Hi everyone. This may appear a very silly or odd question but can anyone explain what a “flare” is?
I was diagnosed in August with Rheumatoid Arthritis. I’m on Methotrexate and Folic Acid. They have been working extremely well until about two weeks ago when I had to miss a week of my Methotrexate as blood test result showed my Liver function was raised. Since then the pain in my hands has returned and my grip is weak. Is this what a “flare” is as it seems to be easing a bit today but the pain has been there for about two weeks.
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Moonjean
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It sounds like a flare to me. I usually consider a flare to be a sudden onset of your RA symptoms once you’re well controlled rather than the symptoms when you are first diagnosed and the medication is still not right. It might mean though that the mtx isn’t working as well as it should and you might need another medication added to it because missing one week shouldn’t bring on a flare. I would contact your rheumatology team for some advice.
When I have a flare, I have lots more pain and discomfort than usual, and draining fatigue. I am lucky as I don't work so can call a duvet day. It's often over in a day, not 2 weeks, so I agree with Ruth, contact your team . Good Luck
I had months and a year or two constantly flaring. Agony fatigue and really not good. i never slept properly for just as long, couldn't because of pain. Drained i was. I really just put up with it not knowing what was wrong. Thought i had gout and because i was an endurance runner i just dismissed it as doing to many miles and with working, using hammers and saw just carried on until it got to much. Couldn't walk ,lift my arm even personal admin i struggled with in the morningsSome people talk about remission when the drugs work and you should get back to how you were but me personally still have stiff wrist shoulder and generally my right side even tho the drugs Mtx and folic acid are really working for me. I feel almost back to how i use to feel,
good enough to get life back on track. Horrible flares stay away..
Thank you for your comments. Seeing nurse on Monday.
Hi moonJean . It took me a while to realise a flare and active disease is different . For me a flare can last no more than a week or two or just a few hours . Anymore than 2 weeks then it’s active disease and my meds are not working. All ways contact your team so they piece together the symptoms of your disease.
Thank you for making that distinction. I have been in what i have been thinking of as a "flare" for months, but I guess it is actually active disease because my meds are not working. I know I need to make a change. The thing is whenever I have had a few days of increased pain or fatigue that resolved within a short time, I have always just thought of it as normal ups and downs of my RA. I have been dealing with RA for 39 years.
I’m the same as you. Cannot find meds to control my disease - been 15 years so far. And lots of ups and downs. But even the ups are not exactly great by normal standards!
I hope you can find meds that will work for you. Keep trying. This is a beast of a disease. Over the years, I have had some blessed remissions as well as some really low times.
In my opinion, a flare is a short-lived episode in a period of otherwise well-controlled RA. From what you have said, if you have stopped methotrexate for a while, your RA is now not fully controlled. If you're not allowed to restart the methotrexate then you need to be started on another RA drug treatment quickly. Meanwhile, if you're in agony and struggling with mobility, ask your Rheumy for a short course of steroids (or steroid injections) until the new RA drug treatment is working fully.
Hello Moonjean, sorry you have more pain t deal with. I advise you to go to the NRAS website. There you find a lot of information about a flare which might answer some of your question. There is also a lot of information on how to live better with RA, self-management and so on. You can request peer to peer support via their help line or just have a chat with them. They area wonderful team. I hope you find a way to have less pain soon.
Hello Moonjean, not a silly question at all. For me a flare is, as others have said, a short lived (few days) of joint and muscle pain and fatigue. Usually first felt in my neck, feet and some fingers. I try to take extra care and not do anything strenuous (which for someone who used to ride their bike up to 100km a week is a real downer).Take care and hope you get support from your nurse appt on Monday.
I’d add that when you are at the uncontrolled disease stage, you can get “flares” that are essentially weeks to months of feeling even worse that you normally do. It’s not technically a flare but it is an increase in the symptoms you experience every day. Kind of the difference between feeling really rough and absolutely horrendous 🙃
A flare for me is pain in unusual places,I can’t open anything like crisppackets I cry at adverts and feel awful. Lasts a week and I am like a werewolf. Then the moon changes and I am better. Over the years I have noticed air pressure affects my pain too. As you are unfortunately new to this you will begin to recognise good and bad days. But don’t worry! Drugs are good and consultants know a lot more so take care and don’t be afraid to ask for help. 🌺
well I have been trying to find out the same thing for few months now,I had been diagnosed with PMR oct 2016, started me at 40 mgs, tapered very slowly through last 41/2 years, finally was down to 5 mgs for few mos last summer and fall, bloodwork has never shown esr, etc numbers up, only white blood cells, for most of that time, so rheumy suggested could continue to taper to 4mg,s which I did and by late Dec earlyJan was on 4mgs steady, however, at that time started having several issues, IBS changed from IBSd to Ibsc, and started to get pain, stiffness in hands, hard to bend fingers, feet, heels hurting, along with other body stiffness, had ultrasound, catscan, bloodwork, exrays on hands and feet done over last couple mos, am told my rheumy, not PMR, not RA, bloodwork for that was negative, simply old age and degenerative disease?? so she was of no help on my last visit to her month ago, GP< simply says osteoarthritis, well a "flare" from reducing to 4 mgs, never mentioned, told to take tylenol, while still on pred, can,t take anything else, so basically, just put up with it nothing we can do?? at anyrate, naturally I am frustrated, pain everyday, especially on waking, and lasts half or better of day, so have you talked to your rheumatologist about what you are experiencing, and hands and feet , do your symptons get better later in day?
Thank you for your comments. It’s only my hands that are painful. At the moment will discuss with nurse and have appointment with Rheumatologist next month.
so were you diagnosed with RA from positve RA bloodwork then? I believe mine is RA, hands and fingers, so painful best part of day, and heels, do you feel less pain later in day, early evening?
well I seem to have symptons of RA, but as I said, bloodwork, RA and anti cpp test showed negative, so that is what rheumy based her comments on for me, I am actually going to try and find another rheumy, my GP said wait until your next appt with her before we refer to another rheumatologist? and im sure will take mos for that to happen, especially given the pandemic situation, thank you for your comments though
My bloods do not reflect how my disease is . I’m s-negative and was eventually diagnosed through examination and symptoms . Even at my worst my bloods are ok .
A flare is usually painful. And I consider it to be, you are feeling ok for awhile and then you start hurting again or having some other symptoms that you have not had in awhile. If you do think it's a flare you need to let your rheumatologist know...
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