12 RA Triggers to Know

Medically Reviewed by Sabrina Felson, MD on March 29, 2022

Part of successful rheumatoid arthritis (RA) management is understanding what triggers your flares. Flare-ups are the times when inflammation levels are high and your symptoms feel worse than usual.

Not all flare-ups are caused by triggers. And triggers vary a lot from person to person. But over time, you may notice a pattern. For example, your RA may act up when you have a cold or are stressed out at work.

Your best chance of reversing a flare is catching and treating it early. Listen to your body, communicate with your doctor, and look out for these top RA triggers.

Environmental Triggers

Weather. Maybe your joints act up every time it rains. Research hasn't quite figured out why. Some studies say it's because of changes in air pressure. Humidity and temperature may play a part as well. You can’t control the weather, so control what you can: Listen to your body, take your medications consistently, and work with your doctor to control your pain.

Smoking. Not only is smoking bad for your overall health, but it also activates molecules in your body that trigger RA. Smoking makes pain and stiffness worse and some medications less effective. If you smoke and have a gene variation called the human leukocyte antigen (HLA), your RA symptoms — including bone destruction — will likely be more serious. If you smoke, talk to your doctor about healthy ways to quit.

Pollution. Air pollution is a mix of carbon monoxide, ozone, lead, sulfur dioxide, nitrates, secondhand smoke, and other toxic elements. Research shows that if you live near a highway, air pollution could cause inflammation and trigger your RA. Check your local newspaper, TV, or use a smartphone app for daily information about air quality. When possible, avoid spending time outside when pollution levels are high.

Pesticides. Pesticides are used to kill everything from weeds and insects to rodents, but they might affect you, too. They get in the air and soil, which makes them part of our water and food. Though one study found a link between farming, pesticides and RA, we need more research to understand how it affects people outside the agricultural industry. Consider non-chemical methods of pest control and organic produce.

Physical Triggers

Stress. When you feel stress, your body releases chemicals that can create inflammation in your body. That’s fine every once in a while. But long-term stress can make many conditions worse, including RA. Flare ups themselves can be stressful, too. To offset stress, consider gentle exercise, meditation, breathing techniques, and talking to a therapist.

Infection or illness. Your immune system is there to protect you from disease. But when you have RA, your immune system attacks healthy cells instead. When you get an infection or have an illness, your immune system works to fight it off, but it may trigger inflammation, too. To reduce your risk of infection or illness, wash your hands often, keep up with vaccinations, stay away from sick people, and avoid touching your face.

Medication issues. Changes to your medication, like switching from one drug to another, may trigger an RA flare-up as well. Stick to your schedule and talk to your doctor before stopping or changing treatments.

Sleep trouble. It may be hard to sleep when you have joint pain or stiffness, but it’s important to get enough rest. Experts recommend 7-9 hours. Sleep gives your body time to heal. Lack of sleep wears you down and can be so stressful it causes a flare. It also makes it harder to manage your pain, which can lead to depression. Create a sleep environment that works for you and stick to a sleep schedule as much as possible.

Overexertion. Exercise doesn’t trigger inflammation by itself. But if you do too much, too soon, it can make your joints painful or stiff. It can also stress your body and cause inflammation elsewhere. Start slowly, work your way up, and modify if need be.

Poor dental health. Sounds crazy but it’s true: Medical professionals have traced the connection between RA and gum diseases since the early 1900s. Though the two seem unrelated, they look the same on a cellular level. As with the rest of your body, an infection in your mouth can trigger RA. Keep up with your dental visits and resolve any infections or conditions.

Hormones. For women, hormonal changes during the month, like lower levels of estrogen, can send signals to your immune system that cause a flare. Hormone-related symptoms, like cramping and pain, may also intensify your joint pain during this time.

Long stationary periods. It’s a vicious cycle: When you’re dealing with joint pain and stiffness, you may not want to be active. But lack of movement decreases your joint motion and makes your muscles weaker. Work with a physical therapist to stay active in the best way for your body.

Can Certain Foods Trigger RA?

Research hasn’t identified any specific foods that can trigger flares in people with RA. But following a diet rich in antioxidants may lower levels of inflammation in your body in general. That means choosing foods like nuts, leafy greens, fruits, and fatty fish.

Some other foods, drinks, and ingredients are thought to change your gut bacteria and possibly promote inflammation. They include:

  • Meat cooked at very high heat (such as by grilling, broiling, or frying)
  • Fried foods
  • Foods containing saturated or trans fats
  • Sugar-filled foods and drinks like sodas, cookies, and cakes, as well as sneakier sources like cereals and sweetened plant milks
  • Red and processed meats like hot dogs and sausage
  • Dairy foods like cheese and ice cream, if you’re sensitive to them
  • Alcohol
  • MSG, or monosodium glutamate
  • Gluten, if you have gluten sensitivity or celiac disease

Show Sources


Arthritis Foundation: “What Triggers an RA Flare?” “Five Reasons Smoking Makes Arthritis Worse,” “How Stress Affects Arthritis,” “Rheumatoid Arthritis and Sleep,” “High Intensity Arthritis and Rheumatoid Arthritis,” “Can Hormones Cause Arthritis Flares?”

Hospital for Special Surgery: “HSS Scientist Wins Grant to Uncover Link Between Smoking and RA.”

Mayo Clinic News Network: “Causes or [sic] Rheumatoid Arthritis a Combination of Genetic and Environmental Factors.”

University of Michigan Health Lab: “How Environmental Pollutants and Genetics Work Together in Rheumatoid Arthritis.”

United States Environmental Protection Agency: “Air Pollution in Autoimmune Rheumatic Diseases: A Review.”

Rheumatology: “Association Between Environmental Air Pollution and Rheumatoid Arthritis Flares.”

American Lung Association: “10 Tips to Protect Yourself from Unhealthy Air.”

Arthritis Care & Research: “Insecticide Use and Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus in the Women’s Health Initiative Observational Study.”

Cleveland Clinic: “17 Simple Ways to Prevent Air Pollution in Your Home,” “Rheumatoid Arthritis.”

Centers for Disease Control and Prevention: “Rheumatoid Arthritis.”

Mayo Clinic: “Germs: Understand and Protect Against Bacteria, Viruses and Infection,” “Methotrexate,” “Sleep Tips: Six Steps to Better Sleep,” “Trans Fat Is Double Trouble for Heart Health.”

Johns Hopkins Arthritis Center: “Will Exercise Cause Damage to My Joints or Cause a Flare?”

Johns Hopkins Rheumatology: “Gum Disease Linked to Rheumatoid Arthritis.”

Harvard Health Publishing: “Can Weather Really Worsen Arthritis Pain?” “Foods That Fight Inflammation.”

Rheumatoid Arthritis Support Network: “RA Inflammatory Foods: What Foods Cause Flare Ups?”

University of Chicago Medicine: “What Foods Cause or Reduce Inflammation?”

Hackensack Meridian Health: “Foods You Should Avoid with Rheumatoid Arthritis.”

Rheumatology and Allergy Institute of Connecticut, LLC: “8 Inflammation-Causing Foods to Avoid When You Have Rheumatoid Arthritis.”

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