Treating RA Flares and Exacerbations
Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by an overactive immune system that mistakenly attacks tissues and joints. The most common form of autoimmune arthritis, RA affects more than 1.3 million Americans. The symptoms of RA typically include swelling, redness, stiffness, and sometimes erosion and abnormality in the affected joints.
For some people, the symptoms of RA can last for a long time. The disease flares up and causes more symptoms. Learn how to cope with flares of the ras.
The amount of time a flare lasts can vary in the same way that the symptoms of the disease can. A flare can last a day, a few days, a week, and even years if it goes undetected.
Flares can start suddenly.
RA flares can start suddenly and unexpectedly. In some instances, there is no definable cause. In other cases, an RA flare can be triggered by mental stress, physical overexertion, or an infection.
There are signs that you may have an RA flare.
- “The joints were not as limber in the morning and weren’t as limber throughout the day.”
- increased fatigue
- night sweats or fever
- A general feeling of ill health.
Flares can be suppressed with medication and sometimes with home remedies.
Home remedies can help calm flares if you have a RA.
- Hot and cold therapies. Heating pads and hot baths can help soothe stiff joints. Ice packs can help with dulling acute pain and easing swollen joints.
- Massage. Massages can help with relaxing stiff muscles and easing stress
- Acupuncture. Acupuncture is the practice of inserting tiny needles into the skin.
Research suggests this alternative therapy can help improve function and quality of life in people living with RA. - Daily movement. Staying active when possible can help prevent stiffness and maintain muscle.
- Rest. You may not be able to complete as many activities or errands when you’re dealing with an RA flare. Giving yourself time to rest in between activities can help keep stress levels lower.
- Meditation. Stress can trigger an RA flare, so it’s important to find ways to attempt to lower your stress levels via activities like meditation. There is some clinical evidence to support mindfulness meditation as a productive alternative therapy for easing RA symptoms.
- Supplements.
Studies show that fish oil supplements, which contain omega-3 fatty acids, can help reduce the number of swollen and tender joints. Curcumin, a main ingredient in turmeric, has alsobeen shown in studies to help ease arthritis symptoms. However, talk with your doctor before starting any supplements. Not all supplements are created equal, and the FDA doesn’t regulate fish oil or curcumin dosage. - Diet. While there is no specific diet that can cure arthritis, there are foods that may help your RA symptoms by helping to lower inflammation in your body, such as fatty fish, peas and beans, fruits and veggies, and olive oil.
Those with RA can take certain medications to help treat and suppress flares. The most common medications for treating RA can be divided into three groups.
NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are designed to relieve acute pain and inflammation. These are often the first type of drugs prescribed for people dealing with RA.
Ibuprofen and naproxen are two examples of over-the-counter NSAIDs, which can also be prescribed by a doctor at higher dosages.
Mild side effects of NSAID are usually the only side effects that are serious, but there are more serious side effects that can be serious.
DMARDs
Disease-modifying anti-rheumatic drugs, or DMARDs, are designed to slow the progression of the disease while also helping to reduce inflammation. These can only be prescribed by your doctor or specialist.
There are three types of DMARDS.
- Conventional DMARDs suppress your immune system in order to ease inflammation.
- TargetedDMARDs block pathways inside cells.
- The immune proteins known as cytokines are the focus of the biologicDMARDs.
Common DMARDs include methotrexate, leflunomide (Arava), and hydroxychloroquine (Plaquenil).
All of the DMARDs suppress your immune system. They can make vaccines more dangerous. Make sure to talk with your doctor about the side effects of any specific drug.
JAK Inhibitors
The American College of Rheumatology (ACR) classifies JAK inhibitors as targeted synthetic DMARDs.
“If your doctor doesn’t think that your RA is treated with a drug, he may prescribe a drug called a jak inhibitors. The drugs affect genes and immune cells, which can help prevent inflammation and stop damage to joints and tissues.”
The JAK inhibitors include:
- The baricitinib is a drug.
- Tofacitinib is a drug.
- Upadacitinib is a drug.
Before starting a JAK inhibitor, you should talk to your doctor.
Biologics
Biologics are a specialized type of DMARD usually prescribed when traditional DMARDs don’t seem to be working. Biologics are usually administered via a shot or through an IV, and work by blocking certain immune system signals that can create inflammation.
Common biologics include adalimumab (Humira), certolizumab (Cimzia), and etanercept (Enbrel).
The risk of infection can be increased by using biologics. Discuss your medication with your doctor to find out what other side effects it might have.
In addition to incorporating both home remedies and medication to help suppress your RA flares, finding a rheumatologist (a doctor who specializes in diseases of the joints, bones, and muscles) you like and can trust, and keeping an open line of communication with them, may make it easier to navigate flares when they do arise.
If your RA makes movement difficult, you can visit a physical therapist.
“When an RA flare strikes you off guard, you may feel like you can’t keep up with your commitments. Tell your friends, family members, and colleagues what you are experiencing. Open communication helps them understand what you are going through and helps you find people who will help you when you are having trouble.”
“Don’t be afraid to admit that you can’t do something. Stressing your body beyond what it can handle may make your flare worse.”
Like many other autoimmune diseases, RA can feel frustrating at times due to the unpredictability of flare-ups. However, medication interventions have made treating flare-ups easier, and may even help to lessen the number of flares you do experience.
Home remedies like maintaining a diet that is high in inflammation and practicing meditation can help to ease the difficulties that come with RA flares.
Having a doctor you trust and a flare-up plan in place can help you get back up after a flare up.
