What Is a Rheumatoid Arthritis Flare?by Lene Andersen, MSW Patient Advocate
A diagnosis of rheumatoid arthritis (RA) is much like moving to another country. You need to learn about a new culture, customs, and language. One key phrase in your new life is flare, as in “my RA is flaring,” or “I’m having a flare.” This can be confusing to people who previously associated that word only with a particular style of skirt, or perhaps an emergency flare at sea. What is a flare? How do you know you are flaring? What causes flares?
What is an RA flare?
RA is a chronic illness. It will always be around in one way or another. Hopefully, you and your doctor have found a medication that works to suppress your RA and control your pain, so you can focus on your life instead of the disease. The goal of treatment is to help you experience long periods of your RA being fairly quiet or even in remission.
Once in a while, you may experience acute periods of more active RA. Symptoms of increased inflammation can include swollen and painful joints, fatigue, low-grade fevers, perhaps nausea and loss of appetite. All of a sudden, you remember what it felt like when you first developed symptoms. This is a flare.
But is not quite as simple as that. Flares come in different shapes and sizes. Some flares are less intense, subsiding after a few days of rest and being good to yourself. Other flares are like forest fires. They start with a small spark and burn out of control, requiring a much more concerted effort to extinguish them. Next week, I’ll cover ways of coping with flares.
What causes a flare?
Flares can seem completely unpredictable, apparently triggered by anything and everything, including something as ridiculous as changing the channel on the television. Although operating your TV doesn’t actually cause flares, it can be really difficult to see why your joints are all of a sudden twice their size and hurting. On top of that, triggers can vary from person to person, making it even harder to find a pattern. But don’t despair — there are ways to figure out connections between your symptoms and different triggers.
Symptom trackers are apps for your smart phone that help you identify patterns between what you do and increases and decreases in your symptoms. By using symptom trackers, you can begin the road to a more predictable life with RA. There are a number of symptom trackers available, but two are developed specifically for arthritis. The Arthritis Foundation’s Track + React and the new Arthritis Power from CreakyJoints. The latter also allows you to anonymously donate your data to be used for arthritis research.
Although you are likely to have some triggers that are specific to you, there are some which are fairly common to a lot of people who live with RA.
Stress. The flare I described in last week’s post was a result of stress. After a period of intense work, I inevitably crash and need to nurse my body through a flare. We live in a stressful world where we are expected to be responsive at all times, packing too much into our days. Burning the candle at both ends isn’t good for anyone, but it can have some serious consequences for people who live with RA.
Weather. The old adage about people with arthritis being able to predict changes in the weather (especially precipitation) is true for many of us who have RA. Research seems to indicate that this may have something to do with changes in barometric pressure. Another study suggests that people with RA have a particularly hard time with low temperatures. In addition, some people can predict rain or snow better than a meteorologist, while others flare when the weather is humid.
Foods. Common food triggers include sugar, processed foods, fried foods, and the nightshade family (tomatoes, potatoes, eggplant). You may have talked to people who have changed their diet to help control their symptoms. Some swear by a vegetarian diet, some are vegan, others staunchly Paleo or gluten-free. There hasn’t been much research into the role food can play in RA symptoms, but there is evidence that the Mediterranean diet can be helpful. Entering the food you eat into your symptom tracker can help you find out if there is a connection between what you eat and how you feel.
Activity. It’s important that you are as physically active as possible to keep your joints mobile and your muscles strong. However, doing too much can trigger a flare. Identifying where your limits are can be a trial and error process. Use your symptom tracker, pay attention, and eventually you’ll start to recognize the messages your body sends you when it’s had enough.
Learning to speak the new language of RA is your first step towards living well with this disease. Understanding what a flare is and what can trigger it is an important part of taking back control of your life. Although it can seem overwhelming at first, over time you will become fluent in coping with RA.