Psoriatic arthritis (PsA) flares are often unpredictable. However, knowing the signs a flare may be coming, such as exposure to a trigger, worsening skin, and more, can help a person take action to nip it in the bud.
PsA is a type of inflammatory arthritis associated with joint pain and stiffness. It is a chronic condition that often goes through periods of flares and remissions.
A “flare” or “flare-up” is a term used to describe when PsA symptoms worsen for a time. Remission means that the symptoms decrease or go away entirely for a time. Many treatments help focus on gaining and maintaining periods of remission. However, for some, flares can still occur even with proper treatment.
PsA flares can be unpredictable, but in some cases, a person may suspect that a flare is coming on. This can prompt them to take steps toward reducing the severity of the flare.
This article reviews some potential signs of a PsA flare that a person may experience and possible steps that may help lessen their severity.
Understanding what may happen leading up to a flare can help a person pinpoint when the next one is coming.
Exposure to a known trigger
Experts say many triggers play a role in setting off a PsA flare. Experts generally recommend taking steps to learn and avoid potential triggers in an effort to prevent flares.
Keeping a PsA diary can help. A person may want to consider recording their daily activities, including what they eat, and noting how they feel. It is important for them to take note of any new or worsening symptoms. This can help a person determine possible PsA triggers to avoid.
Common PsA triggers include:
- skipping a dose of medication
- eating certain foods
- lacking physical activity
- increasing stress levels
- losing sleep
- experiencing illness or infection
- getting injured, including getting minor injuries
If a person experiences exposure to a known trigger, this could be an early sign that a PsA flare may be coming.
For example, a person may suspect they will have a flare-up if they feel stressed about an upcoming event, such as a job interview or public speaking commitment. If they know they will be stressed, taking steps to get ahead of it may help reduce the likelihood of a flare.
Psoriasis is a skin condition with itchy, scaly skin patches or lesions. It strongly links to PsA. While it is possible to have PsA and not psoriasis, most people experience skin involvement 5 to 10 years before the onset of joint symptoms.
When psoriasis symptoms get worse, it could indicate a PsA flare is about to occur. Worsening psoriasis symptoms may include:
- expanding area of involvement
- worsening lesions
- increasing skin flares
- reappearing lesions in areas that had since become clear
Changing, new, or worsening new symptoms
Symptom changes or developing new ones could indicate a PsA flare. New symptoms can indicate worsening disease, leading to increased flares and worsening PsA symptoms in general.
Some signs PsA is worsening and may trigger a flare include:
- eye changes, such as pain and inflammation
- changes to the nails, such as pitting
- swollen or puffy fingers
- a sensation of burning aches in the elbow or heel
- increased fatigue and difficulty with daily activities
It is advisable for a person to talk with a doctor if they notice worsening or new symptoms. This can be a sign of disease progression, which may warrant a treatment change. A doctor may perform lab tests to look for an increase in inflammatory markers, which may indicate an increase in disease activity.
Understanding the signs a flare is coming can help a person take steps to manage it proactively. Being proactive may help reduce the severity of symptoms and possibly shorten the flare’s duration.
Being proactive toward PsA flares includes:
- recording daily activities and any associated symptoms
- avoiding known triggers
- taking steps to manage stress, such as deep breathing or meditation
- maintaining good quality sleep
- following treatment schedules for medications
- keeping regular appointments with doctors and discussing any changes to symptoms
Maintain a healthy lifestyle
Flare prevention and management also include eating a balanced diet and getting regular exercise. These strategies can help reduce stress, manage weight, and improve sleep quality, all of which can act as PsA triggers when a person may need to improve managing these strategies.
Try home remedies
During a flare, a person can also tailor their treatment to what occurs. A person may find home remedies helpful during a flare. These can include:
- applying topical creams and ointments for pain and swelling
- taking over-the-counter pain medications
- using a heating pad to soothe affected joints
- applying ice to help with swelling
- increasing sun exposure to clear up skin lesions and prevent related joint symptoms
In some cases, a person may need additional help from a doctor to manage the flare. A doctor can:
- adjust medications either with higher doses or new medications
- recommend new medications
- prescribe more powerful topical medications
Before trying a new medication or treatment, it is a good idea for a person to make sure that each care team member provides input, since some medications used to treat PsA may worsen psoriasis symptoms.
It may not always be possible for a person to predict a flare, particularly after the initial diagnosis. However, several factors can help a person suspect when a PsA flare may be coming on.
Common signs of a flare coming can include additional stress, worsening or new symptoms, worsening skin conditions, injury, and exposure to other triggers. However, PsA affects everyone differently, so no one sign will be the same for everyone.
In some cases, a person can manage a flare with home remedies and by following their current treatment plans. In others, a person may need to work with a doctor to make changes to their PsA treatment to help ease a flare.