What is a Rheumatoid Arthritis Flare?
Rheumatoid Arthritis flare symptoms don’t play by the rules
As I’ve mentioned before on the blog, my joints did not read any rheumatoid arthritis books before I got RA. I had no idea which joints were supposed to be my rheumatoid arthritis joints and which were supposed to be my “healthy” joints. I didn’t study for my blood tests either. No, the rheumatoid arthritis had a mind of its own and it did not always obey those moldy ol’ American College of Rheumatology Rheumatoid Arthritis guidelines. What are the rules for rheumatoid arthritis flare?
Like most of you, I faced each new symptom with surprise and dismay. Yes, Rheumatoid Arthritis symptoms may sound peculiar to my neighbor, an RA Atheist, but they seemed even weirder to me in the middle of the night. She may excuse me as a hypochondriac, but what do I do? How can I excuse my own rheumatoid arthritis symptoms as hypochondriacal? “Get out of here, you Phony! You are not real.” I wish.
Again, like most of you, I went to the doctor. I don’t mean my rheumatologist – I mean Dr. Google. I found journal articles, abstracts, blogs, and forums. But, I was puzzled there, too. Everywhere, I read the word “flare.”
So, what’s a Rheumatoid Arthritis flare anyway?
I was so puzzled. What on earth does word flare mean? I kept reading.
Eventually, I began to get the idea that rheumatoid arthritis symptoms for some patients wax and wane. The way they tell it, it seems that for some people, RA symptoms are episodic or interrupted by periods of near relief. I felt like a non-RA’er on the outside looking in, trying to figure out what’s going on. What is a rheumatoid arthritis flare anyway?
Now, I was really in trouble. Was I going to get an “F” at Google University, too? Was it another conflict between the reality of my Rheumatoid Arthritis symptoms and what they are supposed to be?
When I hear a doctor talk about RA flare, it sounds like life is pretty good between the flares. According to About.com, a flare is an increase in symptoms from the usual. That might mean joint pain, joint stiffness, swelling, or fatigue. But, who or what defines the baseline for symptoms? I’m still confused. My RA is always the same: 24/7. Ten feet deep. Wall to wall.
What is your experience?
Do you think “flare” is a clear term? Does your doctor use the word “flare”? Does she seem to think your RA is “better” than you think it is between complaints? Does your rheumatoid arthritis flare even though you are on DMARDs? How much time is there between “flares”? What is your baseline (between flares) like?
Recommended reading:
- So Glad Your Rheumatoid Arthritis Is Cured
- The Use It or Lose It Approach to Rheumatoid Arthritis
- Baloney About Rheumatoid Arthritis
How do you know you are having a flare? I feel like I am back at the start with my pain. I’m having constant throbbing in one of my knees, I have been waking up from the pain. I’m frustrated at this point cause I just don’t know what else to do to get relief.
Hi Doreen, if you haven’t, I’d read through the other comments – 164 here – to see how others describe their experience with flares.
Sometimes flare is a bad word to describe RA because the disease is always there. For other people it goes up and down – It sounds like yours is worse now than it was for a while. THAT’s how many define flare.
Hi,
I have not read everyone’s comments yet, but plan to. For me, a flare is excruciating pain I experience usually in one joint . It always starts in the afternoon and slowly progresses to 8 or 9 out of ten pain, and it keeps me up all night. Through trial and error, I have learnt that as soon as I recognise that one is starting, if I take voltaren & panadine forte, I can nip it in the bud & it doesn’t escalate. I find what causes a flare for me, is after I have done something out of the ordinary 1-2 days beforehand eg: – I ran on my treadmill and felt fantastic at the time, ( I had not exercised for 3-4 weeks) then 2 afternoons later, at work, it started on my left knee ( approx 6:30 pm) . By the end of my shift at 8:30 pm, I could not drive home. I was able to hobble in pain to finish my shift. I did not have the above mentioned drugs on me to take, unfortunately.
A friend had to drive me home. Also, the worse it gets, the less effective the voltaren & panadine forte is, so I was up all night in pain, with a heat pack on my knee, watching tv in the lounge to distract myself, and so that my husband could get a good nights sleep for work the next day!
Every time I do something new or different, there is a high probability I will develop a flare . Another example was when I started a 6 month on line course. I was not use to sitting for long periods of time in front of my computer ( using a mouse and keyboard.) I soon had a flare in my right wrist!
Once, after chewing gum for too long, I had a flare in my jaw! I couldn’t open my mouth wide enough to eat!
I had a flare in my hip after sitting in a car for a 10 hour drive. I was a passenger, and we stopped often and I kept repositioning myself but it still came.
I do have pain every day in my hands and feet however. Mild = 2-3 out of 10 in hands usually, and by the end of every day ( Especially after work ) my feet are between 5-7 out of 10.
Is there anyone else out there the same?
Regards,
Michelle
I am about 2 yrs diagnosed, currently on Enbrel and Mtx. I am a 55 year old guy otherwise in pretty good shape (lol). For me a flare adds the flu like symptoms of temperature swings and fatigue to whatever already hurts, plus an all over body ache. Flares do seem less frequent and shorter since being on these meds. Wishing all here the best, and loving your company…if you get my meaning.
glad to hear the meds are helping. good luck. and yes “misery loves company” – at least we know we aren’t alone.
Good morning, I have been following RA Warrior for the past year now and laughed and cried at postings here. My prayers are with each one of you and sending good thoughts to all who are having a nasty flare up.
Speaking of flare ups I had a pretty nasty one last week. I am a Network Administrator and my hands are constantly typing on several keyboards. By Friday afternoon I blew a large vein on the back of my left hand. By that evening my whole back of my hand turned black and swollen. Husband scooped me up and took me to Urgent Care Centre.
Had an ultrasound done and it showed no clots. Verdict was that my hands had been under tremendous inflammation that it affected the veins. That and taking more than I should have of ibuprofen.
Getting better now and taking the right doses of meds.
Gentle hugs to all, 🙂
Hi
I would love to know if any of you find pre menstruation triggesr a flare for you?
As I am stuck in a monthly flare pattern and the Rheumatologist doesn’t seem to quite understand what I mean (he’s a man, lol)by this and I just wondered how common it was?
Thank you 🙂
Oh Kelly I feel the same!
I cant quite get my head around the whole “life is pretty great between flares” logic.
Although I am presently going through especially difficult and debilitating pain (like someone is backing over me with their car and tearing my muscles ) I have to also say that on my best day I have pain in many different parts of my body that I have to endure.
At the moments my lungs and stomach are out of control as well… and I will stop there because if I Keep going I could go on for hours.
Sometimes it takes everything I have to be “grateful” for my blessings without dissolving into tears from the pain.
I try never to show my doctors these range of emotions for fear that they down play my pain and think I am just “highly emotional” and unable to cope.
Does any of this make sense??
Love and best wishes
Trish D
Fairly new to this site-1st read about a year ago- been commenting on Facebook.
I was dx 1n 1994-age 42- I could find a direct correlation during ovulation with flares. My Rheumy agreed that it was possible.
Now, 20 yrs later, post meno-pausal, my Flares are still somewhat similar. I have 3 types of flares. 1.Mine are severe fatigue, with flulike symptons, EVERYTHING HURTS!!- even my lips! I run a low-grade fever, and stay in bed. Drink lots of fluids- but no food. Luckily- they pass within 24-72 hrs.
2. Moderate flare= a joint (s) unusable for 24-72 hrs. Ie: hands cannot “clench or grasp- severe pain and/or swelling.
I just go to bed. Rest helps.
3. Spend too much energy doing (anything ordinary) cleaning, cooking, shopping, exercising-there seams to be no rhyme or reason.
****My Rationale for my flares:
1. Too much stress
2. I explain my rationale for “with RA- YOU ONLY HAVE SO MUCH ENERGY TO USE A DAY– when you get close to using it-wham- I am down with a flare for 1-3 days.
3. When I have limited aches and few days of pain – I call it temporary remission.***Note I have been on “Biologics” for 10 yrs.
My Rheumy agrees- that when I need a vacation from pain- he prescribes the prednisone 12 day pack (70 mg, 60, 50, 40 and so on-for total of 12 days- to have on hand for “Holidays or vacations” because an RA patient never knows when a flare will hit- and well, life must go on.
I realize, from reading previous posts- we all have a different experience—living with RA is indeed a challenge- but sharing this with others hopefully will help them to understand- we warriors are not alone! God Bless!
I can now tell the difference. When I have a flare. im more stiffer than usual,swollen and in pain all over. When this happens my pain meds don’t work .what has worked for me is hospital administered steroid through the iv.I found out that its the inflammation that causes me so much pain. I pray for a cure and pain relief for all of us dealing with this disease that seems to be so hard to not only diagnose ,but to treat.I’ve had 3 different rheumatologist and no one has the same diagnose, or treatment plan. I live in Michigan. I have been on all kinds of biologics,steroids,still in pain ,less flare ups,but I am experiencing chronic stomach problems ,and fatigue.has anyone been told that the weather could improve there ra?can anyone recommened a good ra doc in Michigan,or etcccc?
hello all first time posting ever, i have RA and fibromyalgia. Diagnosed 2009 started with fibro and then RA . i’m always achey everynow and then i have a couple of great days. Mtx not working as ot once did Rheumy just staryed me on enbrel . All my labs are high rigjt now , so i am exyra tired more achey than usual my feet are now hurting my hips too .A flare up for me is just extra of all my symtoms but even in a flare up you have better days. Meds i take mtx , cymbalta for muscleskeletal pain , folic acid ,vitamin d rx and now embrel and starying celebrex i also take 5 mg of prednosone when i’m really stiff and achey. Rigjt now ! I
Hi, Isabe: I usually do a prednisone increase that goes like this when my RA flares, or gets much worse: Prednisone 20mg for 3 days; then 15mg for 3 days; 10mg for 3 days then 5mg of prednisone daily thereafter. I also have pain meds from a pain specialist, otherwise, I would be totally bed bound during the horrible flares. Maybe you ask your rheumy about the prednisone if you think the NSAIDS are helping or you become immobilized. The only side effect I get from prednisone is I get nervous with the higher doses. I am glad we have this site. Others like us know how much this disease hurts, and yes, the muscles and tendons join in with the joints to make bad flares horrible and bring me to tears. In between these “flares” the joints ache and hurt if I use them much, like walk or stand too long. A good day is when I can walk in my house and try and cook and feel like bathing. Personal hygiene is so hard when I am exhausted and in pain from RA. Take care and God bless
I found out I had rheumatoid arthritis almost a year ago. I myself didn’t really understand what it was. I was put on prednisone. That doesn’t work for me. So rheumy put me on mtx but I was allergic. While this is happening I’m getting flare ups. OMG ? I didn’t know I had that many joints in my body that could hurt so bad. The flares last so long that it feels like when it finishes I’m already starting a new one. Finally I get humira. Super excited about that one and again my body rejects it. Im back on square one. Today I’m in bed because I can’t do anything else. Rheumy is trying to get me on remicaid infusions. Till then I have nothing to stop this pain. I feel alone.
I don’t know that flare is a clear term. I’m always in some level of pain. I call it a flare when it shoots above my ability to cope. If it is affecting the way I plan my life, i.e. staying at home in bed when I’d rather be antiquing, then it’s a flare. Weather is a trigger. Stress is a trigger. And sometimes it happens with no rhyme or reason.
This is all so confusing to me. I have osteoarthritis. I also have Behcets. Now My Rumy thinks I have RA. Which symptoms go with which disease? My toes are always swollen and hurt to bump and shoes are a no. My wrists and thumbs always hurt. Left knee hurts sometimes. Right shoulder kills. Is it RA? Is it my Behcets? Is is it osteo? Its so confusing and frustrating. I’m taking meds and I don’t know if I need them….are they working? I’m always in pain. I’m soooo exhausted all the time no matter how much sleep I get. My rumy is more worried about my RA than anything else. My reason for going there was my behcets….????
My definition of a “flare” has changed over the last year. Originally, I used flare to mean an exacerbation – when pain and symptoms were especially troubling (pain 7 or higher, throbbing joints, having difficulties with activities due to pain, ect). Once I started DMARDs, flares became more of a term I used for disease activity (pain, erythemia, fever, fatigue – basically any symptom I’ve come to identify as being part of the way RA manifests for me).
It actually kinda feels silly to my. I was having pain nearly everyday, receding throughout the day as my joints warmed up, amping up the second I started to unwind and excruciating at night… but “flares” were only when my pain reached an unmanageable level. I thought… Oh, it’s not that bad, my “flares” only last a couple days.
Once I started sulfasalazine and my pain started to reduce I started looking at it very differently. I started to have days of little-to-no pain in my joints. That completely changed everything and I realized that what I had previously called a flare was really just the high point of disease activity. What I now consider a flare was pretty much my daily life… Every damn day – the off and on nerve symptoms, the GI symptoms that hit upwards of three times a day.
I feel like I see it a lot clearer. I was in so much pain all the time and I considered that normal. I toughed it out and used OTC NSAIDS as a last resort (which was becoming a near-dayly reality for me previously to diagnosis). I can’t even believe I put up with that for so long thinking it was fine… as long as I could cope with it (was I really coping??? No… No I was not… I was working denial, trying to be strong, and hoping if I ignored it long enough another remission would come along and maybe this time it’d stick).
So, at this point: if my joints are hurting, I’m having a flare. If my temp is elevated, I’m having a flare. A flare is not just feeling like I got hit by a bus and being unable to get myself out of bed. *Facepalm*