Flare-ups – ‘my joints are on fire’
The symptoms of rheumatoid arthritis vary from person to person. They can come and go, and they may change over time. You will experience flare-ups when, from time to time, your condition worsens and your symptoms become more intense and severe. This may be fairly short term or may last weeks. A flare can include not only joint pain and swelling but also fatigue, stiffness and feeling low in mood, this can be both painful and frustrating.
A flare may occur following an infection, a vaccination, surgery or when you are stressed. Sometimes however there is no obvious cause. Some people are able to recognize when a flare is going to happen, as their symptoms start getting worse over a period of days, but for many people they can wake up in flare with no warning, or it develops in a matter of hours.
It is possible to self-manage flares with a few days of rest, taking prescribed painkillers i.e. Paracetamol and anti-inflammatory medications i.e. ibuprofen. In some cases where the symptoms do not improve you may need to see a health care professional. This may be your GP or one of your rheumatology team to discuss treatment options. This can include short-term management with steroids or if your flares are persistent or occur on a regular basis you may need your treatment plan revisiting.
Although it is important to rest, being stationary for too long can make the joints feel stiffer and more painful to move afterwards. Moving your joints gently and slowly on a regular basis can help reduce the stiffness and help to shift stubborn swelling. If you have swelling in your hands and wrists or in feet and ankles, then elevate them e.g. feet up on a stool, or hands on a pillow so they are higher than the elbow. This can help fluid drain, helping your joints to feel less stiff.
Sometimes it can help to try some of the following –
If flares continue to persist on a regular basis, it is important to ensure you have an appointment with your rheumatology team so that your medication can be reviewed.
If you have a persistent flare you can contact:
Adapted from :
NRAS Managing flares 2022
And
Royal National Hospital for Rheumatic Diseases, Royal United Hospitals Bath NHS Foundation Trust