Self-Care During RA Flares

You were feeling pretty good last week, but now your rheumatoid arthritis (RA) has flared. You're exhausted, and your joints are swollen, tender, and sore.

A flare can be brought on by doing too much -- for instance, working in the yard or having an extra-hard session at the gym -- or by getting an infection like the flu. Maybe you haven't been taking your medicine as prescribed and that sparked your increased symptoms. Or maybe you did nothing out of the ordinary. RA can be like that. You can have a flare for no apparent reason.

But no matter why it happened, there are things you can do to feel better.

Balance Rest and Activity

At the height of your flare, you may need complete bed rest. Your body may not give you any choice. But try not to stay in bed for more than a day or two. Spending too much time lying on the bed or sofa will make you stiff and increase your pain.

Once you start to feel a bit better, get up, stretch, go for a walk, and continue with as many of your usual activities as possible. You may need to cut back on your work, exercise, and social activities, but don't abandon them. Take breaks when you get tired.

Adjust and Ask for Help

Tell your family and friends that you're having a flare. Let them know you'll need help with some chores you ordinarily handle.

Adjust expectations of yourself. Rather than cook dinner for friends, invite them over for take-out pizza. Getting together is the point, not the food.

If possible, make a flare plan ahead of time with your supervisors and coworkers. Arrange to work fewer hours or from home, or take a few days off if you need to.

Try Cold and Heat

Cold is usually best for the acute pain and swelling of a flare. Use ice packs or even bags of frozen vegetables wrapped in a towel -- 15 minutes on, 15 minutes off.

Heat can soothe aches and stiffness by increasing blood flow and relaxing tight muscles. Try heating pads, warm baths, or hot compresses.

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Relieve Stress

Stress and anxiety can make your symptoms worse. Deep breathing exercises, guided imagery, yoga, tai chi, hypnosis, visualization, or muscle relaxation can help control your pain.

You can also relieve stress by talking with a friend, taking part in a support group, writing in a journal, or engaging in a relaxing hobby. A massage or acupuncture can help ease pain and stress.

Eat Well

During a flare, you may lose your appetite. And you may not have the energy to prepare meals. But it's important to eat a balanced, nutritious diet even -- and especially -- when you feel poorly. Your body needs fuel to heal.

Eat plenty of fruits, vegetables, lean meats, and whole grains. Cold-water fish (like salmon) are rich in omega-3 fatty acids, which have been shown to fight inflammation. It may help if you eat small amounts several times a day rather than big meals.

Stay away from alcohol, tobacco, or processed foods and sweets. They'll make you feel worse.

Support Your Joints

Use your strongest muscles and larger joints when possible. For example, lean into a door to open it and hook your grocery bag over your forearm instead of holding it in your fingers. Braces, wraps, or splints can support weak, sore joints. Wear flat, supportive shoes.

Use Over-the-Counter Pain Medications

Over-the-counter medications, such as acetaminophen, ibuprofen, or naproxen sodium, can help ease pain caused by a flare. But be sure to ask your doctor before taking these.

Your prescription medicines may have variations of the same ingredients as these drugs, so taking more could be dangerous. Topical pain relievers that contain salicylates, capsaicin, or counterirritants like menthol or camphor are also options.

When to Call the Doctor

If your flare was caused by overexertion or from having a cold, it's probably okay to wait to call the doctor. Practice self-care tips and give yourself a couple of days to feel better. Call your doctor if things don't improve in a few days.

If your flare came on because you skipped your medicine, call your doctor. The two of you will need to come up with a plan for getting you back on track.

If you don't know what spurred your flare, call your doctor. Medication that has worked before can sometimes stop working. Your doctor may want to adjust the kinds or the amounts of medicine you take.

WebMD Medical Reference Reviewed by David Zelman, MD on November 04, 2018

Sources

SOURCES:

Arthritis Foundation: "16 Joint-protection Tips," "25 Treatments for Hip and Knee Arthritis Pain," "Arthritis Flares Are Normal but Still Difficult," "Coping With an Arthritis Flare," "Rheumatoid Arthritis Self-Care," "The Ultimate Arthritis Diet," "Understanding RA Flares," "Why Your RA Went Into Remission, but Relapsed."

Cedars-Sinai: "Diet for Rheumatic Disease," "Lifestyle Modifications," "Rheumatoid Arthritis."

Mayo Clinic: "Arthritis Pain: Treatments Absorbed Through Your Skin," "Is There a Connection Between Rheumatoid Arthritis Flare-ups and Stress?" "Rheumatoid Arthritis: Treatment."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Handout on Health: Rheumatoid Arthritis."

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