Flares in rheumatoid arthritis

What factors can cause flares of rheumatoid arthritis?

Here are some “suspects”:

rheumatoid-arthritis-handFlares with RA can occur as a result of:

  1. Going off medicines.  Sometimes patients need to hold their medicines if they’re sick or they’re having a surgical procedure.  It’s not uncommon for them to flare.
  2. Stress.  Emotional or physical stress can cause flares.
  3. Tapering of therapy.  Sometimes patients will have their medicines tapered either because they want to or because the doctor wants to.  An example might be tapering of prednisone.  That can cause a flare.
  4. Weather changes. This is controversial since studies have been conflicting.  All I can say is my patients tell me they feel worse with cold damp weather.
  5. While not a flare inducer, smoking is a risk factor for RA and smokers seem to do worse.
  6. Illness. Sometimes colds might be associated with flares but not as often as one might think.
  7. Changing therapies.  Sometimes when a treatment is undergoing transition, ie going from one biologic to another, the patient might flare.  Haven’t seen this often but it has occurred.

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