Flares are periods of increased disease activity during which people’s arthritis symptoms, which typically include joint pain, swelling, and stiffness, are more severe.
People with rheumatoid arthritis (RA) often find that flares come and go in waves throughout their lives. The duration of flares varies from a few days to several months. The specific symptoms and their severity may also differ between people and situations.
In this article, we discuss how people can reduce and manage RA flares.
Dealing with RA flares
There are currently no medications that can cure RA or consistently prevent flares. The goal of treatment is to reduce symptoms, minimize inflammation, and prevent joint damage.
People can try the following techniques and home remedies to relieve their symptoms when they feel an RA flare coming on:
Managing flares at home
Writing down potential flare triggers and symptoms can help people deal with RA flares.
Being aware of the early symptoms of flares is useful for preventing and dealing with them.
1. Keep a symptoms journal
It can be beneficial to keep a journal of potential flare triggers and symptoms to try to identify when and why the flares happen. Avoiding triggers and resting may be enough to manage a minor flare.
2. Rest more
Once a flare starts, many people will need to reduce their activity levels.
During severe flares, people may need to rest completely. Working from home and having a reliable support system of family and friends in place can help.
3. Exercise gently
Doing gentle range-of-motion exercises and stretches can prevent stiffness when an RA flare occurs.
4. Use hot or cold packs
Hot or cold packs can help reduce joint pain and swelling. People can start using these packs as soon as symptoms appear and continue to use them throughout the flare.
It is essential to avoid placing hot or cold substances directly on the skin. Instead, wrap the pack in a towel before applying it to the affected area.
5. Make dietary changes
Following an anti-inflammatory diet can help prevent flares and improve RA symptoms when they do occur.
People wishing to follow this diet should avoid processed foods, refined sugars, and artificial ingredients, and eat a Mediterranean diet that is rich in whole foods.
Foods that people with RA should incorporate into their diet include:
- foods rich in omega-3 fatty acids, such as flaxseed, chia seeds, walnuts, salmon, and tuna
- foods rich in antioxidants, including colorful vegetables, fruits, beans, cacao, and cinnamon
- extra-virgin olive oil
- nuts and seeds
6. Try a dietary supplement
According to the Arthritis Foundation, certain herbal supplements can help relieve the symptoms of a flare. These supplements include:
- curcumin, a chemical in turmeric
- ginger
- fish oil or omega-3 with EPA and DHA
- capsaicin
- gamma linolenic acid (GLA)
Specific vitamin and mineral supplements may also be helpful, including:
7. Reduce stress
Meditation can help reduce stress.
Reducing stress is essential for preventing flares or shortening their length and reducing symptoms. People can try the following techniques to reduce stress when they feel a flare coming on:
- meditation
- guided imagery
- deep breathing
- mind-body exercises, such as yoga and tai chi
- journaling
- positive thinking
- gratitude practice
Medications
It is possible to divide the medications that doctors usually prescribe for RA into three major groups:
- Medications to treat symptoms. Steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen are among the medicines that can relieve the inflammation and acute pain that RA may cause.
- Immunosuppressant drugs. These treatments slow the progression of RA and prevent joint damage by halting the body’s inflammatory response. They are also known as disease-modifying antirheumatic drugs (DMARDs).
- Biologic response modifiers. These drugs are a newer generation of DMARDs, which mimic human immune molecules. Biologics inhibit the inflammatory response in a more targeted way.
What does an RA flare feel like?
Everyone with RA will experience flares differently, but it is common for RA symptoms to come and go in waves.
RA flares usually begin with an initial phase, during which people may sense that something is not quite right and that a flare is coming soon. The distinct symptoms of the flare will follow.
The symptoms of an RA flare may include:
- pain
- fatigue
- swelling
- stiffness
- tender joints
- inflammation
These symptoms may lead to a loss of functioning and interfere with people’s mood, sleep quality, and ability to perform everyday activities.
Symptoms tend to increase until they reach their peak. As the flare ends, the symptoms will lessen and may completely disappear.
In mild cases, a person’s symptoms may be absent for a long time, and periods of disease activity may be brief. However, the condition is usually more severe, and most people will experience some symptoms throughout their lives.
There is also a link between RA and an increased risk of depression and anxiety, which can worsen the symptoms of a flare. It is vital that anyone who is feeling depressed or worried about developing depression speaks to a doctor.
Causes of an RA flare
Poor sleep is a typical trigger of an RA flare.
There are two types of RA flare, which doctors refer to as predictable and unpredictable.
Predictable flares usually occur in response to one or more triggers.
Unpredictable flares do not have an apparent trigger and people can struggle to link them to any specific causes. This type of flare is more challenging to prevent and treat than predictable flares.
Typical triggers of an RA flare include:
- stress, either emotional or physical
- poor sleep
- infection
- overexertion
People who have predictable flares may be able to take precautions to prevent them or reduce their severity.
Outlook
RA is a chronic disease that does not currently have a cure. RA generally comes in waves, meaning that people experience flares in alternation with periods of remission.
Each person is different, but it is often possible to manage RA flares using medication and lifestyle strategies.
A doctor can help people create a management plan that is specific to their needs, symptoms, and situation.