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Flare Action Plan: Do You Have One?

The dreaded rheumatoid arthritis flare—we hope to avoid them, but it is not always up to us. We work hard to maintain our health, stick with our treatments, and work carefully with our doctors to keep the RA quiet. But sometimes flares just happen and we have to be ready to respond.

The unpredictable RA flares

I find flares impossible to predict. While they are more frequent during the winter, as the cold takes its toll on me, they are not exclusive to these months. Sometimes I may predict a flare with a big weather change, yet other times the weather seems to make no impact. While I have not been able to find a pattern, I do know that I need plenty of rest, to manage my stress, and to eat a proper diet to minimize flares.

Everyone’s RA flare action plan is unique to them

During the years I have gradually learned things that help me to get through a flare. It has taken many conversations with doctors and a ton of trial and error. My feeling is that every person with RA is different and needs to develop their own RA flare action plan. Honestly, I still experiment a little with mine to find out if I can recover faster or ease my pain.

Here’s how I take action when I have an RA flare:

  • Get to bed! In my experience, the only way to recover is to get loads of extra rest. When I flare, my body is in overdrive and it feels like I am burning up from inside. My RA is overactive in its attack on my body and I need to get sleep or just plain lay down to recover my energy.
  • Adjust my medications. In previous appointments with my rheumatologist, we have agreed on how to change my medications in the short term for a flare. In my case, that means a temporary increase in prednisone to calm the inflammation and pain. Every person is different, so it’s best to pre-plan with your doctor to determine what works best for you.
  • Update the doctor. If a flare is unusually harsh or goes on for more than a couple days, I leave a message for my rheumatologist to let him know what is happening. I explain the flare symptoms, duration, severity, and how I have been coping. If he has further instruction, I’m happy to follow it.
  • Practice soothing techniques. This is all about doing things that provide pain relief and make the RA flare hopefully a little bit more comfortable. For example, hot showers or going in a whirlpool, icing some joints, gentle massage, meditation, gentle stretches etc. I look for ways to feel a little better that are not physically challenging or will avoid aggravating my angry joints.

My advice is to speak with your doctor early and often about planning for flares. Your rheumatologist should help you to create a plan and then if you need to use it, assess its effectiveness so that you can improve upon it. They should also provide guidance on when to call and what you can expect from that call—such as emergency prescriptions, an appointment, or a phone consult.

Unfortunately, flares are a common part of life with RA. But that doesn’t mean we cannot be prepared to take action and combat the flare as best we can. In my experience, it’s all about minimizing the pain and other symptoms, and aiming for a recovery as swift as possible. The faster I take action on my flares, the faster I can recover and get back to my life.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Barbara Vincent
    3 years ago

    Yes, I have a plan set up by my Rheumatologist. My premonition of a flare is totally different from Kelly’s. It starts with the inability to get to sleep. Tiredness does not equate to sleepiness. I toss and turn and toss and turn. Cannot relax and cannot sleep. My last bout ended up with me getting up at 1/4 to four in the morning in desperation and had a cup of tea. I felt freezing on the inside, so took my temperature and it was 34.5 C. Nothing could warm me up. Then my hands and feet started to burn, turn red and swell. My Temp started to normalise- it’s never more than 36 C. 5 days of being out of commission followed. O.K now t o the plan. At the first sign of sleeplessness, I start a course of a very high dose of cortisone. which is reduced in steps over the next 12 days. Yes, I know high doses of cortisone destroys bone and can cause other problems also, however the last time I ignored the symptoms, I was admitted to hospital for 8 days. Couldn’t walk and morphine had no effect. So now, I follow my specialists instructions as I never want to end up in hospital in such agony again if I can help it.

  • Kelly Mack moderator author
    3 years ago

    Hi Barbara, I think it is excellent that you have identified the early signs of a flare for your body and have a quick action plan with your doctor. Sounds like you are doing all the right things by knowing your body and getting appropriate treatment. You’re right in that it is not ideal to have to take steroids, but I’m of the opinion that its better to nip a flare in the bud rather than to risk serious illness or RA damage by waiting to treat or not treating aggressively enough. Strangely, I don’t find pain medications that helpful (and they effect my tummy) so would rather be on steroids than to have to treat my pain. Hope you are doing ok and thanks so much for sharing your experience. Best, Kelly

  • Lawrence 'rick' Phillips moderator
    3 years ago

    Well I do the first item in the list pretty well. I am afraid my plan is lacking, after pulling the covers over my head, i tend to pull them up some more. My wife feels getting going might be a better choice. I do like this covers a lot better however.

  • Kelly Mack moderator author
    3 years ago

    🙂 Rick, I totally empathize! As Richard (my husband) wrote, I have a deep and abiding appreciation for staying under the covers, especially when I’m having an RA flare. Frankly, sometimes resting is the only way to ride it out. But getting some meds and getting up can be a solution too (depending on the severity of the flare). Hope you are flare-free! Best, Kelly

  • Richard Faust moderator
    3 years ago

    Hi Rick. I think many will find merit in your “pulling the covers over my head” method. In fact, the author of this piece (full disclosure – I’m her husband), has this other article on giving in and letting the body sleep and/or rest when it demands it after pushing too hard:

    Sometimes the body wants what it wants. Best, Richard ( Team)

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