Dealing with RA flares: Treatment and remedies

Flares are periods of increased disease activity during which people’s arthritis symptoms, which typically include joint pain, swelling, and stiffness, are more severe.

People with rheumatoid arthritis (RA) often find that flares come and go in waves throughout their lives. The duration of flares varies from a few days to several months. The specific symptoms and their severity may also differ between people and situations.

In this article, we discuss how people can reduce and manage RA flares.

Dealing with RA flares

There are currently no medications that can cure RA or consistently prevent flares. The goal of treatment is to reduce symptoms, minimize inflammation, and prevent joint damage.

People can try the following techniques and home remedies to relieve their symptoms when they feel an RA flare coming on:

Managing flares at home

Being aware of the early symptoms of flares is useful for preventing and dealing with them.

1. Keep a symptoms journal

It can be beneficial to keep a journal of potential flare triggers and symptoms to try to identify when and why the flares happen. Avoiding triggers and resting may be enough to manage a minor flare.

2. Rest more

Once a flare starts, many people will need to reduce their activity levels.

During severe flares, people may need to rest completely. Working from home and having a reliable support system of family and friends in place can help.

3. Exercise gently

Doing gentle range-of-motion exercises and stretches can prevent stiffness when an RA flare occurs.

4. Use hot or cold packs

Hot or cold packs can help reduce joint pain and swelling. People can start using these packs as soon as symptoms appear and continue to use them throughout the flare.

It is essential to avoid placing hot or cold substances directly on the skin. Instead, wrap the pack in a towel before applying it to the affected area.

5. Make dietary changes

Following an anti-inflammatory diet can help prevent flares and improve RA symptoms when they do occur.

People wishing to follow this diet should avoid processed foods, refined sugars, and artificial ingredients, and eat a Mediterranean diet that is rich in whole foods.

Foods that people with RA should incorporate into their diet include:

• foods rich in omega-3 fatty acids, such as flaxseed, chia seeds, walnuts, salmon, and tuna
• foods rich in antioxidants, including colorful vegetables, fruits, beans, cacao, and cinnamon
• extra-virgin olive oil
• nuts and seeds

Reducing stress is essential for preventing flares or shortening their length and reducing symptoms. People can try the following techniques to reduce stress when they feel a flare coming on:

• meditation
• guided imagery
• deep breathing
• mind-body exercises, such as yoga and tai chi
• journaling
• positive thinking
• gratitude practice

Medications

It is possible to divide the medications that doctors usually prescribe for RA into three major groups:

• Medications to treat symptoms. Steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen are among the medicines that can relieve the inflammation and acute pain that RA may cause.
• Immunosuppressant drugs. These treatments slow the progression of RA and prevent joint damage by halting the body’s inflammatory response. They are also known as disease-modifying antirheumatic drugs (DMARDs).
• Biologic response modifiers. These drugs are a newer generation of DMARDs, which mimic human immune molecules. Biologics inhibit the inflammatory response in a more targeted way.

There are two types of RA flare, which doctors refer to as predictable and unpredictable.

Predictable flares usually occur in response to one or more triggers.

Unpredictable flares do not have an apparent trigger and people can struggle to link them to any specific causes. This type of flare is more challenging to prevent and treat than predictable flares.

Typical triggers of an RA flare include:

• stress, either emotional or physical
• poor sleep
• infection
• overexertion

People who have predictable flares may be able to take precautions to prevent them or reduce their severity.

Outlook

RA is a chronic disease that does not currently have a cure. RA generally comes in waves, meaning that people experience flares in alternation with periods of remission.

Each person is different, but it is often possible to manage RA flares using medication and lifestyle strategies.

A doctor can help people create a management plan that is specific to their needs, symptoms, and situation.

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