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The Value of RA Related Pre-Pain Clues

At first thought, it may seem strange to discuss pre-pain as a concept but I believe it is a distinctive part of RA and one worth tuning in to.  It takes some time, even years perhaps, to fine tune that “spidey sense” to be able to accept and react to the pre-pain signals our bodies provide.

For me, one of those is general body aches.  By that, I mean overall, non-specific achiness that is mild but distinctive and just annoying enough to get your attention.  This is often a foreshadowing of a flare yet to manifest but heading my way soon.

RA Fatigue: Another pre-flare signal

Another pre-pain signal is fatigue.  This often starts as just overall tiredness but quickly escalates into fatigue that stops you dead in your tracks, zapping you of all levels of energy and motivation.  I often compare fatigue to trying to walk through a wall of dense gelatin.  It stops you from moving at anything beyond a snail’s pace and takes every bit of energy just to put one foot in front of the other.  Once again, it is not uncommon to have this be an early sign of an oncoming flare.

Brain fog can also signal a looming RA flare

Brain fog has always been a sure-fire signal that things are headed in the wrong direction for me.  Brain fog for me manifests in several ways.  First, my ability to think clearly, concretely and with any degree of accuracy completely disappears.  When I talk, I find I am on a constant search for words that normally come right to my lips.  Decision making suffers as well.  I seem to be unable to weigh options at all, let alone select or develop one.  Even the thought of making a determination about what to eat seems like a monumental task.  I actually feel fear when this hits.  I wonder, at age 65, if this is some form of dementia and until it clears, which thankfully it has every time, I am terrified it will stick around.  When brain fog commences, a flare may be right around the corner.

Poor sleep: a sign of the pain to come?

Poor sleep is another pre-pain signal for me.  When my RA is under control, I tend to sleep pretty well.  By that I mean I can get at least 2-3 uninterrupted hours before I wake up and need to move to prevent stiffness.  But when a flare is imminent, sleep is elusive.  I am lucky if I can even fall asleep, let alone get 2-3 hours.  This one is interesting to me because it is different from the lack of sleep that accompanies the full-blown pain, swelling, and stiffness of a flare.  This is pre-flare.  It is like a warning sign of what is to come.  When I think back on it, I have poor sleep for several days before a flare manifests nearly every time.  This is a fairly recent revelation to me but it is distinctive nonetheless.

Emotional agitation: Another sign of the impending pain

Emotional agitation is yet another sign for me.  By that, I mean a sense that something is about to happen, namely a flare.  This manifests in a short temper, lack of patience, sadness, etc.  It is as if my mind knows before my body that something very unpleasant is on the horizon.  The result is a mental upset that is hard to handle.

There are more pre-pain signals and I am sure you have others you can reflect on as well. The point is, when these appear, the key is to prepare for the potential flare coming by taking care of yourself, doing all of the things we know will help ease the discomfort to come.  Taking breaks and resting more often, taking naps to keep that sleep quotient up, get a massage, meditate, do activities that will lift your spirits, move your body gently knowing that overdoing it will only make it worse.

Each of us has the ability to reflect and consider what are the pre-pain clues that my body gives me.  And how can I respond to those in a way that will ease the flare around the next turn?  When you answer those questions, you have once again added another successful tool to your RA management routine.


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.


View Comments (4)
  • Richard Faust moderator
    8 hours ago

    Great article Nan. There certainly are flare precursors. I find that sometimes I see signs of a flare before Kelly does. For everyone out there, if you have a spouse or person you spend a lot of time with ask if they spot signs that you are not doing as well and ask them to let you know. Best, Richard ( Team)

  • anniemac
    2 days ago

    Being new to this whole thing (last year was my diagnosis and “in a flare” for 10+ months), I am just now figuring this whole thing out. One of my pre-flare signals is a scratchy throat. Definitely increased fatigue and emotional irritation and impatience.

    Thank you for a great article!

  • Monica Y. Sengupta moderator
    2 days ago

    Hey @anniemac! Welcome to our community! I hope you take a look at all the great information the website has to offer.

    I am sorry the last few months have been so difficult. From my personal experience, the first couple of years were tough as we tried different medications to see which stuck. I experienced the same fatigue and emotional irritation (which was unfortunately very uncharacteristic of me).

    But, since finding the right regime, I’ve felt almost normal. So, definitely hang in there and please know you are not alone. You can always come here if you have any questions or just need to talk.

    Best, Monica

  • Lawrence 'rick' Phillips
    3 days ago

    I am with you when it comes to emotional agitation. It is almost a straight line between being upset for an extended period and having terrible flares.

    Thank you for the wonderful reminder.

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