Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects the joints and causes long-term inflammation. Even with stable treatment, RA can suddenly get worse due to many factors.
Many patients feel worried when symptoms suddenly flare up: pain, swelling, morning stiffness, and general fatigue.
Recognizing risk factors early and adjusting promptly will help you control RA better, prevent joint damage from progressing, and significantly improve your health.
Why does rheumatoid arthritis get worse?
Here are the reasons:
1. You’re having a flare-up
Red, hot, swollen joints are a sign of inflammation. A flare-up is when inflammation in your body increases dramatically. Symptoms can get worse. You may also have a low-grade fever, fatigue, and feel sick all over. To treat a flare, your doctor may adjust your medications to reduce inflammation. To feel better, get more rest and apply heat or cold to painful and swollen joints.
2. You’re under pressure
Stress, anxiety, and even depression are common symptoms of RA. It’s more than just a bad mood. Depression can make it harder to manage your symptoms. Stress causes your body to release cortisol, an anti-inflammatory hormone. However, prolonged stress triggers too much cortisol, which makes pain worse. Find ways to relax, such as yoga, taking a warm bath, or exercising.
3. Your sleep cycle is off-kilter
Rheumatoid arthritis pain and sleep problems are a vicious cycle. If you’re in pain, you won’t be able to sleep well. If you don’t get enough rest, your symptoms will get worse. Good habits can help you get the rest you need. Use guided imagery to distract yourself from pain. Take pain medication before bed so you can fall asleep more easily. Turn off your phone and bedside alarm clock. Their light can disturb your sleep.
4. Your medication is no longer working
Even if your medication has been controlling your RA for a while, things can change. If your body starts to become resistant to your current treatment, your symptoms can get worse. Talk to your doctor. You may be able to switch to a new treatment. If you’re taking a biologic, your doctor may add other rheumatoid arthritis medications to help control your symptoms.
5. You have another condition
As if RA wasn’t enough to control, you may have related conditions that cause similar symptoms. People with RA are also more likely to have fibromyalgia. It causes chronic pain, fatigue, and similar tender spots to RA. Your doctor can diagnose fibromyalgia to make sure it’s the cause of your problems and suggest treatments.
6. You’re out of remission
The goal of RA treatment is to slow or stop the disease so much that you have few or no symptoms. Doctors call this remission. However, it doesn’t always last. RA can come back and get worse. Symptoms can come and go over the years. See your doctor to adjust your medications.
7. You’re not exercising enough
The pain and stiffness of RA can make you want to lie on the couch. But if you don’t move your joints, your symptoms will get worse. Exercise actually helps relieve the pain and fatigue of RA. Try to move around every day. Walk, bike, or swim to get your heart rate up. Do stretching exercises to keep your joints flexible. Exercise your muscles to keep them strong.
8. You’ve just had a baby
RA symptoms often improve when you’re pregnant. However, they may go away soon after delivery. Caring for a baby can be difficult when you have severe joint pain and fatigue. Your doctor can prescribe treatments that can help control your symptoms but are also safe for your baby if you plan to breastfeed.
9. You’re carrying extra pounds
Excess weight puts pressure on your inflamed joints, leading to more pain. Too much body fat can release hormones that make RA worse. Treatments may not work as well if you’re overweight. Exercise daily and seek help from a dietitian if you’re having trouble maintaining a healthy weight.
10. You smoke
If you have RA and smoke, quit! Smokers with RA who quit often see an improvement in their symptoms. Smoking increases your risk of developing RA in the first place. It can also affect how your RA medications work. They may not control your symptoms as well as expected. And it can lower your energy levels, keeping you from exercising, which can reduce joint pain. Quit smoking or get help to quit.
11. You’re Too Active
Exercise is great for rheumatoid arthritis (RA), but you can overdo it. If you’ve been active all day, take some time to relax. Resting can soothe inflamed joints and help you recover from fatigue. Take breaks to avoid injury. A physical therapist can show you how to protect your joints, prevent painful muscle spasms, and exercise safely.
12. You’re low in vitamin D
People with RA often have low levels of vitamin D in their bodies. If they don’t have enough, RA can become more active. This can lead to painful inflammation and even bone loss over time. A lack of vitamin D can make pain and fatigue worse. Your doctor can do a blood test to measure your vitamin D levels. Spending more time in the sun (with sunscreen) and taking vitamin D supplements can give you the nutrients you need.
13. You have an infection
Rheumatoid arthritis (RA) and the treatments you are taking make you more susceptible to infections. Your immune system is overworked, making it harder to fight off common germs. Even seasonal flu can trigger RA symptoms. It also puts you at risk for infectious arthritis, which can cause severe pain in your knees, hips, or shoulders. Get the vaccines your doctor recommends, such as an annual flu shot.
14. You have stopped taking your medications
They may be too expensive. Or you may feel better and think quitting is OK. But your symptoms may flare up if you stop taking them. Talk to your doctor. You may be able to switch to a medication with fewer side effects, or take a lower dose.
