First RA flare

[Number109]

I was diagnosed with RA just over 2 years ago but it’s been well managed since. A week ago I started with a sore knee, I’ve been resting it and using ice packs but this morning it’s swollen and painful.

As it’s my first flare up I’m not entirely sure what to do. My Gp and rheum nurses don’t work weekends so I’m not sure if I need out of hours help or if I should continue with home care and call on Monday. Any advice please?

RA is worse on a morning and when I’m in flare the first time going down the stairs is a painful “ow-ow-ow” with each step but it does ease though not go away.

Don’t stop doing what you’re usually doing. It won’t feel like it’s a good thing, especially at first, but walking around as you usually do helps joints keep lubricated. I’m not saying go out to the gym just resting joints can make them more stiff (the irony eh?).

If you’ve been prescribed painkillers take those as directed. If not then paracetamol will take the edge off the pain. For my knees I use Flexiseq, my consultant recommended it for my knee. He couldn’t prescribe it to me (U.K.) so I bought some off amazon. It’s fab for easing knee pain.

You may get a low grade fever, that’s perfectly normal, as is fatigue. As it’s your first flare you’re in the difficult part of finding the balance between doing your usual routine, and moving normally, with whether you run out of energy. Have a look at spoon theory for that as it describes fatigue perfectly.

I use heat rather than ice for pain relief too. I have one of those wheat heat bags that you can zap in the microwave.

Thank you. I thought it felt easier yesterday and I’d walked my DD to school then walked down to see her Easter service so I wondered if that could have made it worse as it’s much more swollen today.

I don’t have a fever or fatigue at the moment, it’s just one knee and I can’t put my socks on!

Thank you, I’ll try heat too. I naively thought heat might make the swelling worse.

I was diagnosed 2 weeks before the lockdown started so I feel really unprepared for what to do in certain situations. I have an email address for the rheumatology nurses but it’s not manned at weekends.

Thats tough, being diagnosed just before lockdown. Im having a flare-up now and I'm gutted as my mobility is proper affected and I've wasted the Easter holidays with my children. I have had 6 years previously to this, where you would not have known I had RA, it was so well controlled with meds (Sulfasalazine). It was Covid which seemed to have sparked off a flare up. Can I ask whether you have had Covid and what meds you are on? X

Knees are awful with RA flares.
Occasionally I have them drained when they flare, at other times cortisone injections work best.
I like Velcro ice packs , celecoxib, raising them. I don’t like heat at all, weirdly.

@Sparkalinda thank you, I feel the same about struggling through the holidays. Yes I had covid in Feb and my 4th jab in March.

The rheumatology nurses have referred me for an injection into the joint but it’s a 2-4 week wait and I don’t have a date yet. It’s still very swollen and painful but is the only joint affected at the moment.

[quote Number109]@Sparkalinda thank you, I feel the same about struggling through the holidays. Yes I had covid in Feb and my 4th jab in March.

The rheumatology nurses have referred me for an injection into the joint but it’s a 2-4 week wait and I don’t have a date yet. It’s still very swollen and painful but is the only joint affected at the moment.[/quote]
I think it has been Covid which has set you off! I was the same, Covid in Feb and started having problems in March- i feel in exactly the same boat as you, but frustratingly enough, the steroid hasn't worked for me! I too, normally have a steroid injection and aspiration if I flare, but it doesn't seem have worked the same way this time, which im so upset about. I then had a steroid in my bum, which helped, but like you, when I try to return to normal and walk abit, the knee flares again! I cant offer any advice im.sorry, as I'm.no further forward, but just wanted to say, dont feel alone! I'm going through it also, best of luck to you, let me know how it works out for you xx