What can you do to relieve the pain during a flare-up. What is the best that you can do?

Sorry you're having a rough day. Some days suck so much that your best option is to have what I call a "swish in the self-pity pool". Because, let's face it: the feelings are there and sometimes it's best to get that out of your system. Done in moderation, it can make it easier to get up and fight again the next day.

Aside from a good sulk, my first real, and probably most useful, suggestion is to go back to your rheumatologist and tell him/her that the meds aren't working well enough. Have you been on methotrexate long? If not, it could be that it's still working up to its maximum effect, but if you have been on it for several months, talk to your doctor about other options, including perhaps increasing your anti-inflammatories on bad days. Of course, if most of your days are bad, I'm back to increasing your meth or trying another drug - have you considered any of the Biologics?

Medication really is the best/only way to combat a flare, but they are a few things you can do to help yourself feel a little bit better. Try taking a cool bath, holding your hands in cold water (if your hands are affected) or if you are one of those people for whom cold and ice doesn't work, do the same thing with heat instead. Rest is good, but too much rest during a flare can limit function in your joints, so you need to do some sort of exercise. If you have access to a pool, do range of motion exercises and walk in the water - it's easier on the joints. Massage may help - I've had most help from shiatsu massage, but any kind of massage is good. As well, many people with RA find acupuncture helpful in providing relief from the pain. In terms of your diet, try staying away from potatoes, tomatoes and fried foods - according to my shiatsu therapist, these are foods that may increase inflammation (I especially noticed the thing about fried foods).

Lastly, there's the mental aspect. When you're having a flare and it feels like you're wrapped in pain and hopelessness, it messes with your mind and impairs your ability to cope. Being able to connect to a feeling of hope and faith in tomorrow is the most important thing you can do. Try meditating - it helps you feel more peaceful, opens you up so you can listen to your body and working with your body instead of against it will make it easier. As an aside, there are several forms of gentle exercise that are a sort of "meditation in motion" - yoga or tai chi may be helpful for you. Find laughter, whether it's by having a good chinwag with a friend, watching a silly movie or seeing kittens at play. There are many ways of connecting to that faith in tomorrow - some people go to church, others go into nature. There are books and audio programs that may help you - personally, I've found books on mindfulness very helpful in dealing with chronic pain. As well, connecting to other people with a chronic disease can be very liberating - you can read the share posts from the community here on HealthCentral or maybe consider writing some yourself - expressing your feelings within a group of people who understand exactly where you're coming from can help.

I think this got a little disjointed, but I hope some of it will help you. Please write again if you have other questions.

What has been helpful for me is a hot shower and a 500 Vicodin.  I used to take Aleve, which is by the way a great anti-inflammatory and pain killer.  But my gastro doctor indicated I should get off of it. He saw some lesions in my duodenum.  I never took a lot of them and only when I was feeling bad.  But they were very helpful over the last 10 or 15 years that I have been dealing with this disease. One time I was having a flare in my right hand. It got so swollen and painful that I was going to have to postpone a drive home from Denver. About 11PM that night my relatives went out to get me something for me and came back with Aleve. I took two pills and by 2 AM the pain started subsiding and swelling started going down. By 7 AM I was almost back to normal.  This was back several years ago. Now, I just get sore all over most of the time instead of flaring. But I have found Aleve to be a good product.  Hope this helps.

Hi Lindsey,

Echoing what Lene suggested regarding meditation and yoga (though ditto on her medication advice), I would highly recommend restorative yoga, which is a form of yoga that helps prod the nervous system into its parasympathetic state (ie. the relaxation response) by placing the body in completely supported yoga poses, most of which are laying down, to combat stress, but also pain and other ailments.  The poses involve a lot of props so that your body is 100% supported and your muscles are able to genuinely go into a resting mode, which could help to alleviate some of the pain you are feeling.

When I was first diagnosed with RA and experiencing overall pain and fatigue constantly, it was about the only thing I could do, and I found that it really did help me battle the pain and find some measure of comfort in my body. 

If there is not a yoga studio by you that offers these classes, then I would recommend checking out Judith Hanson Lasater's website (http://www.judithlasater.com/about/) and/or book.  She is one of the most well-known and respected teachers of restorative yoga and is also a physical therapist.  I did my training in restorative yoga with her, and she is pretty incredible. On her website, you can also check to see if there is a restorative teacher in your area that you could contact.  If you want to go the do-it-yourself method, her book has good illustrations and instructions on how to set the poses up yourself, though you might need to invest in some props.

On days when I'm feeling too tired to do anything else or having a flare, I pull out my props, turn the lights down, grab a blanket and spend a good 20-30 minutes in one of the restorative poses, and it always manages to make me feel a little bit better.

I hope some of this is helpful. Good luck-

Sara

For me, taking it easy is crucial.

But conversely, doing my water aerobics in a warm pool with emphasis on stretching after warming up the muscles is key.  I like to get my body moving enough to feel energized and limber.  Then a good stretch-out.  In a flare, this is a shorter version of what I would normally do.

Avoiding walking on concrete and eating well also helps.  I notice a few foods can worsen symptoms for me and I avoid them.  I think my symptom-worsening foods are pizza (even homemade), carbs, and salt.  Still watching those!  LOL!!

Try changing positions a lot.  Don't get cold.  And do what you can to take your mind off of it, like call a friend, read, or encourage someone else in whatever way you can without bringing on more pain.

HOpe it helps!

there are two ways of looking at this. One is if the cause of the flare is something you have done then rest is probably best but if it another influence, say weather I usually rest and use dry heat  moist heat seems to make mine worse and then go about your routine a bit slower your body is telling you to slow down. That is what pain is for.

Hi I have had RA for 26 years. I got it when I was 26. In 2000 I started on clinic trails which is working but if I have a bad flare up the doctor has me do a 5-10 day prednisone

treatment. I keep prednisone on hand for this reason. I was on prdnisone for 20 years

and have been off of it for 6 years. A small treatment like that is really no harm done.

Hallo,

I use Dicloflam (Blackcurrant) (46.5mg diklofenak) I this is a generic from Cataflam. Most of the time this helps.  It is still painful but it is not as bad. My left knee is my biggest problem it is now swollen for about a year, I received treatment from the Dr but nothing really helps.  Most of the prescribed medication will upset ones stomach but so far this Dicloflam is the best.  You may get the same medication in the US, may be by a different name.

Regards,

Willie

Distraction is the only thing I know of that helps.  Find something that you love to do that isn't hard on your joints and focus on it.  Sometimes I go window shopping or even computer work can help.  I hope you have an understanding person by your side because it makes so much difference in my case. Good luck.

Well, what I do when I get a flare is to try and rest a little more than ususal and maybe take  an extra cortison pill to help whith the flare, i dodn't know if you are taking cotison as one of youdr meds. Try not to excerscise when you have a flare or you could feel worse and hurt your joints.

I am guessing you are already taking a little extra pain medecine (other than Tylenol) and Prednisone if you are on it .  In lieu of chewing off my arm and/or leg, the best non-medicated thing I do is take a warm bath because it takes pressure off my joints.  Lying in bed usually feels the least amount of pain, but I find the longer I do not move the harder it is.

I try to go to the YMCA and spend time in the pool.  This seems to help for a while.

I would like to know how to relieve pain in ankles and feet.It is a constant ache and is sometimes hard to stand or walk.

Hey Lindsey,

The worst time for me (and most RA patients) with soreness and pain is right after getting up in the mornings (sometimes before I'm ready to get up, at the crack of dawn!) I force myself out of bed because laying flat is sometimes too painful. I can sometimes manage the pain by using strategicly placed pillows (under sore arm/shoulder) while I sleep. I seem to have less pain in the mornings if I take an anti-inflamitory (prednisone/advil, etc) before I go to bed (after dinner), rather than just in the mornings. I find that the combination of heat/cold and light massage helps to releave the pain of these symptoms too. If you have access to a hot-tub (or even warm/cold water in bath or shower) I find this helps manage the pain alot. Swimming is a perfect excercise for RA and I recommended it. I also use cold pads for my hands or ankles when they are swollen and sore. I find that light message works wonders for sore feet, ankles and hands too. Also, just walking (or hobbeling ) seems to make me feel better after a while. I try to take it easy in the mornings if I'm real sore and elevate my feet in while resting in my recliner.

Lastly, Its possible that your medication may not be ideal if you are having pain so often. I'm starting a drug trial next week, so I've been off all my DMRDs for about 3 weeks now and I'm beginning to feel it.

Take care sister and God bless.

Bret

I go into my jucuzzi or I go to the gym and I go in the pool

I have had R.A. for the past 8 years.I deal with the flare-ups by taking a mild pain pill and rest. If i were you i would talk to your Rheumatologist and primary care Doctors,They can help ease the pain.But do rest that the most important thing you can do!!

Hi Lindsey.  Rest is always my first line of action during a flare (I am trying to stave off a flare now).  Hot green tea helps sometimes, although I don't know if that's just psychological.  You can try heating pads, that has helped.  The trouble seems to be that there isn't anything I can find that will help consistently.  When all else fails, and this is really a last resort, my doc will give me a shot of cortisone. 

I am sorry you are having such a hard time, I hate being ill too.  Good luck to you.

Beth

I would like to know too

Hi Lindsey,

             I'm so sorry your feeling so bad.I find that having a pet to love and cuddle help's to keep my mind off the pain.I've been living with RA for almost 15 yr.'s now and I have to tell you i'm still working on pain issues.I'd like to say it'll get  better,but the truth is no one has found a sure fix.I found pain med.'s are a great relief,though it's not a cure they make it easier to get out of bed.But while in bed my 3 dashound's give me great pleasure.

           My god bless you,and I'm praying for a quick recover.Hang in there you'll find just the right med's with help from Dr.

                                                                             Judy

1st thing I would suggest is taking warm baths. It helps alot when your sore all over. I also like to add "detoxifying bath salts" and/or some type of aromatherapy to the bath. This also helps the mind to relax ...possibly help with the perception or tolerance of pain. Also certain aromatherapy can perk you up if you need that.  When my energy is low due to pain, I like using uplifting scents like Peppermint.

Next I would recommend massage. Especially if you can have this done after a warm bath or sitting in a hottub. Alot of spas have day passes to use their hottub or saunas. Of Course muscle relaxers can help this along as well.

Followup with getting extra sleep because your body has been fighting the pain/flare, so to lessen the severity or duration of the flare more rest will help.

Keep your joints covered or warm. I notice my joints feel better or don't get as bad if I wear stuff like socks, gloves in colder weather. I use a topical prescription gel, Solaraze, that works well on the joints to reduce inflammation/pain.

If nothing works & the flare is hanging on, I temporarily go on steroids to stop it dead in it's tracks. And if the pain is intense don't hesitate to use pain medication. I have learned the hard way that by not taking something soon enough or when the pain was actually less intense, my pain quickly has turned into a freight train running outta control. Then it really gets hard to keep it under control. Listen to your body.

Lastly, I would say to occupy your mind as much as possible. This helps to keep your focus OFF the pain. At night, I enjoy using relaxation music to help me sleep. I focus on the music, prayer, meditation & find that it keeps my mind from wandering.

Hope these tips help. Healing, Love,  & Understanding go out to you.  

I have flare-ups to sometimes they are so bad I just want to Die but I keep going.I mean I get up and go to work find something to do get my mind off of my pain.I know it hurts but if you can move around it helps.

Probably not recommended too highly from the doctor, but I rest first and try to releve pain w/ice or just rest. When I feel better, I don't exercise but gradually do more and more than likely over-do MORE than I should. I also have pain pills on hand to keep the pain tolerable once again. Am never pain-free.

Vivian

 I have suffered or lived with RA for about 18 years, initially diagnosed when my son was 7 and my daughter was 3.  I've tried a little of everything including some rather bizarre "mountain culture" treatments, such as horse linament!  Through the miracles of "better living through modern chemistry" I no longer have days when I am completely confined to a wheel chair but there are many days that require giving in, admitting to myself that this will be a "down day" and a "good day for a nap" so my favorite comforts are a T-pump (a water heating pad system) and ice packs.  I also make sure that I do simple, from a chair or the bed, exercises which promote a modicum of flexibility such as gentle stretching.  My lap top computer and a comfy chair in sight of my bird feeders help keep me connected with the outside world and full of hope for the good days which eventually arrive.  My family has been a great source of support, offering to read and discuss the newspaper, filling the bird feeders, and providing me with subjects suitable for sketching.  I, too, hate being ill so I try, hard as it may be some days, to stop thinking of myself in terms of what I can no longer do even on good days but in terms of what I can do even on the very worst days.  Rest, a combination of soothing heat from the T-pump (which is incredibly more effective than a heating pad) and cold from a towel wrapped gel frozen ice pack, staying connected to the rest of the world, and simple movements help me regroup and recover from a very painful and, at times, demoralizing episode.  We are not alone, many medications and treatments exist which can modify the disease, and we can survive even the worst days by listening to our bodies signals.  I think attitude is more powerful than any medical strategy alone.

take it easy on yourself. prepare for sudden flares. make up meals and freeze them. have a buddy system to help with shopping, ect. don't worry so much about a clean house, just keep it organized when you can, and get help with the other.  if you hate asking for help, trade help with friends. ask if they need anything when you run to the store. share errands.

to handle pain, try different topical creams. walmart has gloves without fingers and has a velcro strap. thy act like isotoner gloves and make my hands and wrists feel better. take a nap. try not to stress. meditate. i am going to look into biofeed-back. when you are in pain, your body uses a lot of energy. energy you need. eat well. take ALL your meds when you are supposed to. i fix a weekly dispenser so i don't have to think so much about them, and make it a habit. i keep them on the table so i won't forget.

keep a buddy system. share with someone and trade feelings.

most of all, find something you love to do and make time for it. and reach out and help someone else. this ALWAYS makes me feel better.

i hope some of this helps. writin this down helped me to remember what I should be doing. thanks.

Bonnie

Best thing is rest. Flareups happen when you don't get enough rest.

THE ONLY THING I HAVE FOUND TO HELP IS TO REST..... TRY YOUR BEST TO MOVE AROUND SOME BUT DO NOT OVER-DO IT.  PAIN MEDICATION WILL HOPEFULLY HELP YOU.  I AM SORRY YOU ARE IN A FLARE-UP NOW.....  I TRUELY KNOW HOW YOU HURT!!

well while nothing will completely take the pain away until you find the rights meds, what i like to do durin a flare up is take two tylenol (important because you can take it for the pain but its not an anti-inflamitory which would conflict with your other meds) and use a heating pad.  I dont know if it works for everyone, but for me the heat lossens up my muscles and makes me not as stiff.  just a thought, unfortunatly though there really is nothing that makes a flare up all that much easyer, but dont worrie you'll make it.  Good luck.

I think it's everything and anything available, lots of ibuprofin (not on an empty stomach!), lots of water, rest/sleep, ice on inflamed joints, hot baths/ spa time, and if necesary contact your Dr. for a very small dose of a steroid like predinisone, otherwise it can get out of control.

Nikki

I've found that the longer I stay in one place, my joints just get stiffer. But it hurts to move, so I can't win for losing.  The best thing I've found is to have a prescription of some type of steroid (prednisone, cortisone, etc. whatever your Dr. thinks is best for your level of RA).  I have an extreme case, so I am on it everyday. But if you don't need it everyday, it is a great to have as an as-needed anti-inflammatory. So it will bring your flare-ups down.

In the meantime, get comfortable on the couch or some spot where you can relax. Use an ice pack on the joints that are inflamed the most. But remember to get up and move around from time-to-time so you don't get locked up. 

My son is 3 and I just found out he has RA I dont know what do to, there talking about putting him on a low dose of chemo therapy, i am verry worried