Monday, January 25, 2010 Jamie, Community Member, asks

Q: What exactly is a flare up and how long does it last?

I've had RA since Dec 2007, diagnosed officially in January, 2008. I take methotrexate and Humira every week. They seem to be helping a lot; however, once in a while my wrist will hurt and I'll have to wear a splint for a day - is that a flare or am I just overusing or incorrectly using or placing that particular joint which leads to the pain?  I've heard people talk about flare ups, but I don't really understand what it means. Could someone explain what they are and how long they last. Thanks.

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Answers (3)
Lene Andersen, Health Guide
1/27/10 1:18pm

Like Kelly said, that's an interesting question. I'm not sure there is a medical definition of a flare. For instance, where is the line between uncontrolled RA and a flare or are they the same thing? I'd argue that 10 years of active disease qualifies as uncontrolled RA - sure, flaring is part of that, but to me, sort of a part of the other term.

 

it sounds to me that if your RA is generally managed, your occasional symptoms are probably caused by overdoing. However, only if the pain is not accompanied by redness, heat and swelling in the joint - as those are symptoms of active disease, they would indicate that you should speak to your doctor about adjusting the medication dose. That said, when you have RA, it can damage your joints and make them more susceptible to stress and it's very common to experience pain if you do too much, even when your disease is suppressed. When that happens, splints, increased pain killers, applying heat and/or ice are all parts of managing the consequences of doing too much.

 

Did I just confuse things even more? Smile I'd recommend that you bring this up with your rheumatologist to get their input.

 

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Kelly Young, Community Member
1/27/10 8:59am

It was interesting to see your question since I've been asking that one too. One guy on my FB says his doctor told him his flare has been for 10 yrs.! I think that means there are those who are really in "flare" all the time.

 

For most people though, the RA will be more active at times. And then remit somewhat. Yes, I think it can be caused by activity. But not always; it can come out of the blue in the middle of the night. I was doing a survey asking "What is a flare?" on my blog. Here is the link. Maybe some of the answers will relate to you.

 

Kelly Cool

http://rawarrior.com

 

 

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Jamie, Community Member
1/27/10 7:55pm

I read your blog, very interesting. I consider myself blessed because my RA seems to be manageable compared to what I've read that others have posted. My RA is severe, but medication is helping. However, I guess you could say I've learned to live with the pain, and even though its not as severe as it was in the beginning, I do notice my toes hurting, wrists still sore with certain activities and I can't carry heavy objects (like a 20 lb bag of dog food) like I used to without my fingers hurting afterwards and causing me to lose my grip. While I'm not in constant pain, its still there. I guess in a way I've learned to adjust to it. I do notice my fingers don't work quite like they used to (I'm a sign language interpreter) and they don't move as gracefully as they used to. The knuckles seem stiff and slightly painful at times.  So I guess even though the pain is mild to moderate, its still there and I'll always experience some in some form or fashion. The fatigue I feel can be from RA, but could also be from other stressors in my life, too... or maybe a combination of it all.  Even though I consider myself to be doing very well on medication, I guess it will never be the way it used to be. 

 

I'm scared about the future and when the flares will happen... Is this temporary? Will I have to start using a cane again? Will my RA flare up to the point it was before I started on the meds? Will I be able to continue working? All those questions plaque me and I guess its like always, wait and see.

 

I will check out the rest of your webpage later when I have more time, but it looks very interesting from what I've seen so far.  Thanks for sharing it.

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Kelly Young, Community Member
1/28/10 12:15pm

You're welcome, Jamie. A sign language interpreter!!! With RA? What are the odds? Two of my children are deaf, btw.

 

You have lots of other interesting questions. You can message me here, too, if you want to talk more.

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Jamie, Community Member
1/29/10 9:16pm

That is interesting.  Do your children sign? Where do they attend school, locally or a Deaf School?  My husband is deaf.  It wasn't until I was diagnosed did I realize how many people have RA. There are two interpreters who live in this area that have RA, one must have it extremely mild because as far as I know she is not on any medication - or she is in remission. She did say that when she lived in a different climate (going from a hotter climate to a milder/colder climate) seemed to help, possibly cure it. And moving back has aggravated it somewhat, but I don't think she is on any medication for it right now. The other one is taking predisone and methotrexate and at times has a very difficult time with her RA. And because of the predisone she has bruises all up and down her arms and frequently has kidney stones requiring hospitilzation and breaks a rib almost every time she gets a cold due to coughing.  I also work with a female coach who not only has RA but fibromyalgia as well - she really has a rough time with it. She had to be take off methotrexate for a while because it was hurting her liver and only recently has she begun to start taking it again. She has been involved in a lot of trial studies and finally found a medication to help, the only problem is now that the study is done she has found out that her insurance will not cover it. That is three people who I work closely with who have it. Makes one realize that RA is not that rare of a disease.

 

 

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Kelly Young, Community Member
1/29/10 9:51pm

Yeah, not that rare at all. But also very diverse as you've noticed. I actually met a lady via my FB page w/RA (http://www.facebook.com/arthritiswarrior ) and just found out she lives only blocks away!!! How long have we lived nearby & I could not have known?

 

Your friend w/ a mild RA is lucky so far. I do live in Fla. & I hear the "gotta move to a better climate" a lot. I don't believe it. I think RA changes or fluctuates for some & confuses them, making them think they did something to cure it. It's like wearing a lucky t-shirt: we think it helps, but really not. Just my opinion... (My RA is severe & Fla has not helped that one bit.)

 

One of my kids goes to a small college now. She reads lips & wears strong aids, but it's still tough. She's brave. The other is my son who is homeschooled. He's also wearing aids to help, but needs close captioning & lots of patience. They have a genetically malformed cochlea. Was your husband born deaf?

 

Sorry to hear about your friend & the pred. I hear horror stories of it. The books say that pred is only meant for short term, but so many docs seem to prescribe for long term & these sad stories happen.

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Jamie, Community Member
1/29/10 10:53pm

Yes, my husband was born deaf. His mother was exposed to rubella during pregnancy. She didn't come down with it, but either the person had it or was exposed to it then in turn exposed her to it.  This was in the early 50's even before the rubella epidemic occured.

 

I told my rhuematologist I didn't want to go on predisone at all, and only took it once or twice, it was the the pack that you start off with 10 and take so many per day for a week, gradually weaning off it.  That helped in the short term.  I would much rather try the other medications than steroids.  I also dont' want the weight gain associated with it, although my weight has increased here lately and not sure if its me or the medication I'm on - like you I have severe RA,too.  I would like to blame it on the Humira or Methotrexate.. which I know can cause an increase in appetite..... but I know part of it is me, too.. But it does sound so much better to blame it all on the medication.. lol

 

Thanks for everything.

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booboolove, Community Member
1/27/10 6:24pm

flare up is anytime you start to develop pain - swelling- stiffness etc that dosent mean they all will happen you could just have severe stiffness or just severe pain with no swelling and so on..and flare up dont have a certain amount of time that they last..really it just depends on you and your ra. everyone differs. also i have noticed with myself that it depends on why im having a flare up..for example if i completly stressed myself out my flare up usually last longer than say if i just wasnt getting enough sleep that particular week. it really depends ..i would recommend you write down when you get your flare up- what it is consisting of (pain,swelling, fatigue etc) - how long it lasts - and i would try to really pay attention to how you are feeling in that particular time (stress, more work and so on) that way you can see if your flare ups are coming out of no where or maybe you are doing something that you dont even realize that is causing them to happen. I hope this helps!

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walkfast, Community Member
2/ 6/10 9:40pm

Your answer was very helpful. Thanks it made me think about different things that might of caused my flares as well. I am new to this as I just found out that I have ra.The hardest part of this is controlling the depression part for me. I am bibolar as well and I really having a hard time.I know people around don't understand the change in my behavior. In my world everyone is used to me doing everything for them and never saying no. That has changed I just don't have the energy anymore.I hoping that i can do my relay forlife walk for cancer this year.I am usally the person that walks the most miles.Lately I been having so many flares that I cant think past the next step sometimes.you know what I am saying. That said thanks for your input it will come in handy as I begin the training

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booboolove, Community Member
2/ 7/10 4:29pm

The depression has been the hardest part for me too. I was always the one who did everything too and now that i cant people just dont understand and i think that just makes everything worse.. you feel worthless almost. it hurts the most when its people that are really supposed to be there no matter what and they just seem to drift. I am having second thoughts about my fiance now because of this disease. there are times where i feel like he is starting to understand but than all the negativity comes back and all i picture is my life with a man that thinks im "faking" it or that im just compaining to complain. that is why i joined this community i just need to surround myself with people who understand what imgoing through too. I am so glad my answer helped you. when were you diagnosed? was it sudden or did you get sick over time? talk to you soon.

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booboolove, Community Member
2/ 7/10 4:30pm

I just realized that you said when you were diagnosed... sorry. what meds are you on?

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By Jamie, Community Member— Last Modified: 12/10/13, First Published: 01/25/10