soundly. With a lack of sufficient rest, you may not be able to concentrate or function normally. This loss of normal functioning can affect every facet of life, from meal preparation to grooming and hygiene. Consequently, flares may be accompanied by a loss of weight and neglect in appearance.2
What Is The Prognosis For People Who Have Rheumatoid Arthritis
Although there is no cure for rheumatoid arthritis, there are many effective methods for decreasing the pain and inflammation and slowing down the disease process. Early diagnosis and effective treatment are very important.
Extensive research is being done to learn the cause of rheumatoid arthritis and the best methods of treatment.
Last reviewed by a Cleveland Clinic medical professional on 11/17/2017.
References
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