When Your RA Flares, What Do You Do?

As a freelance writer and professional musician, I use my hands a lot; I mean really a lot! It is not uncommon to be keyboarding away for hours on end.

Normally this isn’t an issue. My rheumatoid arthritis has basically been in remission since I began using my current biologic and disease-modifying anti-rheumatic drugs. I am very fortunate.

Aside from the occasional stiff wrist, ankle, toes, or shoulder, I haven’t experienced much disruption in my daily routine from RA. I certainly haven’t experienced any pain that approaches the excruciating horrors that plagued me prior to diagnosis. For that, I am thankful.

But lately, something is going on. A few days ago, I thought that I had been typing too much, causing some pain and stiffness in my left hand, particularly in the metacarpophalangeal (knuckle) and proximal interphalangeal (mid-finger) joints of my 4th and 5th fingers.

Day 1
I tried to rest my hand and allow the pain to dissipate. But after letting my hand rest in a partially closed position, the joints would hurt even more. So I tried to rest my hand in a flat, relaxed position. This was hard to maintain because it meant I needed to basically stop using my hand entirely.

Day 2
I finally broke down and dug though my “prescription drawer” to find an old bottle of naproxen. I took a pill and a few hours later it seemed like my hand might be feeling better. But I’m aware that some doctors recommend avoiding NSAIDs (non-steroidal anti-inflammatory drugs) when you take methotrexate, which I do. So I was reluctant to take too much.

Day 3
After thinking that overuse may be the cause of my pain, I realize on day 3 that perhaps something more is going on. Grrrr. I can still feel the pain. Maybe my body is reacting to the bag of Twizzlers that I indulged in? I’ve been craving a jelly donut like crazy lately, but I haven’t had one so I can’t really blame any baked goods for my troubles. (Bakery cookies are the worst. I am sure to swell and become stiff after having a few of those.)

Day 4
I really should think about getting an ice bag out of the freezer and using it on my knuckles; maybe that will feel good. Or, perhaps soaking my hand in some warm water will be soothing. I take some more naproxen and notice that my arm is feeling a little numb. The numbness is left over from nerve damage caused by the MS. It’s a sign that there is inflammation messing with my body.

Day 5
This is so unusual, I think to myself. It has been so very long since I’ve experienced an honest-to-goodness RA flare-up (not caused by food reactions or overuse) that it is difficult to admit to myself that a flare-up is probably exactly what’s going on. Dang. My wrist has also begun to “click” and my elbow is just a bit more noticeable than usual.

Since I’ve responded beautifully to my current RA treatments for so many years, I don’t plan to entertain the thought of switching. But this constant pain and discomfort causes me to ponder a few questions:

  • Are my RA treatments starting to lose their effectiveness?
  • Did I do anything to cause this flare-up?
  • Should I call my rheumatologist? What would she suggest that I don’t already know to try?
  • Why don’t you actually do some of the things you know to try, Lisa? Get on with it.

I basically know what I should do, but somehow having the knowledge doesn’t always translate into immediate action. I suppose that I should decide what my plan of action will be if I’m still experiencing increased pain, interfering with my ability to use my hands, by the end of the week.

I would feel silly, however, if I called the doctor then everything was back to normal by the time I got to see her. But I suppose that it is important to have this episode, especially if it continues, documented in my record. If the pain gets worse, I will definitely call, but fortunately it is still at a tolerable level right now.

I guess I'm opting to stay in a holding pattern for now. Wait and see. In the meantime, my husband is taking care of a few more things around the house for me. For that, I am also very grateful.

What do you do when a minor flare-up emerges, especially if you’ve been in remission for quite some time? Please share your experience; your story will help others dealing with the effects of RA.


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