About RA flares
People with RA experience times of flare when their condition is unpredictable and causes a worsening episode.
An RA flare can include joint pain, swelling, fatigue (tiredness) and stiffness, and a feeling of low mood. Flares can vary in intensity, duration and frequency, but they are usually reversible if treated promptly.
Symptoms
Flare symptoms can include the following:
- increase of swelling and/or joint stiffness
- worsening joint pain
- increased fatigue (tiredness)
- general feeling of being unwell
- night sweats
- fever
- weight loss.
Causes
Flare causes can include the following:
- winding down or stopping treatment
- over-exertion (doing too much)
- stress
- infection
- lack of sleep.
Flare self-management
Rest and gentle exercise
Pace yourself and prioritise your activities during a flare.
Plan your day carefully, taking your fatigue into account.
Try to take a short rest between activities, but keep your joints moving. This will help prevent stiffness and maintain muscle tone.
Movement
Keeping moving is one of the best ways to limit the duration and intensity of your flare.
Try to go out for a short walk, even if it is just to the front gate.
Natural daylight helps to lift the mood by releasing endorphins (chemicals naturally produced by the body). These, in turn, help people cope with pain.
Gently stretch the areas that tend to tighten up with your RA, even if this feels uncomfortable. Stop if you begin to feel intense pain.
Heat or cold
Applying heat or cold to your joints may reduce pain and inflammation.
Try hot or cold showers, a hot water bottle, wheat bag or heating pad, or an ice pack, bag of frozen peas or cold gel.
- Always place a towel between your skin and the source of heat or cold to prevent skin damage.
- Alternate between using hot and cold for 15 minutes at a time.
- Do not use heat or cold on psoriasis skin patches.
Treatment
Medicine
Non-steroidal anti-inflammatory drugs (NSAIDs) are drugs that block inflammation and help reduce flare symptoms.
NSAIDs are not a long-lasting fix and you may have to take them regularly.
Some NSAIDs can affect the stomach, so you may need to take omeprazole as well, to reduce the amount of acid your stomach makes. Ask your GP to advise you.
Topical treatment
Anti-inflammatory gels may be applied to inflamed joints locally. Always follow the manufacturer’s instructions.
If you have psoriatic skin lesions, consult your GP or dermatologist for advice on the most suitable cream for your skin.
When to seek further help
If you have tried all of these methods and your symptoms show no signs of improvement after 7 to 10 days, you may need to contact your rheumatology team.
If you experience regular flares, your GP or dermatologist may decide to review your medicines.
Your symptoms and blood test results will help them assess whether your RA is becoming less controlled or whether you are experiencing pain for other reasons.
More information
For more information visit the National Rheumatoid Arthritis Society
The Rheumabuddy app can help people understand rheumatoid arthritis
Contact information
Kingston Hospital Rheumatology Department