Your Guide to Managing Rheumatoid Arthritis Flare Ups

Just when you thought your back was safe from rheumatoid arthritis, an RA flare up strikes your spine. Learn how to manage and prevent RA flare ups

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Managing your rheumatoid arthritis (RA) is an ongoing balancing act. You’ve had your share of painful symptoms, and your rheumatologist has prescribed medication that should help you handle them. You’re also doing your best to follow your doctor’s lifestyle instructions, even though you may have hit a few bumps in the road. Overall, you think you’re on a good path.

RA flare up in spineLearn how to manage RA flare ups in your spinal joints.

And then, you wake up one morning and you can barely get out of bed. Your joints feel swollen and stiff, and it’s a challenge to even get through your morning routine. You’re likely experiencing a rheumatoid arthritis flare up, and you’re certainly not alone. Even people with well-controlled RA symptoms can be surprised by sudden flare ups.

Learning how to manage your RA flare ups will help you to better manage your overall health. By monitoring your daily activities, you can also minimize your chances of experiencing these uncomfortable episodes.

What Is a Rheumatoid Arthritis Flare Up?

A rheumatoid arthritis flare up describes a short-term escalation of your RA symptoms. A flare up can subside within a day or two, or it can persist for several weeks or months.

An RA flare up generally involves joint stiffness and pain, although it can manifest itself as a worsening of any symptom. If the flare up is especially severe, it can affect your ability to perform your everyday activities.

Ai Mukai, MD, a physiatrist with Texas Orthopedics Sports and Rehabilitation in Austin, Texas, emphasizes that RA flare ups are a known part of rheumatoid arthritis and its course and symptoms. Dr. Mukai, who possesses board certifications in pain medicine and physical medicine & rehabilitation, is also a SpineUniverse Editorial Board member.

How Does a Rheumatoid Arthritis Flare Up Feel?

RA flare ups can cause varied symptoms, and not every person experiences the same ones. However, Dr. Mukai says many of her patients describe their flare up symptoms in a similar way. “Most patients describe ‘flare ups’ as a sudden increase in pain, stiffness, and swelling of the joints of the body,” she notes.

Other common RA flare up symptoms include limited joint mobility along with severe fatigue and symptoms that mimic the flu. Note that your symptoms’ frequency and severity may vary. Because there is no standard list of RA flare up symptoms, physicians may find it difficult to design standard treatment options.

How Common Are RA Flare Ups in the Back?

Rheumatoid arthritis is a complex condition that can affect many joints. Since RA is inflammation of a joint’s synovial membrane, any joints with such a membrane are fair game, including the facet joints in the spine.

Anatomy of synovial joints susceptible to RA flare ups in the spineRA flare ups can affect any synovial joint, including the facet joints in your spine.

Dr. Mukai explains that although other joints are more commonly affected, the spine is not immune to RA flare ups. “The most common place in the spine affected by RA is the upper neck – near the base of the skull. The C1-2 joint at the top of the neck can become inflamed and in severe cases can become unstable or form a pannus (abnormal tissue) that sticks out the back of the spine and can start compressing the spinal cord or even the brain.” 

Rheumatoid Arthritis Flare Up Triggers

Dr. Mukai’s many patient interactions have helped her to identify several potential RA flare up triggers. She counts:

…as possible triggers.

Dr. Mukai also notes that many flare ups occur without an identifiable trigger.

Certain foods are thought to increase inflammation and could contribute to an RA flare up, including:

  • Processed meats
  • Red meat
  • Dairy products
  • Added sugar
  • High-sodium foods
  • High-MSG foods
  • Gluten
  • Alcohol

By avoiding these foods and sticking to a rheumatoid arthritis diet, you’ll likely reduce your RA symptoms’ severity.

Excessive physical activity can also trigger an RA flare up. If you participate in exercise or sports that could result in an injury, follow protective guidelines to keep yourself safe. By learning to identify the start of an RA flare up, you can moderate your activity accordingly.

Finally, airborne toxins can trigger an RA flare up. Besides cigarette smoke, these harmful substances include chemicals such as household cleaners. Switching to environmentally safe cleaners may help. Airborne toxins are a particular cause for concern in densely populated cities and other areas that experience air pollution and smog. To minimize your risks, stay indoors during periods of poor air quality.

Preventing RA Flare Ups in the Back

When managing any chronic medical condition, it’s difficult to predict when a flare up will occur. As a result, there isn’t a foolproof strategy for preventing one.

Dr. Mukai does have some advice that should minimize your risks of an RA flare up in the back. “[Follow] a healthy lifestyle including proper nutrition (some people are proponents of eating whole unprocessed foods and avoiding pro-inflammatory foods like trans fats and high fructose corn syrup).Getting good sleep (practicing good sleep hygiene), reducing stress (meditation, regular light impact exercise), and not smoking – can all help to reduce risk of RA flareups,” says Dr. Mukai.

Finally, Dr. Mukai offers bigger-picture recommendations that should help all RA patients better manage their condition. “Patients in RA should have a good long-term relationship with their rheumatologists and understand that their disease can change over time, necessitating change in medications and need for multimodal treatment. Learning good self-care techniques early will go a long way in managing symptoms.”

Updated on: 09/08/21
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