One of the most challenging aspects of living with rheumatoid arthritis (RA) is managing flare-ups — periods when symptoms suddenly worsen. These RA flares are unpredictable and disruptive, often significantly impacting daily life.
In uncontrolled RA, flares can last several weeks or even months. This occurs because the immune system persistently attacks the body’s tissues, leading to ongoing inflammation and pain. Research indicates that flares in uncontrolled RA may last an average of four to six weeks and are often associated with joint damage progression and disability.
Even in well-controlled RA that has not reached remission, flares can still occur. However, they are typically shorter and less severe than those in uncontrolled RA, lasting a few days to a couple of weeks on average. The duration of a flare can vary between individuals. On average, a flare may last anywhere from several days to a few weeks, with studies suggesting an average duration of seven to 10 days.
The Unpredictability of RA Flares
Everyone with RA experiences flares differently, but it’s common for symptoms to come and go in waves. The frequency and severity of flares can vary greatly from person to person. With effective treatment, some individuals may spend months or even years in remission, while others might experience flares more frequently.
RA flares can strike without warning, even when I am carefully following my treatment plan and taking medications as prescribed. Despite advancements in RA management, flare-ups remain a mysterious and often frustrating aspect of the disease. Their unpredictability makes it challenging to plan and manage daily activities.
Common Symptoms of a Rheumatoid Arthritis Flare
When I am in an RA flare, the physical symptoms can be debilitating.
Common symptoms include:
- Increased joint pain: Affected joints become extremely painful, making movement challenging.
- Swelling and stiffness: Inflammation causes noticeable swelling and stiffness in the joints, further limiting mobility.
- Fatigue: The body’s inflammatory response can lead to overwhelming fatigue, making even simple tasks exhausting. Some individuals may find themselves needing multiple naps throughout the day.
- Reduced range of motion: Stiff, inflamed joints can restrict the ability to perform everyday activities.
- Low mood: Chronic pain and fatigue may contribute to feelings of sadness or depression.
- General sense of being unwell: The cumulative impact of a flare can cause a persistent feeling of malaise or discomfort.
- Fever: Inflammation may trigger a low-grade fever.
- Weight loss: Persistent inflammation can disrupt appetite and metabolism, potentially leading to unintentional weight loss.
- Emotional distress: The sudden and unpredictable nature of flares can create frustration, helplessness, and anxiety. These feelings are often heightened by the challenges of maintaining normalcy during flares.
Impact on Daily Life
RA flares can significantly disrupt daily life. The unpredictability and severity of symptoms often make it challenging to adhere to schedules and commitments. This inconsistency can lead others to perceive me as unreliable or flaky, despite the reality that I am managing a chronic illness.
- Work and productivity: Flares can severely impact my ability to work effectively or meet deadlines. Pain and fatigue make it difficult to concentrate and complete tasks.
- Social activities: Attending social events or even casual outings can feel impossible during a flare. Frequently having to cancel plans at the last minute may strain relationships and contribute to feelings of isolation.
- Household responsibilities: Managing household chores and responsibilities becomes daunting during a flare. Even simple tasks like cooking, cleaning, or attending to personal hygiene can require immense effort.
Coping Strategies
Managing RA flares can be challenging, but several strategies may help reduce their impact:
- Medication adjustments: Consult with your health care provider to modify your treatment plan during a flare. This might involve increasing doses or adding short-term treatments to alleviate symptoms.
- Rest and self-care: Prioritize rest to allow your body to recover. Gentle stretching and relaxation techniques can help reduce stiffness and discomfort.
- Heat and cold therapy: Applying heat or cold packs to affected joints can provide relief from pain and inflammation.
- Healthy diet: Eating a balanced diet rich in anti-inflammatory foods can support overall health and may lessen the intensity of flares.
- Support system: Lean on friends, family, and support groups for emotional support and practical assistance during flares.
- Lifestyle changes: Consider adopting stress management techniques, engaging in regular low-impact exercise, avoiding smoking, maintaining good oral hygiene, and following a healthy diet.
Not all flares require medication adjustments. Many can be managed with lifestyle changes and over-the-counter pain relievers. However, if your symptoms are severe or persistent, it’s important to consult your rheumatologist to explore treatment modifications.
Communicating with Others
Living with RA means dealing with flares that can happen unexpectedly and disrupt daily life. Talking openly with friends, family, and coworkers about RA can help them understand what you’re going through. Letting them know that flares are sometimes unavoidable can make it easier to handle both the symptoms and the impact on your relationships. While flares are hard to deal with, having support and a good plan can make them easier to manage.
Be a More Proactive Patient with PatientSpot
PatientSpot (formerly ArthritisPower) is a patient-led, patient-centered research registry for people living with chronic conditions. By joining, you can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and you can share this information with your doctor. Learn more and sign up here.
This article was written with help from rheumatologist Debaditya Roy, MD, DM.
