Flare ups

  • By Scott Howard

    What are your flare up like?

    I have what I think are micro-flares. I’ll get sudden, sharp, shooting pain in my fingers or toes.

    I also get aching major joints: hips, knees, and ankles. Is that a flare up too?

    Knowing how individualized our symptons can be, what are yours?

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  • By Andrew Lumpe, PhD Moderator

    Scott, I’ve struggle with understanding the exact nature of flares. There even seems to be no clear definition in the scientific literature. For me the symptoms can wax and wane. I like your characterization that if can be micro or macro. I think they can also be short term and long term. If you go beyond 3-6 months, then you know that your treatment is not working.

    You can read more about flares at

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  • By Barbara Vincent

    Hi Andrew,
    I am having a flare right now. Started a month ago and I can tell you, I have no trouble telling when I have a flare. It starts a few days before with major fatigue and wanting to sleep all the time. Then one or two joints will start to throb and within an hour or two, there is swelling, redness and throbbing, indescribable burning agony.

    Today it is my right knee and also the Cricoarytenoid joint in my throat. Can barely walk,can’t swallow and can hardly talk. Waiting for the Dr’s surgery to open so that I can get an appt. today. That is how a flare is for me.

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  • By Barbara Vincent

    Thank you Andrew,
    Yes, once more with the help of large doses of cortisone(oral) swelling and pain have eased off. Joints still a little touchy and tender, but functioning normally again- until next time. The problem with needing to take large doses of cortisone all the time is the way it strips calcium from your bones. I’m on Fosamax Plus but each time I have a bone scan it is a little worse. A trade off between becoming crippled if I don’t take the cortisone and a fracture if I do. Win some, lose some I guess.

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  • By Mariah Z. Leach Moderator

    I agree that the nature of flares can be confusing. For me sometimes it can be intense pain in a specific joint or sometimes it can be just an all over general body ache and malaise. There’s lots of different ways my RA can be “active.” And Barbara it can certainly be difficult to balance the benefits and side effects of medications. Best of luck figuring it out!

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  • By Laurie

    being new to RA, diagnosed in January, my flare is mostly in my hand and what was just my middle finger. Two days ago it has moved to include my pointer finger. I have trouble closing my hand and the joints are stiff and swollen. I never know if I should just ride it out or do I call to see if my meds need adjusting. Currently I’m taking methotrexate (gone from 4 to 7) and prednisone. any suggestions?

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  • By Barbara Vincent

    Hi, when I was diagnosed 6 years ago it was with a sudden acute attack. The symptoms were so bad that I thought it was Dengue fever or Ross River fever. The symptoms I had came on overnight and consisted of: Swollen joints,joint pain of a powerful, overwhelming, burning needle like pain in most joints, low grade fever, drenching perspiration and nausea. The pain was so excruciating that I couldn’t stand. The fingers and my wrist on the left hand side in particular were grossly swollen and immobile.

    I got an urgent appt. with my doctor, who said he would test me for Dengue or Ross River Fever but thought it may be RA. I said, ‘Oh it couldn’t be because I am fit and healthy and work hard and I eat well. Unfortunately it turned out that he was correct as all the blood tests came back positive for RA. All levels were elevated: CRP, ANA, ESR and my RF levels were 51. It took three months and much medication to get it reasonably under control. I am currently taking Plaquenil, Methotrexate, Cortisone, Sulfasalezine and Folic acid to replace that destroyed by the methotrexate. The Methotrexate is the one which has mostly stabilised my condition. From time to time, I do get an outbreak and then need to go on a high dose of Cortisone for a few days, which is tapered off slowly until I get back to my regular dose. Most of the time I am well, but when I start finding that I am having trouble getting to sleep and staying asleep, I know that a flare is on its way.

    I was lucky in a way that the condition didn’t come on slowly because I was diagnosed and started on meds. early in the illness, so that now I only have two fingers which have damaged joints (very painful sometimes). So to cut a long story short, it can take several months to stabilise your condition. Eat well, rest when you are tired, but don’t sit in a chair all day, as you need to keep moving to keep your joints mobile and to keep good muscle mass to help support your joints.

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