Although rheumatoid arthritis (RA) is a chronic disease, you can have acute episodes of pain and inflammation, known as flares. An arthritis flare may occur after an infection, or after a highly stressful situation. Often, however, what triggers a flare is not clear. You may have long periods when your RA is quiet, or in remission. Then, suddenly, the inflammation becomes more active and you have a rheumatoid arthritis flare. Remember that you have a range of weapons in your arsenal to address pain.
Discuss a plan of action with your doctor. One approach would be to adjust your medications temporarily while the disease is unusually active. This will not only relieve some of the pain associated with an arthritis flare, but also help minimize any damage that may occur from unchecked inflammation.
Be aware that your medications may not control the flare right away, even if your dosages are increased. Or they may only have a limited effect on your flare. Of course you and your doctors should be in agreement about possible increases in your medications, or even additions of new medications during a rheumatoid arthritis flare. Many doctors will suggest a plan that you can use at each flare’s onset without having to seek his or her permission each time.
The following is a list of some other steps that you may want to incorporate in your plan. Remember, some techniques work better for some people than others. Try a few of these, and if they don’t work for you, discard them and try others.
• Balance periods of activity with periods of rest. Although more rest can help during an arthritis flare, you probably do not need to abandon your regular activities, work or exercise program. A doctor or physical therapist can help you modify your program when you experience a flare. Spending long periods in bed is counterproductive, usually prolonging your pain. Instead, try to intersperse periods of rest with some light activity. Finally, to keep joints from becoming stiff, move them through the fullest range of motion possible, gradually increasing your range as the flare subsides.
• Have a plan to deal with your obligations. Have a contingency plan both for work and family obligations. At work, try to arrange for coverage, work fewer hours per week or bring work home. Discuss your plan with supervisors and co-workers ahead of time, and assure them of your commitment. At home, plan to apportion a few extra jobs among family members, and make sure everyone knows what they are expected to do to keep things running smoothly.
• Communicate with your family and friends. The time to let your family and friends know that you may need more help is when things are going well. When a rheumatoid arthritis flare occurs, if someone volunteers to help you, give them a specific job. Otherwise, well-intentioned offers of assistance go unused. Other sources of help, such as members of your religious institution or community volunteer organizations, may be available to you as well.
• Apply a hot or cold pack to inflamed joints. Although heat can theoretically make inflammation worse, because it tends to increase blood flow and nerve sensitivity, some people find a warm pack soothing and pain relieving. Others get benefit from cold, which decreases blood flow to the inflamed area and lessens inflammation and muscle spasm. You can buy hot and cold packs from a drugstore, or you can use a hot water bottle or a pack of frozen vegetables (wrap a towel around the pack first). If you find that heat helps, try these warming techniques.
• Practice relaxation or mind-diversion techniques. These techniques work best when you do them on a regular basis. Even though relaxation may not directly reduce your pain, it can minimize stress, which has been shown to make pain worse. Try this simple muscle relaxation technique.