6 Ways to Soothe a Rheumatoid Arthritis Flare

Living withrheumatoid arthritis (RA)often means balancing periods when symptoms are well controlled with periods of flares — when symptoms ramp up suddenly and severely. A flare can turn your daily routine upside down, making small tasks, even getting out of bed, seem impossible.

Though their severity and length can vary greatly from person to person,RAflares generally involve joint pain, swelling, and stiffness, along withoverall fatigue. “These symptoms can make activities of daily living quite difficult — getting dressed, preparing food, doing chores around the house, using your hands to grasp objects, and shopping,” saysHoward Smith, MD, arheumatologistat the Cleveland Clinic in Ohio.

Flares may be brought on by external factors such as stress, infection, or simply not getting enough sleep, according to Dr. Smith. It’s also thought that there may be an internal cause, but the process by which it happens isn’t well understood, he adds.RA symptomstend to “wax and wane,” Smith explains. “At times, the immune system becomes overactive and that leads to increasing joint pain and swelling.”

The joints you use the most frequently are typically the ones most often affected during a flare, saysDavid Lee, MD, a rheumatologist at Kaiser Permanente Riverside Medical Center in Riverside, California. These include the joints in your hands and wrists; weight-bearing joints such as your knees, ankles, and feet; and your neck. Smith adds that a flare may affect more joints on your dominant side.

Here are some steps you can take to soothe an RA flare:

1. Follow your treatment plan.Work with your rheumatologist on an action plan that you can initiate in the event of a flare, Smith recommends, and follow it to a T when a flare kicks in. Everyone experiences RA and flares differently, somanagement strategies differtoo, says Michelle J. Ormseth, MD, a rheumatologist at Vanderbilt University Medical Center in Nashville. In most cases, a regimen ofnonsteroidal anti-inflammatory drugs (NSAIDs)and acorticosteroidcan bring minor flares under control. More severe flares may call for an immunosuppressant drug or, if you’re already on one, a change in that drug, and a corticosteroid to help tame inflammation and other symptoms.

2. Try hot and cold packs.A heating pad or an ice pack can increase your pain threshold wherever you apply it, thus helping to decrease the sensation of pain, Dr. Ormseth says. Dr. Lee recommends cold therapy if joints are swollen because heat can worsen swelling. Apply a cold pack, like a bag of frozen vegetables, to swollen joints two to four times a day for 15 minutes each time. You can use heat if joints are painful but not swollen during your flare. Try a heating pad, warm compress, heat patch, or warm bath for the affected joints two or three times a day for 15 minutes at a time. Just make sure you don’t overdo either treatment, hot or cold.

3. Soothe your body and mind.Give yourself some extra TLC to help your body recover from a flare. Though it’s not always easy, try to relax, Ormseth says. Practice relaxation techniques to help your mind and body calm down and recover. Engage in deep breathing, meditation, and visualization. Try a little pampering — soaking in a warm bath, listening to soothing music, enjoying quiet time, or sipping on a steaming mug of tea — the Arthritis Foundation suggests. Also, adds Smith, do your best to avoid physically and emotionally stressful situations.

4. Call for backup.The world doesn’t stop when your RA flares, and neither do your responsibilities. When RA knocks you down, put a second action plan in place to address life’s other essentials — work, family, and household chores.

Designate responsibilities to each member of your household so that they know how and when to help when a flare strikes. Delay or reschedule anything that’s not urgent. The Arthritis Foundation recommends that you reach out to your place of worship or a volunteer group in your neighborhood that can pitch in when you need help.

5. Balance rest with activity.Rest is important. However, sticking with your regularexercise program, or a modified version of it, may actually help you feel better, according to the Arthritis Foundation. Try alternating rest with light activity, which could even be something as simple as slowly raising and lowering your legs while seated. But don’t overdo it, and if it hurts, stop. Talk to your doctor or physical therapist about the type of exercises that are easiest on your joints, and whether practicing gentle stretching in the morning might help relieve stiffness.

6. Prioritize your response.It’s important to take action against an RA flare, but there’s no exact order in which you should tackle these steps, Ormseth says. If possible, try to do all of them together to bring symptoms under control quickly. “Since it’s an immune-mediated attack on the joints, particularly for a severe flare,” Ormseth explains, “it isn’t good for people to just wait it out with rest, because the joints may get damaged.”

Work with your rheumatologist to manage flares appropriately and to control your RA — don’t just deal with your symptoms. “It’s very important,” Ormseth adds, “to treat the disease itself and not just mask the pain with pain medications.”

It’s crucial to tame your flare as quickly as possible, adds Smith, because “the longer the flare goes on, the harder it may be to get it under control.”