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Community > Expert Q & A > Rheumatoid Arthritis > How Long Does a Flare Last?
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How Long Does a Flare Last?

Q: I was diagnosed with rheumatoid arthritis (RA) three months ago, so learning to recognize an arthritis flare is new to me. I realize the length of a flare can vary, but how long does a flare last for most people? Months? Years? 

A: People usually know an arthritis flare is getting under way when morning stiffness increases. That is, they wake up in the morning feeling their joints are stiffer than usual, and it takes longer until the joints loosen up sufficiently for daily activities to be performed. With bad RA flares, morning stiffness and fatigue may last all day and greatly interfere with people’s lives. To the question "how long does a flare last?" the answer is that they can persist for weeks or months unless there is a change in treatment. 

Changes in blood work may indicate an increase in inflammation. For example, both the erythrocyte sedimentation (“sed”) rate or the blood level of C-reactive protein may rise. Although these test results don’t change only when there is an arthritis flare, they may provide supporting evidence of worsened disease activity for the doctor and often are helpful in tracking improvement of the disease flare after treatment. Usually your symptoms are reliable indicators of an arthritis flare, so it is important to keep tabs on them, as well as what you are doing to treat your arthritis.

It’s crucial to suppress inflammation during flares, especially so soon after your diagnosis, when initial damage to your joints can occur. How long it takes to suppress a flare depends upon the medications you take. One strategy for severe flares is to control symptoms quickly with low-dose prednisone, which can improve symptoms within days, while simultaneously starting methotrexate and other medications designed to suppress RA disease activity within weeks or months. 

John H. Stone, MD, Rheumatologist

Wanda
02 Nov 2009, 20:30
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I'm 58 yrs old and have RA. My fingers on my right hand are very swollen and have large knots on them. I take metortrexate (6 per week along with folix acid daily. I take remicade every 6 weeks. I was taking remicade every 8 weeks. I do have an increase in energy, but I can't say that my hand is any better, but the swelling is getting worse.Even my students have noticed that they are swollen.
What else is there? I would put my pain level at a 9 more often than not. I hate to complain and depress my family as well. Any suggestions will be appreciated.
Wanda
Penny
25 Oct 2009, 20:50
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I am still not taking their meds, the pain is excrutiating at times but I don't buy into their ideas of medicating. I have found that ginger root and turmeric help with the swelling which is causing the pain. I am still going to try other avenues like having the mercury taken out of mouth, aloe vera juice to keep the permanent damage at bay,Food grade peroxide soaks and prayers. There will never come a day when they say there is cure or even a reason for RA, it makes too much money for them this way.
Joe
08 Oct 2009, 12:50
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I am 46 year old male diagnosed with ra in jan 08. the rheumatologist tried me on all the oral meds but nothing seemed to work to control inflamation and severe pain in multiple joints. I finally got the 50 mg sure click enbrel. The first week I could tell a difference in joint mobility and pain control. within the first month the pain ,inflimation and fatigue was at a manageable level.Yes there is some side effects but it is also side effects for asprin ibuprophen etc. I'm just saying if the pain gets bad enough you can over look the warnings to get some relief.After getting the perscription It took me 3 months to decide whether or not to take the first shot after reading all the info and warnings but so far i'm glad i did.It only takes 20 seconds once a week in the comfort of your home and you will be able to motivate and do most of the things that you want to do without severe pain.
Tom
23 Sep 2009, 08:47
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Go to this website: karenhurd.com, I have had RA for 7 years, got off medication with this diet. Try it, but stick to it, I didn't for a couple of months and I am in a pretty good flare up. I did, however, have great success for 6-7 months (med free) now I have to get back on track. Feel free to email me or post back with questions. I know the feeling of fear and what not, but there is hope with this diet.
Lisa
16 Sep 2009, 12:39
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I can most identify with Karen.Her symptoms are very much similiar to what I have been experiencing, now, for the past 6 months to a year. I just got the call this morn. from my Orhtopedic Surgeons office. The Dr.strongly recommends I see a Rheumatologist. Quite frankly, I feel terrifed. I know there's treatments available, however, I'm not feeling suffiently secure with the info. provided on any, to be confident enought to take them. If indeed, I am diagnosed with above said condition. Thank-you for listening.
Andrea
12 Sep 2009, 15:38
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I was diagnosed a little over a year ago. My meds are doing an ok job...plaquenil 2x day and 2.5mg of prednisone, motrin and tylenol daily....but I have been in a flare up for over a month. I am so tired of the pain, stiffness and fatigue. My question...what sets off a flair? The weather has changed from hihs and lows with no change in my pain. Stress...yes, but no more than usual...I can't figure this disease out!
I walk for excercise but then can't walk for a few days. I am gaining weight...and as you can tell...cranky!! Where I used to be so active and always busy, now I can't wait to lie down. I feel like I drag myself through work, my sights set on bedtime...to wake in pain and beging it all again. Am I alone in this??
Ileen Swelland
16 Jul 2009, 13:58
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I was diagnosed with RA in Oct of 08. My Rheumatologist started me on plaquenil twice a day. So far it is working most days. I take an aleve every now and then. We walk every day and that seems to help. We go to the gym twice a week and that seems to help also. My Rheumatologist told me Enbrel is supposed to come out with a new treatment in the fall and she thinks it is in pill form. Is this true and if so, how will it be distributed?
Karen
15 Jul 2009, 09:20
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I have been seeing an RA for about 6 months.
They are still not sure if I have sero negative RA or polymyalgia rheumatica.
I am not sure of anything. I do not have much swelling, just pain and fatigue. The pain seems to be in the ends of the bones, not always the joings. Both my wrists and hands ache, about 2 inches from each shoulder joint, going into my chest area, both hip joints in the groin area, my neck, shoulders. Sometimes I have to lie down and use the heating pad, and most pain relievers do not work.
I have been on 20 mg methatrexate, once a week and have come down to 1mg of prednisone per day. I do not have the morning pain and stiffness that I used to have, but this burning, stinging pain is hard to live with.
Do any of you have the same symptoms? With what disease have you been diagnosed? Do you ever have pressure and ringing in your ears, or the dizzy feeling when you move your head and when your eyes and head stop, you still feel that you are moving for a second or two?

Any info will be deeply appreciated.

Irish
08 Jul 2009, 14:17
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I have RA and had my second treatment with Rituxin in Feb of 2009. The treatments got me to almost no pain at all until I started to increase my activities and exercise. The last 3 weeks have been so painful that I cannot bare sometimes to be without pain meds and lying down. I take methotrexate 4 pills a week now which my RA dr cut down from 5 pills a week. The only thing that helps me with the joint pain and swelling is the darvocet and very warm water soaking in my tub or hot shower relieves any stiffness. Do I need to let my RA dr know that I am having much joint pain the last 3 weeks since I got the 2 Rituxin treatments in Feb 2009? I can barely stand to move the joint pain, poor circulation and tingling in my hands feet and my right shoulder and arm I can not stand to move it without cringing from pain. I feel when I mention my pain to others that I am complaining and no-one wants to hear. My RA dr seems to understand and but I don't want to come across as whinning to him and can control the pain on my own with the methods that I have been using the last 3 weeks so far. Does anyone have some advice?
Glenda
29 Jun 2009, 09:11
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Is it normal to be in pain all the time?I developed this condition after contracting a virus May 2008 but only diagnosed with RA February 2009.I have been on prenisone, methatrexate,which was unsuccessful & have just started arava 2 weeks ago plus I take panadol 4th hourly.Nothing seems to control the pain.
costantino Micallef
06 May 2009, 08:27
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Male71. Have had Polymyalgia which turned into RA for 8months.Take 10mg methotraxate& 2x 200mg morn.&evening Plaquinol. During the day all is fine. In bed asleep for 2 to 3 hrs get strong cascade of inflammation throughout body only when horizontal in bed.necessetates getting up and sleeping on sofa upright is OK but very uncomfortable inflamm. goes away. This happens 3 to 4 times per night.
Investigating Low testostorone& high estrogen and perhaps gastro exam.Had a cat scan and all is ok all other blood test ok Crp 1. Rheumatologist has no solution
Welcome any ideas .Kind regards from -New Zealand
Nancy
27 Apr 2009, 13:27
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I have RA which I developed at 72 yrs. I lost over 20 lbs in about a month and had low fevers every day. After many blood test by a Hematology Dr. They were looking for Leukemia and Lymphoma they found out I had RA.
I was in 15 mg of Prednisone for about a yr.
Since last May I am down to 5 mg Prednison and 15 mg of Methotrexate once a week.
Now my Dr. wants to give me Rituxan, since although I am feeling pretty good when he did a Lab CREATININE was 0.77, and BUB/CREAT RATIO was 45.4. CRP 1.0.
ANA POSITIVE HOM 1:320. NEGATIVE 1:40
CCP 46 U/ml.
SEROLOGY: DNA 11 EU/mL, RNP 10 EU/mL, SM 7 EU/mL RF 160.0 IU/ml.
I trust my Dr. but I am concerned about the side effects of this drug, specifically PML.
since it could affect the vision part since I only have vision in one eye.
The lost of my right eye is a mystery. I had 3MRI's of the eye and a Cerebral Angiogram but that did not really show the reason of the lost of the eyesight. But I don't want to loose the sight in the other eye.
How long has this medicine used for RA and do they have any % of people who has developed PML.
I would appreciate any comments of the subjet by a Dr if possible.
Thanks
Dot
16 Apr 2009, 13:39
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Phyllis,
I had a condition called "Tietze Syndrome", sometimes referred to as "Costalchondritis" some years ago where the cartilage around my ribs and breastbone would become inflamed and very tender. The pain was excruciating, especially if I pressed on the juncture of the ribs to the breastbone. It was considered to be a "benign" condition (I guess like fibromyalgia is considered to be a benign condition), although it was very debilitating at times.
I don't believe my doctors never bought into the idea, but I definitely noticed a relationship with changing barometric pressures and episodes of flares. After moving to another state where the barometric pressures didn't fluctuate so violently, the episodes diminished and eventually disappeared.
You may want to do some research on both conditions to see if either may be causing your chest problems. Good luck!
Ann
31 Mar 2009, 09:37
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I am under treatment with Plaquinel & methotrexate. It works fine but every so often I sense a "flare" trying to breaking through with some increase in pain and swelling just in a few joints.(Otherwise I feel fine) It's not a full flare, just some joint swelling that eventually goes down and I feel fine again for months. Can a temporary "pulse" therapy of low dose prednisone, for example, be used to bridge the gap and then be tapered off when the "flare" goes away (as it usually does)with minimum side effects? Is there any high % prednisone creme that can be applied to the joint that would help as a spot treatment on that particular joint? Can you do the same with a Remicade infusion (as a temporary "pulse" therapy) or once you get on Remicade do you have to stay on it as a permanent, long term therapy?
Phyllis
30 Mar 2009, 10:48
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Hi ,
Can you tell me how common is athritis in your chest.I keep tryin to find info on this area and can't find anything.can you help?
I was told I do not have any heart problems that is it arthritis.
Thank you

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