Understanding and Managing RA Flares
Rheumatoid arthritis (RA) flares can be unpredictable, lasting anywhere from a day to a year if left untreated. While home remedies like acupuncture and medication can help alleviate the symptoms of a flare, they cannot cure the condition. RA is a chronic inflammatory disease caused by an overactive immune system that mistakenly attacks the body’s tissues and joints. As the most common form of autoimmune arthritis, RA affects over 1.3 million Americans. Typical symptoms include swelling, redness, stiffness, and occasionally joint erosion and deformity.
For some individuals, RA manifests as a cyclical disease: symptoms can disappear for weeks, months, or even years before flaring up again.
How Long Do RA Flares Last?
The duration of an RA flare can vary widely, just like the symptoms and triggers of the disease. A flare might last for a day, a few days, a week, or even potentially years if untreated. Most flares are unpredictable and can begin abruptly.
Causes of an RA Flare
RA flares can start suddenly and unexpectedly. In some cases, there is no identifiable cause. However, potential triggers include mental stress, physical overexertion, or infections.
Signs of an RA Flare
You may be experiencing an RA flare if you notice:
- Increased stiffness in the joints, particularly in the morning, which does not easily subside throughout the day
- Heightened fatigue
- Night sweats or fever
- A general feeling of being unwell that lingers
Typically, flares can be managed with medication and sometimes alleviated with home remedies.
Read on to discover techniques and strategies for coping with RA flares.
Home Remedies for Managing RA Flares
Even if you’re using medication for your rheumatoid arthritis (RA), certain home remedies may help in calming flares:
Hot and Cold Therapies
- Heating Pads and Hot Baths: These can help soothe stiff joints.
- Ice Packs: Useful for dulling acute pain and reducing swelling in joints.
Massage
- Massages can assist in relaxing stiff muscles and relieving stress.
Acupuncture
- Acupuncture involves the insertion of tiny needles into the skin. Research suggests that this alternative therapy can help improve function and quality of life for people living with RA.
Daily Movement
- Staying active, when possible, can help prevent stiffness and maintain muscle strength.
Rest
- During an RA flare, you might not be able to complete as many activities or errands. Allowing yourself time to rest between activities can help manage stress levels.
Meditation
- Stress can trigger an RA flare, so it’s important to find ways to lower your stress levels, such as through meditation. There is clinical evidence to support mindfulness meditation as an effective alternative therapy for alleviating RA symptoms.
Supplements
- Studies indicate that fish oil supplements, which contain omega-3 fatty acids, can help reduce the number of swollen and tender joints. Additionally, curcumin, a key ingredient in turmeric, has also been shown to help ease arthritis symptoms. However, consult your doctor before starting any supplements, as not all are created equal and the FDA does not regulate fish oil or curcumin dosages.
Diet
- While there is no specific diet that can cure arthritis, certain foods may help alleviate RA symptoms by reducing inflammation in the body. These include fatty fish, peas, beans, fruits, vegetables, and olive oil.
Medications for RA Management
While there is no cure for rheumatoid arthritis (RA), certain medications can help treat and suppress flares. The medications most commonly prescribed for RA can be divided into three groups:
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
- Purpose: Designed to relieve acute pain and inflammation, NSAIDs are often the first type of medication prescribed to individuals dealing with RA.
- Examples: Over-the-counter NSAIDs include ibuprofen and naproxen, which can also be prescribed by a doctor at higher dosages.
- Side Effects: When taken at the correct dose, side effects are typically mild. However, more severe side effects can include gastrointestinal issues, bruising, an increased risk of heart attack and stroke, and potential allergic reactions.
DMARDs (Disease-Modifying Anti-Rheumatic Drugs)
- Purpose: DMARDs aim to slow the progression of the disease while also reducing inflammation. These medications can only be prescribed by your doctor or specialist.
- Types: Currently, there are three types of DMARDs:
- Conventional DMARDs: Broadly suppress the immune system to ease inflammation.
- Targeted DMARDs: Block specific pathways inside cells.
- Biologic DMARDs: Focus on individual immune proteins known as cytokines.
- Common DMARDs: Include methotrexate, leflunomide (Arava), and hydroxychloroquine (Plaquenil).
- Side Effects: Since all DMARDs suppress the immune system, they can increase the risk of infection and make vaccinations more dangerous. Discuss the specific side effects of any prescribed DMARD with your doctor.
Taking these medications as directed by your healthcare provider can be crucial in managing RA flares and improving quality of life. Always consult your doctor about potential side effects and how to mitigate them.
JAK Inhibitors
The American College of Rheumatology (ACR) classifies JAK inhibitors as targeted synthetic DMARDs. Your doctor may prescribe JAK inhibitors if traditional DMARDs or biologics are not effectively managing your RA. These medications influence gene activity and immune cell functions to help prevent inflammation and halt joint and tissue damage.
Common JAK Inhibitors Include:
- Baricitinib (Olumiant)
- Tofacitinib (Xeljanz, Xeljanz XR)
- Upadacitinib (Rinvoq)
Before starting a JAK inhibitor, consult with your doctor to weigh the benefits and risks.
Biologics
Biologics are a specialized type of DMARD usually prescribed when conventional DMARDs are ineffective. Administered via injection or intravenous infusion, biologics work by blocking specific immune system signals that trigger inflammation.
Common Biologics Include:
- Adalimumab (Humira)
- Certolizumab (Cimzia)
- Etanercept (Enbrel)
Like traditional DMARDs, biologics can increase the risk of infection. Given the variety of biologics available, it’s essential to discuss with your doctor the potential side effects of any specific medication you are considering.
Lifestyle Tips
In addition to implementing home remedies and medications to manage your RA flares, finding a rheumatologist you trust and maintaining open communication with them can make it easier to navigate flares when they arise.
- Physical Therapy: If RA has made movement difficult, routine visits to a physical therapist can help restore some flexibility.
- Communication: During unexpected RA flares, you may feel overwhelmed by your commitments and workload. Communicate your experiences with friends, family members, and colleagues. Open communication can help others understand your situation and provide you with a support network during difficult times.
- Self-Care: Don’t hesitate to admit when you can’t perform certain tasks. Pushing your body beyond its limits can exacerbate flares. Prioritize self-care to manage stress and prevent worsening symptoms.
Being proactive in managing your RA with the help of your healthcare team, along with adopting supportive lifestyle habits, can significantly improve your quality of life.