8 Steps to Calming an RA Flare
As with other autoimmune diseases, rheumatoid arthritis (RA) symptoms can ebb and flow. You will likely have stretches where your RA hardly registers—and periods when it flares up, becoming a painful disruption in your life. While these flares may be inevitable, you can take steps to ensure that they interfere with your time as little as possible. Researchers know more about treating RA than ever before and educating yourself on how to prevent and treat a flare before it strikes can make the disease much more manageable.
The Only Rule? Don't Wait It Out
While it’s all too easy to think, I’ll just let it be and maybe the flare will go away on its own, this mindset can be unhealthy. A study conducted by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) found that leaving rheumatoid arthritis flares untreated can lead to you having a greater risk of joint damage and poorer health in the future. Instead, when you experience an RA flare, jump on it right away. Here’s everything you need to know about how to deal with a flare and then head off the next one.
Spot the Signs ASAP
You’ll have a head start in fighting a flare if you know what brings one on and can recognize symptoms right away. While there are common triggers for flares—things like overexertion, stress, infection, and bouts of poor sleep—knowing what usually sparks your RA matters most. If you’ve dealt with RA for some time, think carefully about what you were doing before each flare has occurred. And if you’re new the RA game, keeping a symptom journal can help you learn to spot patterns. Bottom line: Listen to your body!
Talk to Your Doctor
Always maintain open communication with your doctor and make them aware anytime you’re experiencing a flare up. “The most important aspect of treating flare ups is the discussion between the patient and the rheumatologist or other health care provider,” says Orrin Troum, M.D., a rheumatologist at Providence Saint John’s Health Center in Santa Monica, CA. As soon as you feel an RA flare up coming, call your doctor to get medicine prescribed and have a check-up if necessary.
Get Plenty of Rest
Resting the affected joints is critical if you’re experiencing a flare up, says Dr. Troum. Expect to work from home or avoid work all together. Call on friends and family to help with errands or childcare. And get plenty of shuteye: Research shows that sleep loss can exacerbate RA symptoms. If your pain or anxiety is causing insomnia, work with your doctor to find a routine that helps you clock more sleep; this may include avoiding alcohol, caffeine, and technology before bed.
Do Some Gentle Movement
Although rest is key, total inactivity can make joints and surrounding muscles stiffer and more painful. Don’t push yourself to the point that the flare is aggravated, but even trying very light activity such as walking around your room or moving a limb back and forth can help avoid stiffness. In fact, the movement may lubricate the joint, easing inflammation.
Try Hot and Cold Packs
Just because they’re simple (and cheap!), doesn’t mean they’re not effective. According to the Arthritis Foundation, heat enhances circulation and is best used when you’re experiencing stiff joints or tired muscles. Get your fix via a hot shower, a heating pad, or a 20-minute soak in hot water. Break out the cold packs to ease acute pain; they slow your circulation while reducing swelling. Whether you take some frozen peas out of your freezer or go all in with an ice bath, the choice is up to you.
Take Prescribed Medication
When your RA goes on the rampage, you usually need additional medicine to get it back under some semblance of control. “Flares of RA are usually treated with prednisone or nonsteroidal anti-inflammatory drugs (NSAIDs),” says Linda Lee, M.D., a rheumatologist a Summit Medical Group in Berkeley Heights, NJ. Taking the medicine as directed provides your best chance of avoiding side effects and getting relief from the flare.
Practice Stress Management
Researchers have found that patients with RA are more likely to report a flare up following a stressful or traumatic life event. While you can’t always avoid stressful situations, you can learn healthier ways to cope with them. Techniques such as meditation, journaling, and deep breathing can have the potential to decrease the impact of stress on your body. If you find yourself stressing out and flaring up, turn to one of these strategies to help short-circuit the panic cycle.
For Next Time: Update Your Treatment
Have you taken your prescribed medication but the flare ups just keep on coming? Dr. Troum recommends working with your rheumatologist to make a change to your regular disease-modifying therapy. What works for one patient with RA won’t necessarily work for you. And sometimes, medication that worked before suddenly loses its effectiveness (this can happen with biologics in particular). Finding the best treatment for you can require a bit of trial and error, but being proactive with it can get you on the path to a healthier, more manageable life much quicker.
- Risks of Untreated RA Flares: Annals of the Rheumatic Diseases. (2016). “The Role of Rheumatoid Arthritis (RA) Flare and Cumulative Burden of RA Severity in the Risk of Cardiovascular Disease.” ncbi.nlm.nih.gov/pmc/articles/PMC4520792/
- RA Triggers: Arthritis Foundation. (2019). “Arthritis Pain Relief and Shoe Inserts What Triggers an Arthritis Flare?” arthritis.org/living-with-arthritis/pain-management/flares/arthritis-flare-triggers.php
- RA and Sleep: Sleep. (2012). “Sleep Loss Exacerbates Fatigue, Depression, and Pain in Rheumatoid Arthritis.” ncbi.nlm.nih.gov/pmc/articles/PMC3296796/
- RA and Stress: Arthritis Research & Therapy. (2010). “The role of stress in rheumatic diseases.” ncbi.nlm.nih.gov/pmc/articles/PMC2911881/
- Hot and Cold Packs: Arthritis Foundation. (2019). “Heat Therapy Helps Relax Stiff Joints.” arthritis.org/living-with-arthritis/treatments/natural/other-therapies/heat-cold-pain-relief.php