Question: What Defines an Arthritis Flare?
Arthritis patients sometimes say they are in a "flare". What clinically defines being in an arthritis flare? What should the patient do when they feel they are in a flare? What possible action would a rheumatologist take to treat a flare?
Flare Means Increase in Symptoms
Doctors use the term "flare" to describe an increase in a patient's symptoms from their baseline (their usual symptoms). Patients with osteoarthritis may notice an increase in their joint discomfort with or without swelling. Rheumatoid arthritis patients may complain of an increase in joint pain or joint stiffness that is often associated with swelling and fatigue. When lupus or Sjogren's syndrome patients flare, they might notice an increase in achiness and fatigue.
A Flare or Fibromyalgia?
Some patients who are experiencing an increase in joint pain and fatigue may actually be suffering from an exacerbation of fibromyalgia and not their underlying disease. Fibromyalgia is a common musculoskeletal condition associated with arthritis. It is characterized by widespread body pain, fatigue and non-restful sleep.
For patients with rheumatoid arthritis, lupus and Sjogren's syndrome, your doctor may order blood tests such as the ESR (sedimentation rate) and CRP (C-reactive protein). If these tests are higher than usual, and there is no fever or sign of infection, it would help confirm that your symptoms are related to a flare. In addition, for lupus patients, blood tests such as a DS-DNA antibody and a C3 level can be obtained to help with the assessment.
How to Treat Flares
Also read: Remission - What Is a Remission?
Answer provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle of Anti-TNF Blockers and co-author of Natural Arthritis Treatment.