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