RAers, keep an emergency plan handy!

I’m sure all of you know that Rheumatoid arthritis (RA) is characterized by remissions & exacerbations. The aim of treatment is to keep your RA in remission & avoid flares as much as possible.

What is a RA flare?
RA flare describes an exacerbation of RA activity. It is the period when joints start hurting & are swollen.

What brings on a RA flare?
1. Change of weather. Sudden rain/ winter generally is responsible.
2. Physical exertion
3. Mental stress
4. Dietary changes. Sour food items tend to bring a flare in many RAers.
5. Stopping of medications.

How does a flare affect you?
1. The pain & suffering due to the joint inflammation.
2. If the flare gets prolonged, the dose of other DMARDs would eventually go up.

The best way to take care of a flare is to detect it early & treat is asap. You may contact your Rheumatologist & consult him immediately. However this may not always be feasible. The waiting list at your Rheumie’s clinic may not always allow you an immediate consultation.

Hence, speak to your Rheumie when you visit him the next time & get an emergency plan ready.

The emergency plan
1. An analgesic (NSAID) that you can immediately take when you sense a flare. Ask you rheumy about the number of tablets that you can take in a day, the interval you need to keep between 2 tablets. NSAIDs are never taken on empty stomach. Always eat something before taking a NSAID to avoid gastritis (acidity).
2. Ask your Rheumie if you can take a small short course of a steroid in case of a severe flare. You need to understand that steroids are not to be continued in the long run & you can start it & see your Rhumie asap. Speak to him regarding the dose & duration.
3. Once you sense a flare, put the plan in action immediately. The best way to take care of a flare is to treat it immediately.
4. Always take adequate rest during a flare.


  1. Thanks Doc!

    I am suffering from RA since last 5 yrs. Flares are a nightmare for me. Many of them last for 20- 25 days. Being a working woman, I am unable to see my Doc in time & press a panic button whenever there is a flare.

    I’ll surely discuss the emergency plan with my Doc. Thanks again.



  2. The emergency ction plan is really useful. However in this blog there appears an important missing link. Any patient who comes to a specialist normally comes goes to a specialist through recommendations of of a General Medical Practitioner. He is called a Family Doctor. When a patient and his family members visit a GP freequently for all his normal problems freequently the GP becomes a family doctor. He in all normal cases knows patients health problems. Naturally by his knowledge and some experiments he prescibes medicines which clears the patients of his health problems. In case of some abnormal illness for which he has not been able to diagnose the problems he refers the patient to specialist. Since the Family Doctor knows about the general health status and other diseases of the patient, is it not a good idea to include the emergency plan of RA flare up ? It is more easy and time saving to see family doctor in case of RA flare up. It will also be easy for him if he is appraised of the line of action in such case.This would also ease the burden of rhumatologist who has to see 100+ patients in a day. Not everybody is luckey enough to have access to you through internet. Pls let us know your views.



  3. Hii,
    I am the hypnotist working successfully as well as housewife, I was suffering from Rheumatoid Arthritis since 8 years. It was painful period of my life. Every new morning, any new joint of my body was get contracted. And the surrounded nerves became reddish blue. The affected area pained like piercing with needle. This kind of pain was unknown to me. Day by day this disease gave me disappointment. There were no. of therapies I used to undergo with. When the pain reduces slightly, the very next day another joint started paining. Sometimes my neck joints were also paining excessively.
    No ointment was able to heal my joint’s inflammation. Even sometimes I feel this pain with my breathing continuously. Consequently, my routine was literally broke down due to R. A. ‘s joint pain.
    After those 8 years, my maternal aunt at Bhandup, suggested me about the specialist for R. A. He used to came in one of the Multi-specialty Hospital at my hometown. At the same time my father was admitted in I. C. U. in the same hospital. I was not that hopeful about my R. A.
    But…… but……but…. As I entered in Dr.’s cabin calmly he assured me and proclaim that do forget all the misconceptions about R. A. if you have with you. Dr. stated honestly that just keep in mind this disease can completely eliminate from body. It is curable.
    Earlier it was told that this R. A. is varying with your mental status. I asked about this to Dr. He smiled and explained the people are saying this may have some mental problems.
    As a patient, I found everything believable because surprisingly I used to obtain relief from the R. A. within a week as soon as the treatment was started. Dr. called me after few day later with some concern reports.
    In next 5 months, Dr. had started minimizing the doses and the no. of medicines as per requirement.
    And now, I am having no R.A. at all………… It was miracle for me. But it is only truly proper medication. Apart from all the rumors about R.A., I get rid of R. A. totally.
    No doubt the R. A. specialist is properly doing his job and duties perfectly, but the patient should also have 100% belief in him & therapy.
    I suggest that…….. you must must must chose and FOCUS on what you want for your own body – Disease OR Ease?
    Keep in mind, R. A. is totally curable, You can free yourself from Arthritis. Take a proper breakfast at morning excluding ‘maida’.
    I share this to inspire you, and to give you POSITIVE APPROACH towards body. Frenz, discuss your experience regarding RESCUE FROM DISEASE.
    Thank you.



  4. I also want to add one point. Please take these analgesics as and when required and then do consult your doc. We never know what the extent of damage a sudden flare-up can cause to our body if not controlled carefully. I know people who take Indocap when it pains and then forget the disease. When they develop abnormality then they repent they should have visited a doc just after the emergency.



  5. hello doctor.. i`m a new reader of your blogs.. n i find it really interesting… i too am a patient of JRA n have been suffering for the past 45 yrs… i think there is no cure for it at all… just pacifiers.. its a make believe feeling that one is getting better…rati



  6. Hello Doctor, There is so much confusion about consumption of alcohol during RA. Some of the reviews says its good in moderate quantity, as not more than two drinks per day for men and not more than one drink per day for women. Definately considering the geographic area and social events some times its needful to take alcohol. Could you please elaborate more about the consumption of alcohol during RA is ok?

    Some reference for my conclusion



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