If you live with rheumatoid arthritis (RA), you know that this autoimmune disease can go through cycles of flares and remission. An RA flare is when your symptoms suddenly get worse for a period of time. Knowing how to recognize when a flare might be developing is key to getting the right treatment to manage the symptoms. This guide covers the common signs of rheumatoid arthritis flares and how to tell if you’re having one.
What Is a Rheumatoid Arthritis Flare?
A rheumatoid arthritis flare refers to a sudden worsening of RA symptoms, such as joint pain, stiffness, and swelling. During a flare, you may also experience increased fatigue, loss of appetite, low-grade fever, and other systemic symptoms as your immune system acts up.
Flares can range from mild to severe. Some may last just a few days or up to several weeks. You may continue to have some ongoing joint symptoms between flares or enjoy periods of remission when your symptoms fully subside.
What triggers RA flares isn’t always clear. Sometimes they happen without an obvious cause. Other times, flares may be brought on by:
- Viral or bacterial infections
- High stress levels
- Changes in medications
- Weather changes
- Overusing sore joints
- Poor diet or lack of sleep
Paying attention to your symptoms and knowing what indicates an RA flare can help you get the right care to manage it.
Early Signs Your Rheumatoid Arthritis Is Flaring Up
In many cases, the early signs of an oncoming RA flare are noticeable days or even weeks before the worst symptoms set in. Being aware of subtle changes is important so you can start flare treatments as soon as possible. This can help minimize the severity.
Some early warning signs include:
- Fatigue and weakness – Having less energy than usual is often one of the first indicators of inflammation brewing.
- Low-grade fever – Your temperature may rise slightly, around 99-100°F.
- Appetite changes – Some people notice they don’t feel as hungry leading up to a flare.
- Mood changes – Increased pain, fatigue, and immune activity can impact your emotions. You may feel more on-edge, stressed, or down.
- Tingling and numbness – Nerves can become aggravated by nearby inflammation. Tingling or numbness in the hands and feet can result.
- Light flares – You may notice minor flares leading up to a major one – your joints feeling worse for a day or two then improving again.
Paying attention to subtle shifts in your energy, appetite, mood, and symptoms are all wise strategies. Even minor flares are good indicators that more severe symptoms may shortly follow if not properly managed.
Key Symptoms of an RA Flare
Once an RA flare is fully underway, the most pronounced symptoms are typically in your joints. However, whole-body effects are also common. Know what to look for:
Joint Pain and Swelling
The hallmarks of rheumatoid arthritis are joint damage and swelling due to rampant inflammation. The joints most often impacted include:
- Hands and wrists – Typically the small joints closest to the fingernails.
- Feet – Often the forefoot and joints of the toes.
- Knees – The knee joint can become very inflamed.
- Elbows – Pain concentrates on the inside of the elbow.
- Ankles and shoulders – Other commonly affected joints.
During an RA flare, you may experience severe joint pain, excessive warmth, redness, and swelling. The inflammation is much more pronounced than usual. Moving the affected joints is often difficult due to significant stiffness and pain.
Fatigue and Weakness
As your immune system works overtime churning out inflammation-producing chemicals during a flare, you may feel wiped out, even after resting. Fatigue and body weakness are very common.
Simple physical tasks like grocery shopping or climbing stairs may leave you utterly exhausted. You may also have low stamina for exercise you can normally handle. Allow yourself to rest as needed.
Fever and Chills
The immune system chaos behind your flare can also trigger flu-like fever and chills. A low-grade fever around 100°F is typical. Feeling unusually cold and shivery can also happen as your inflammation levels rise.
Appetite Changes
When pain levels are high and your body is stressed from immune activity, your hunger cues can become suppressed. Losing interest in eating is common. Food may be unappealing.
On the other hand, some people report an increase in cravings for sugary and salty foods leading up to or during an RA flare. Listen to what your body wants and respond accordingly.
Emotional Changes
Finally, don’t underestimate the toll RA flares can take on your emotions. You may feel more impatient, on-edge, stressed, or blue when your symptoms worsen. Mood changes are very normal.
Coping with the disappointment of losing ground in your treatment progress combined with increased pain is challenging. Extend yourself compassion rather than bottling up difficult emotions. Confide in loved ones for support.
When to See Your Rheumatologist About a Flare
Ongoing education between you and your rheumatologist is key for managing your RA symptoms long-term. Always have an action plan for contacting your doctor if you experience a flare.
In many cases, adjusting your medications is warranted to get the inflammation back under control. Your rheumatologist may also want to order follow-up blood tests to look for signs of high inflammation.
As a general rule, reach out to your care team if:
- Your flare lasts more than 48 hours with no improvement
- Swelling and pain are severe
- You have a high fever over 101°F
- You have extreme fatigue or loss of appetite
- Over-the-counter pain medication offers little relief
- You’re experiencing emotional distress from pain and disability
Describe all your symptoms in detail. Be ready to report what the flare feels like compared to your usual flares, how it impacts your daily function, sleep, and more. With this information, your rheumatologist can make informed treatment tweaks to help resolve your flare.
Flare Treatments and Self-Care Tips
While you wait for your rheumatology appointment during an RA flare, focus on gentle self-care:
- Take medications as prescribed – This includes both your disease-modifying antirheumatic drugs (DMARDs) as well as any over-the-counter NSAIDs your doctor recommends for pain.
- Apply cold packs – Icing painful joints reduces swelling and offers natural pain relief.
- Pace activity – Balance rest breaks with gentle movement to prevent stiffening up too much.
- Use compression – Wrapping joints with an elastic bandage can support and temporarily ease pain.
- Elevate inflamed joints – This reduces blood flow to swollen areas.
- Consider assistive devices – Braces, splints, crutches or a cane could help take pressure off sore joints.
- Ask for support – Don’t neglect emotional health. Confide in loved ones when you’re struggling.
During severe or frequent flares, your rheumatologist may administer steroid injections or infusions to rapidly calm your overactive immune response. Adjusting your medications is also common – either by adding another DMARD, changing drugs entirely, or modifying dosages.
The bottom line is that while RA flares are undoubtedly disruptive and difficult to manage, you have more power to handle them than you think. Pay close attention to your early symptoms, stay in touch with your rheumatologist regularly, and be diligent about self-care. With the right treatment plan adjustments, this too shall pass.