Rheumatoid arthritis is a chronic inflammatory disease that affects the joints. It is a lifelong disease, with periods of remission and flares. Helping you understand what a flare is and how you can both prevent and treat them are key to limiting the effects of this disease.
What Is a Flare?
A flare is a worsening of rheumatoid arthritis (RA) that can be very painful. A flare can be defined both by a worsening in your symptoms, or by the impact the flare has on your ability to do your daily activities, like going to work or school, driving, getting dressed, taking care of your kids or cooking dinner. Symptoms that you can experience when having a flare include swelling and tenderness around your joints, pain, fatigue, fever and weight loss. A flare can also disturb your sleep and mood, and it can lead to symptoms of depression and anxiety.
Doctors describe flares as being either predictable or unpredictable. In predictable flares, patients can identify triggers that may lead to a flare. These triggers can be stress, poor sleep, infections (like the flu), overexertion, certain foods or medications, or when your doctor tapers you off one of your rheumatoid arthritis medications. Unpredictable flares are ones that have no known trigger and are often more debilitating and harder to prevent.
Flares are a very serious part of rheumatoid arthritis; if flares are left untreated, it can increase your risk for joint damage, worse long-term outcomes and cardiovascular disease. This is why it is so important to focus on preventing flares from happening and treating them when they do occur.
How to Prevent a RA Flare
There are currently no medications available that can completely prevent flares from happening, but there are things you can do to take control of your disease and prevent flares from getting worse. By taking the right steps, you can keep doing the things you love and stay healthy in the future.
Keep an RA journal
An important element in preventing flares is to know the signs of an oncoming flare. Keeping a journal to record what the early signs of a flare are, what symptoms you experience and how long the flare lasts will help you better manage your disease in the future.
Manage Your Stress
Psychological stress can be a trigger for RA flares. An increase in everyday stress can lead to an exacerbation of your disease. Stress management can include meditation, yoga and seeing a therapist. There is also an increased risk of flares in rheumatoid arthritis patients with depression and anxiety.
Get Your Rest
Trouble sleeping has been shown to increase the number of flares and how painful a flare is. Sleep problems in RA can include both having trouble falling asleep and waking up often during the night — all leading to chronic fatigue. Having a flare can also cause problems with sleeping, leading to a vicious cycle of flares and lack of sleep.
Getting immunized for flu and pneumonia can prevent you from getting sick, and it can prevent you from getting an infection (both can act as triggers for RA flares).
Avoid Pollutants and Other Triggers
Air pollution has been shown to trigger RA flares, and people living in urban areas have a greater chance of being diagnosed with RA. Food sensitivities have also been found to be associated with RA and flares. Keeping a food diary and avoiding triggers can also help to prevent flares.
Smoking not only increases your chances of getting RA, but it can also make your symptoms worse. Smoking has been identified as one of the biggest environmental risk factors for RA.
Take Your Medications
Continue with disease-modifying drugs and the possible addition of steroids, NSAIDs or acetaminophen to help manage inflammation and pain of a flare. Remain adherent to your prescribed disease-modifying drugs, as how adherent patients are with their medications is associated with the risk of disease flares.
How to Treat a RA Flare
Despite your best efforts, flares can still happen. The goal of treatment is to decrease inflammation and prevent joint damage. When you do have a flare, home remedies can help to lessen your symptoms. These can include the use of hot or cold packs to decrease your pain, stiffness and swelling.
Gentle exercise can help reduce the pain and stiffness that accompanies a RA flare. During a flare, even something as straightforward as range-of-motion exercises can help to keep mobility and alleviate pain.
Psychological stress can not only bring on flares, it can also make them worse. By successfully managing stress, you can help manage your disease. Meditation, yoga and cognitive therapy can help reduce stress and make your RA easier to manage.
A lack of sleep has been shown to make the pain of flares worse, which makes resting during a flare very important. Working from home and getting help with daily activities are ways to rest during flares.
Eating a healthy diet, including one that has inflammation-fighting foods in it, has been shown to make RA symptoms better in nearly 25% of patients. Foods that have been shown to decrease inflammation include fruits and vegetables, fish rich in omega-3 fatty acids, and whole grains.
Manage Your Pain
Take your pain medication and anti-inflammatory medications, as prescribed. These medications can reduce the symptoms of your flare and help you manage your pain.
When self-management of your flare doesn’t help, go see your doctor. She/he has additional ways to fight your flares and help you get control of your disease.