When a person with rheumatoid arthritis has a flare-up, their symptoms worsen for a time. Medication and home remedies can help manage symptoms during a flare.

Typical symptoms of rheumatoid arthritis (RA) include:

  • joint pain and swelling
  • stiffness
  • fatigue

Symptoms can vary in intensity, worsening during a flare and improving or disappearing during times of remission.

A flare can last from a few hours to several weeks or longer. How it affects an individual will also vary.

For some people, medications can help prevent flares and stop symptoms from becoming severe. Medical treatment and home remedies can also help manage symptoms during a flare.

In this article, we discuss how people can reduce and manage RA flares.

Share on Pinterest
Anupong Thongchan/EyeEm/Getty Images

An RA flare can have a significant impact on a person’s mental and physical well-being and their overall quality of life. The following approaches and tips may help manage some of the problems that can arise:

Various home remedies can help manage a flare. Here are some tips to follow at home:

1. Know the early signs

Knowing how to spot the early signs of a flare may help prevent a flare from becoming severe.

It is not always clear what causes a flare, but there may be some common triggers.

Keeping a journal may help identify common patterns. This can help a person take action to reduce or manage a flare’s impact by, for example, making time for extra rest.

What are the early signs of RA?

2. Rest

Once a flare starts, many people will need to reduce their activity levels. They may need to rest completely for some time.

Having strategies in place before a flare begins may be helpful. This may include:

  • Arranging to work from home, if a person’s job allows for this.
  • Letting caregivers or family members know when the early signs of a flare begin, so they can be ready to help.
  • Checking that food and medical supplies are sufficient to last until symptoms improve or help can be arranged.

RA can cause brain fog, making it hard to think or focus. Learn more here.

3. Gentle exercise

The idea of exercise can be daunting during an RA flare. However, gentle exercise may help prevent stiffness.

For example, a person can do simple stretching and range-of-motion exercises while seated to maintain mobility in the hands and feet.

Water exercise and walking are suitable activities for many people with RA. However, they may not be possible during a flare. A healthcare professional can help an individual make a suitable activity plan.

4. Hot or cold packs

Hot or cold packs can help reduce joint pain and swelling. People can start using these packs as soon as symptoms appear and continue to use them throughout the flare.

It is essential to avoid placing hot or cold substances directly on the skin. Instead, wrap the pack in a towel before applying it to the affected area.

5. Dietary choices

Following an anti-inflammatory diet may help prevent flares and improve symptoms when they occur.

Tips include:

  • limiting the intake of processed foods, refined sugars, and added fats
  • consuming a variety of fruits and vegetables
  • having an adequate fiber intake
  • limiting alcohol intake

Foods that may benefit people with RA include:

  • foods rich in omega-3 fatty acids, such as flaxseed, chia seeds, walnuts, salmon, and tuna
  • foods rich in antioxidants, including colorful vegetables and fruits
  • whole grains, which provide fiber and other nutrients
  • plant-based oils, such as olive oil
  • nuts and seeds
  • spices, such as ginger, cinnamon, and turmeric

6. Dietary supplements

According to the Arthritis Foundation, certain herbal supplements can help relieve the symptoms of a flare. These include:

  • curcumin, an ingredient in turmeric
  • ginger
  • fish oil or omega-3 with EPA and DHA
  • capsaicin, available in creams and gels for applying to the skin
  • gamma linolenic acid (GLA), an omega-6 fatty acid with anti-inflammatory properties
  • Cat’s claw (Uncaria tomentosa), which has anti-inflammatory properties

Specific vitamin and mineral supplements may also be helpful, including:

It is worth noting that the Food and Drug Administration (FDA) does not monitor the quality of vitamins and other dietary supplements or guarantee their safety and effectiveness.

Often, there is not enough evidence to prove that these products are safe and beneficial for a specific purpose. People should always check that their product comes from a reputable source.

Anyone considering a supplement should check with a doctor that the product is suitable, especially if they are taking other medications.

7. Mental well-being

In a 2017 study, over 86% of people with RA said that stress and psychological factors could trigger a flare.

Reducing stress levels, where possible, may help manage or prevent a flare. Some ways of doing this include:

People with RA may have a higher risk of depression and anxiety. Anyone who has concerns about depression should seek medical advice.

Counseling may help relieve or manage stress, anxiety, and depression. Some research now suggests that treating depression may also help reduce the impact of RA.

Find out more about how natural and home remedies can help manage RA.

Doctors can prescribe various types of medication for RA. Some help prevent flares and maintain remission. Others manage symptoms when they occur.

Medicare may cover some forms of treatment for RA. Here, find out more about the type of coverage that may be available.

Treating symptoms

Drugs for relieving inflammation and pain include:

Immunosuppressant drugs

These slow the progression of RA and prevent joint damage by halting the body’s inflammatory response. They are also known as disease-modifying antirheumatic drugs (DMARDs).

Methotrexate is the preferred choice, either alone or alongside other drugs.

Here, learn more about using methotrexate for RA.

Biologic drugs

These drugs are a newer generation of DMARDs, which mimic human immune molecules. They include TNF and non-TNF inhibitors.

Biologics target specific parts of the immune system to inhibit the inflammatory response.

How do biologics help with RA?

Everyone with RA will experience flares differently, but it is common for RA symptoms to come and go in waves.

The symptoms of a flare may include:

  • an increase in joint pain
  • fatigue
  • swelling
  • stiffness
  • tender joints
  • inflammation
  • low mood
  • a general feeling of being unwell
  • night sweats or fever
  • weight loss

The symptoms of RA can be frustrating and bewildering. They can affect a person’s sleep quality and ability to perform everyday activities.

Here, learn more about how RA affects the body.

The length of time an RA flare lasts can vary widely, from a few hours to several days or weeks. If a flare does not improve after 7 days, it may be a good idea to contact a physician. The doctor may suggest adjusting the person’s medication.

Before a RA flare begins, a person may experience fatigue or feel that something is not quite right.

During a flare, symptoms tend to increase until they reach their peak. As the peak passes, the symptoms will lessen and may completely disappear.

The frequency and severity of flares can vary widely between individuals. With treatment, a person may spend months or years in remission, while others may experience flares more frequently.

RA flares can be predictable or unpredictable. A flare will occur when something triggers an increase in disease activity, which means that levels of inflammation go up.

Predictable flares usually occur in response to one or more triggers.

Some flares have no apparent trigger, and a person may be unable to identify why it started. This can make them harder to avoid.

In 2017, a survey involving 274 people with RA who attended a clinic in Turkey found the following appeared to worsen their symptoms:

  • emotional or physical stress
  • infection
  • physical trauma
  • fatigue
  • seasonal changes
  • some dietary choices, including red meat and ingredients in processed foods
  • smoking
  • spending a long time standing or without moving

People who have predictable flares may be able to take precautions to prevent them or reduce their severity.

How can COVID-19 affect a person with RA?

RA is a chronic disease that does not currently have a cure. Symptoms come and go, so that flares alternate with periods of remission.

Medications and lifestyle tips can help prevent flareups, and they may also help manage symptoms when they occur or worsen.

An individual can work with their doctor to create a management plan specific to their needs, symptoms, and situation.

Read the article in Spanish.