Why Are My RA Symptoms Getting Worse?

When you're living with rheumatoid arthritis (RA), your symptoms can be a rollercoaster ride. One day, you're feeling pretty good, but the next morning pain and stiffness can flare up without a whole lot of advance notice.

To learn why it's happening, it's time for a little detective work. If you can figure out what's making your symptoms worse, you may be able to avoid problems down the road.

RA is unpredictable. It can be better or worse for reasons you can't control. But you may also find that some activities, foods, or situations may trigger your symptoms.

Stress

When you're stressed out, it's not just in your head. Your body starts churning out higher levels of stress hormones, too, which may trigger RA symptoms.

There's no way to avoid stress completely, of course. But you can help prevent it if you plan ahead and take better care of yourself when you know you have stressful events coming up, like work deadlines. Try relaxation techniques, like meditation and deep breathing.

You Don't Get Enough Sleep

When you sleep, your muscles repair themselves and your brain makes chemicals that help ease pain. So if you're not getting your ZZZs, that's a problem.

It can be a vicious circle: you can't sleep well because of RA pain, and the pain gets worse because you can't sleep. If you're having trouble getting some shut-eye, ask your doctor about ways to break the pattern.

Certain Foods

We don't have clear evidence that diet has any effect on RA. But some people with RA say they feel better when they cut out certain foods, such as:

  • Beef, pork, or bacon
  • Wheat or rye
  • Milk
  • Coffee
  • Processed or fast foods

If you want to adjust your diet, that's probably fine. Just don't make big changes -- like cutting out a lot of foods at once or entire food groups -- unless your doctor thinks it's a good idea.

You Overdo It

You clean the garage, push yourself too hard at the gym, or help your daughter move into her new apartment. All that stress on your joints can leave you aching the next day.

You can avoid this trigger if you pace yourself and take breaks. If you need to do physical work, protect your joints. Carry heavy objects with two hands, and always bend from the knees when lifting.

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Infections

It's the last thing you need when you're already feeling sick, but the flu and other illnesses can bring on an RA flare.

For some kinds of infections, medication can help. But with flu, the best treatment is usually time and rest. To protect yourself, make sure you get a flu shot each year.

Having a Baby

A lot of women notice that their RA symptoms get better during pregnancy. For some, that lasts after birth. But for others, flares come back after the baby is born, which can make those early days with a newborn even harder.

Work with your doctor to control symptoms, and if you're breastfeeding, make sure your medications are safe for your baby.

Smoking

Lighting up is linked with a higher risk of developing RA in the first place, and it can also make the disease worse. If you smoke, ask your doctor about ways to quit.

Track Your Triggers

Over time, you may notice a connection between RA flares and certain activities, experiences, and moods. Keep a diary or use an online tool to note symptoms and possible triggers. When you look back, you may see connections you didn't notice at the time.

Flares Aren't Your Fault

While avoiding triggers is important, you also need to understand the limits of what you can do on your own to stop flares. Sometimes you can do everything right -- like taking your medicine regularly, avoiding triggers, eating healthy, and exercising -- and still get flares.

So when you have a flare, don't blame yourself or go crazy trying to track down triggers that may not exist. Instead, get some extra rest, take care of yourself, and check in with your doctor. You may need to increase or change your medication until the flare ends and you're feeling like yourself again.

WebMD Medical Reference Reviewed by David Zelman, MD on October 31, 2019

Sources

SOURCES:

Arthritis Foundation: "Understanding RA Flares," "Arthritis Flares Are Normal But Still Difficult," "Stress and Worry Affect RA," "Rheumatoid Arthritis and Sleep," "Rheumatoid Arthritis Self-Care," "Track+React."

Johns Hopkins Medicine: "RA Flares: What Triggers a Rheumatoid Arthritis Flare?" "Vaccinations for the Arthritis Patient."

Cedars-Sinai: "Lifestyle Modifications."

UW Medicine, Orthopaedics and Sports Medicine: "Stress and Arthritis."

UpToDate: "Patient Education: Complementary and Alternative Therapies for Rheumatoid Arthritis."

Mayo Clinic: "Rheumatoid arthritis: Can diet affect symptoms?" "Rheumatoid Arthritis: Does Pregnancy Affect Symptoms?"

FDA: "Snort. Sniffle. Sneeze. No Antibiotics, Please."

American College of Rheumatology: "Pregnancy and Rheumatic Disease."

CDC: "Rheumatoid Arthritis."

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