What is a flare up?

gemz10

Hi

Have heard this term a lot and guessing it is when symptoms get worse?

I have just been diagnosed with RA and havibng trouble with my foot at the moment, it's very hot and feels twice the size of the other (this can be quite common, but had settled down a bit).

The problem is I dont know when I should rest and when to keep active. Im very stressed and tired at the moment (maybe stress, lack of sleep, methotrexate or all three), and although i have had days when im like a little old lady (im only 29) or when i cant lift my feet to walk, at the moment i can walk but limping a bit and in pain also have painfull knee and ankle.

Am sorry to read some of u guys are suffering so much but just wondering if anyone has any advice. My doc once said use it or loose it (before i was diagnosed) but then i dont want to carry on if it makes it worse.

Gemz

skezier

Hi Gemz,

I really hope someone will help you with this and also that it backs off. I don't know what a flare actually is either. I got pa and its not been under control from day one. I sometimes feel better than at other times but its always swollen hot and red but its hard to believe you could have a flare for so long.

I wondering what meds have they got you on and hen do you see the rumo again? if its not soon it might be worth trying to get a quicker appointment cus it does sound like you could do with some help there.

I really hope it eases back for you soon and ncie to meet you and will see if someone says what is a flare. Cris x

tjt6768

Hi Gemz, sorry to hear about your problems.. I am 42 and have had OsteoA for a number of years in my spine and knees, more recently been diagnosed with sero-negativeA in my wrists..
I had not really heard much about 'flares' till about August this year, I am always in pain but can move about pretty much ok unless my back goes, but this night I was just getting into bed, no sudden movements or anything like that and my knee just started throbbing and got worse through the night, by morning I could not bend, move or weight bear.. Went to the hospital and they said it was a flare up of my arthritis..
I have only been on this site a few days and have learnt more from the folks on here than the hospitals and GP's.

I hope that they have your pain under control soon, keep us up to date..

Tony

cythna

Hi, Sorry to hear you're not feeling too good.

Re "Flares". With RA you often jog along at a certain level for most of the time. You can have pain, but it's often pain caused by damaged joints, and the drugs keep the disease under control. However, due to various circumstances, illness, reaction to drugs, or indeed for no reason at all, the disease "Flares", which is a whole other thing. You might feel ill, and the joints become hot and commonly swollen. The pain can be intense, and it's at this time the joint damage happens. You can get a flare in one joint or many.

My doctor's advice is not to use an inflamed joint too much. Passive movements to keep it mobile are a good idea, but don't push it. And never take pain relief to allow yourself to exercise, as you could do damage and make things worse. RA is a variable disease, not everyone gets it badly, and the drugs that are available now really can make a difference. Have you seen a rheumatologist? If not you really need to push to see one, they are the experts, not your GP!

Hope you feel better soon.

Susan

livinglegend

I have had RA for many years and have struggled to cope in the past. Having an understanding of the disease and how it affects you and why, may help you cope better. No-one knows what causes RA or why and there is no cure. MTX helps me to cope so I stick to it and take the pills as prescribed.

An RA flare up is when one or more of your joints gets hot and red, (hence the term, flare up), and you feel very ill and exhausted.

It is caused by the white cells in the affected joint attacking other white cells inside the joint itself. Think of it as similar to a big bee sting, where the affected part swells up and is very painful and red.

After about 24 hours it all suddenly goes away, but by then the damage is done as the internal swelling forces the joint apart and stretches the muscles that support the joint weakening them. So you should rest the joint while the flare up is happening and then a sensible level of gentle exercise to tighten up the muscles afterwards.

Because your white cells are being over produced and flowing to the joint to kill each other, your body's main defences are triggered. This is why you feel so exhausted and tired, your body is saying that you are very ill and need to rest and recover. So you are not only in pain, but feeling very ill as well when you have an RA flare up.

It is different when you are diagnosed with osteoarthritis where the joint is worn, then exercise has been found to be beneficial for most sufferers. This is often confused as a treatment for RA but the causes and treatment are totally different.

So, for RA, rest and support the joint, expect to feel really ill until the flare up passes and you feel more able to cope. When you feel better be careful not to overdo things.

Expect regular flare ups and don't be surprised if it happens at the most inconvenient time. I often say to people that RA is a part of who I am, you get me and my RA comes too. As it fluctuates, then make the most of the good days and rest during the bad.

Joseph 8)

dreamdaisy

I have PA (psoriatic arthritis) which is like RA but with the added extra of psoriasis. I am on humira, methotrexate, sulphasalazine, naproxen and oral steroids to 'treat' it. Despite this chemical onslaught I still flare, frequently, and sometimes for weeks at a time.

My affected joints become inflamed and now only warm (they used to be red-hot but the humira has calmed that aspect). I feel extraordinarily tired, have greater problems with moving, and the pain increases in its intensity. I also feel 'ill' but I cannot define how.

The 'use it or lose it' approach is advice best ignored in the case of RA. If you try to push yourself thro a flare you will only cause greater damage to the joints. I suspect your GP may be thinking more of OA, where gentle exercise is recommended to keep the joints mobile. That form of arthritis has a different systemic cause to the others, which are related to over-active immune systems. Everyone has their own version of arthritis, what works for you may not work for another. You need to learn to 'listen' to your body, which is an art in itself. If it is telling you it is tired, then rest.

Methotrexate can be an effective treatment for RA, what dose are you on, how long have you been taking it and are you also taking folic acid? I guess you have seen a rheumatologist as they are usually the ones to prescribe meth - when are you seeing him again? There are other meds that could help, perhaps an anti-inflammatory. I wish you well. DD

gemz10

Hi guys

Thank you all for your advice and information, so nice to 'meet' u all. I agree this site offers so much good info suppose doc's only have limited time and many question only arise once u are at home. x

I have been to see rumo 3wks ago, which was my 2nd app where they confirmed RA, I go back in 2months. Have been taking methotrexacte for 3wks 7.5, 10, 15mg and start 20mg next wk. Also had a steroid injection which doesnt seem to be working yet. I used to take diclofenac (cant spell it) to help with inflamation but cant mix that with the Mxt.
My fingers are swollen too, mainly just the left hand but the middle joint of index finger is always swollen and red but rumo said x-rays show no joint damage
...............

gemz10

......sorry to go on but u guys really have helped. Next time i wont feel guilty if i have to phone in sick and wont be bullied in to goingin when i dont feel up to it (this is what happened mon morn)
Before reading this i thought maybe i should just get on with it. Anyway this is more working with RA not living with it so buy for now.

I hope to be able to return the favour and help u guys in the future

xx