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Ask Me Anything: Answers To Your Questions on RA Flares and Fatigue

Ask Me Anything: Answers To Your Questions on RA Flares and Fatigue

We asked our Facebook community to participate in an Ask me Anything, where they could ask our team anything about RA. We received several questions that we have broken apart and placed into a 3 part series.

Quite a few questions were asked about flares and fatigue.

Rheumatoid arthritis flare ups

Is it common to have small flare ups when your medication is supposedly working?

Tamara Haag
Yes, it is indeed common to have small flares of symptoms even when the treatment plan is working fairly well the majority of the time. There are numerous reasons this can happen, such as getting close to your next injection/infusion, overexertion (I call these “activity hangovers”), not sleeping well, or for no particular reason you can put your (swollen) finger on.

Even with minor flares it’s a good idea to call your rheumatologist’s office, as it’s important for him/her to know how often they’re happening. There are tweaks that can be made to the treatment plan, such as temporarily adding a medication such as a steroid or NSAID while symptoms are flaring. Furthermore, if these small flares are happening more frequently, the rheumatologist may want to alter the treatment plan by adding another medication for longer periods of time or changing a medication.

Kelly Mack
Yes, it is common to have flares even when the medication is working. I hate to say it, but I’ve even had big flares at times and needed temporary measures, but eventually returned to my regular treatment regimen. It’s important to work with your rheumatologist to have a plan for when you experience a flare, or temporary worsening of symptoms.

For example, they may have you increase steroids or call if it lasts more than a couple days. If you do experience a flare, it is best to react to it as quickly as possible to hopefully nip it in the bud. You’ll develop a sense of what a regular day feels like versus a flare and then be able to describe the differences and consult with your doctor to address.

Rheumatoid arthritis and chronic fatigue

Should the chronic fatigue that goes with the disease make you lethargic and sleep a lot?

Tamara Haag
Unfortunately, fatigue is a symptom of rheumatoid arthritis and can indeed cause people who have the disease to feel very lethargic and to sleep more. When I experience fatigue, I often wake up feeling tired and then trudge through my day feeling very heavy and slow. Fatigue makes every action, including thinking clearly and quickly, more challenging. Fatigue can be debilitating to the person experiencing it, but may not be as evident to a doctor as other symptoms such as pain or inflammation.

Therefore, it is important to discuss the level of fatigue one is experiencing with a rheumatologist. The treatment plan should address fatigue as well as other RA symptoms, so in cases of prolonged fatigue, it may be necessary to alter the treatment plan. Additionally, there are other medical conditions that also cause fatigue, so it’s important for a doctor to be aware of the severity of fatigue in case there may be something else at play.

Kelly Mack
Sometimes, but unfortunately, there is no clear cut answer here. It’s important to develop a sense of what is normal fatigue for your experience with RA. When on treatment and feeling stabilized, what level of fatigue are you experiencing? If this should worsen significantly, then it is important to call your doctor to discuss. A big shift in fatigue could mean that something else is happening that needs to be addressed or that your medication may not be working as it should. Some days the fatigue should be worse than others, but big changes may be a warning sign. Life with RA may also involve just needing more rest and if you are not getting enough sleep at night, this may make you more lethargic during the day.


  • LoriC
    2 years ago

    I was wondering about the fatigue, I knew there was some associated with the disease and some associated with some of the medicines I have to take, but some days I just don’t want to get out of bed. Do you have any suggestions to beat the fatigue? I try to eat right, exercise, take my medicines on time but on most days I end up taking a 2 hour nap. I feel like my days are wasting away and I’m sleeping my life away

  • sadie
    2 years ago

    I so hear you! If I’m not working, I’m sleeping. On the weekends I sleep in late and still end up taking a nap! I think the meds cause a lot of it. I just switched to Zeljanz and the crushing fatigue has lessened. Actemra and Humera made me fall asleep at work! The Rheumatologists don’t care enough to help you so advocate for yourself and try a different med until you get it right. There is hope and you don’t have to sleep your life away. All the best.

  • Lauren Tucker moderator
    2 years ago

    LoriC- So sorry to hear about your fatigue, while yes, it is a common symptom assosciated with RA, you are not alone in your fatigue. While others may chime in I thought this Q&A and and more speicifically, the answers may be helpful: Please come back and ask us anything anytime. We are glad to have you here!
    Best, Lauren ( Team)

  • gratefulgoddess
    2 years ago

    thank you for your articles. I find them helpful in understanding the depth of RA’s effect on our daily lives, and they provide valuable info on all aspects of RA. BLESSINGS!

  • MaryB
    2 years ago

    Thank you for this topic, as it’s a familiar one. I have lost mornings due to pain, stiffness, tiredness,etc. It helps to know that some of these things are “normal”.
    Am so glad I joined this website, it has given me help with various things. Have a good day.

  • Richard Faust moderator
    2 years ago

    Glad that you find the site and the information here useful MaryB. Unfortunately, mornings can be particularly difficult for many with RA. In fact, this article from one of our contributors looks at new research into why mornings are problematic: Also, thought you might be interested in this article in which community members offered tips on combating morning stiffness: Thanks for being a member of the community. Richard ( Team)

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