Flare ups- how long do they last?

[MsEm]

Hello! I've been on methotrexate for about two months now and I've not noticed any difference in pain levels. My hands are in constant pain with swelling pretty much every day! I keep thinking this is what's known as a flare up but it seems to be lasting a long time. Just wondered about others' experiences. How long do flare ups tend to last? Or does that fluctuate? I was diagnosed with RA in April and apart from about 5 weeks after a steroid injection, I've had pain. Thank you for any comments on this!

[helixhelix]

To me a flare means that the disease has popped up after a period when it has been controlled. But it sounds as if you haven't yet got to the point where the disease is at all controlled yet, so I would say that's active disease rather than a flare! There are a few people who have a type of RA that ebbs and flows but for most of us it keeps on going if not controlled with drugs.

If you've only been on MTX for 2 months it's still very early days for you, so it may well still improve. It can take 3 months or more for it to take effect once you have reached an effective dose so if you started at a low dose it could take longer. However, do tell your medical team as it may be that you need a different dose or a different drug.

[MsEm in reply to helixhelix]

Thank you for this- very helpful. I will get in touch with my RA team and see what they say,

[catwoman4]

I was told that mtx takes about 3 months to kick in but would have thought you had noticed slight lessening of pain at least. Think would be an idea to speak with rheumy nurse as after I had a depo injection I was feeling good right away. Maybe you need more help, so don`t suffer, get in touch with the experts and good luck

[RheumTrucker]

I've never had more than a 20% impovement on mtx but took it for years as an adjunct to biologics.

Your RA is not under control and your docs need to address this. Whether it is low dose steroids short term or adding another dmard.

RA should be treated to target. This is well documented in both the ACR and EULAR.

Get in to see your rheumatologist asap.

The squeaky wheel gets the grease.

[Braecoon]

I've been on methotrexate injections for last 3 months and my pain has increased and I would say that I am at same level of pain and discomfort as when I was first diagnosed August 2014.

You may need additional DMARD medications alongside the methotrexate. They normally start newly diagnosed people on the triple package, methotrexate, Sulfasalazine and hydroxychloroquine, but different Rheumatologists have their own regimes. I would imagine that you would have been given a follow up appointment arranged by Rheumatology team around the 3 month mark after commencing on methotrexate.

[Livingston]

I tend not to have dramatic flare ups, rather just things getting slowly & insidiously worse. This can go on for months at a time - basically as long as it takes me to get my rheumatologist to listen.

[MsEm]

Thanks so much for these replies. So useful to hear others' experiences. I called the rheumatology team and spoke to the main rheumatology nurse who agrees that I probably shouldn't be feeling the pain quite so acutely by now. She also told me I should have been scheduled a follow up appointment with her by now but there has been an oversight. It's probably unlikely she can fitalso one in soon unless there is a cancellation. In the meantime my appointment with the consultant has been put back to mid October. But apparently if I go to the hospital and fill out a paper questionnaire detailing where my pain is located, give the questionnaire to the receptionist who will pass it onto the consultant, he could prescribe a stronger dose of methatrexate by 'consulting' my medical notes. Almost like being a virtual patient but without the technology! Hmmm....

[Karen77]

I would consider that you are not in a "flare" persay, but that your RA is not "managed" or "under control". It took me over 8 months taking methotrexate (DMARD) and meloxicam (NSAID) and continual progression of the disease before I was put on Humira (biologic) and only did then the sun start to peak from the clouds. I had about a year or so of feeling amazing, like I had "beaten" RA (which really just means that the disease was under control since there is no cure) and then had a "flare" that lasted another 11 months (can you call a whole year of pain and misery a "flare"? I'd say that it is under control now, though I still cannot fit my wedding ring over the knuckle and the bottoms of my feet are tender in the mornings (but I am not taking any NSAIDS!).

Don't get discouraged, it will get better. It may take time though. Appreciate the good days, try very hard not to overdo things on the great days, and remember you've got friends here who understand you!

Gentle hugs!

[MsEm in reply to Karen77]

Ahh! Thank you so much Karen77, what wonderful kind words and so much needed right now! Thank you for all these comments and replies, they've all been super helpful and so useful especially during a confusing time! X

[Hidden]

Thanks for posting this question MsEm. I am a newbie to RA and I just assumed I was in a flare. Well my flare started last December 2014 and I had my meds adjusted yesterday. My swelling has gone down, but not good enough according to my rheumy. My dr says damage can still be done with slight swelling.

I wish you the best

Sue

[guineapigharriet]

Good to be able to share.