What is a RA flare

[KarenS1]

Hi there

I moved over to methotrexate injections about 4 months ago as I could no longer tolerate the nausea from the tablets. Whilst I still feel wiped out the following day I don’t feel as nauseous. I also take hydroxchloriquine and the normal folic acid 6 days a week.

How do you know you’re having a flare? I seem to be in a constant flare with severe pains and inflammation in my elbows, radiating to my shoulders. My wrists, hands and in particular my thumbs are very painful. The balls of my feet burn to the point I feel I cannot walk, if this is a flare it’s been going on for 6 months with no let up? I thought a flare was just that, you feel pain, swelling etc but it comes and goes? Mine is here almost constantly?

I have been taking meds now for 4 years or so and have got worse, not better? Surely that’s not right? Throughout this time my CRP has remained fairly stable between 5 and 10?! Despite the obvious inflammation and pain!

I really don’t think I would feel any worse if I wasn’t taking all of these meds and seriously considering stopping them...

Amy tips, advice greatly received.

Thank you x

[Hobbledehoy]

You sound as though you need a review, KarenS1. Keep a diary to prove your symptoms. If you haven't an appointment due then request one. And monitor your feet, problems there are common with RA, and as you mention the balls of the feet perhaps you could provide them with cushioning like podiatry felt from Boots, or even Sketchers although they don't give much support. I easily get ulcers on the balls of my feet & they can be v troublesome to heal. Good🍀.

[nomoreheels]

Whatever you do Karen don't stop taking your meds, not without supervision. You will feel a heck of a sight worse within a few weeks I promise you. Even if it doesn't seem it they will be working to some extent so please don't.

What I don't understand is as this has been ongoing why your Rheumy hasn't reacted, either by adjusting doses, of your MTX if not HCQ if you're on 400mg or considering alternative treatment options for you. Are you on the same injection dose as tablet? He must have examined you... even if he's considering your inflammation levels to be ok not everyone's are a reliable indication of actual physical inflammation, mine aren't & I know of others here who's aren't either. Mine can be my normal values mid flare. How does he respond when you've told him after all this time you feel you've got worse not better? Have you asked if you could try something else for example? Four years is a long time to be feeling like that & saying so at every appointment, you must feel dreadful after each wasted visit.

When are you due a review? If it's not soon then do contact your Rheumy nurses & explain to them as you have here. If they don't hear from you they'll assume all is well.