This article appears in Fall Healthy Living 2019

For many rheumatoid arthritis patients, the changing seasons can affect the signs and symptoms of the disease, but arthritis flare-ups can be managed.

“While some patients clearly do have weather or seasonal triggers, this is not a given, and for many patients the seemingly random nature of their flares can be frustrating,” said Dr. Arthur M. Mandelin II, associate professor of medicine at Northwestern University’s Feinberg School of Medicine. “Most patients learn quite quickly whether they personally have a weather/seasonal trigger or not.”

“Colder temperatures and changes in barometric pressure may trigger worsening joint symptoms,” said Dr. Elena Myasoedova, a rheumatologist at the Mayo Clinic in Rochester, Minnesota. Usually these episodes are self-limiting, Myasoedova said, meaning they will resolve themselves without treatment.

Rheumatoid arthritis is the most common form of autoimmune arthritis and affects about 1.5 million Americans. This common chronic condition can significantly impact a person’s well-being and quality of life.

Ups and downs

Rheumatoid arthritis can be unpredictable, with good days when joints are feeling pretty pain-free to bad days when it’s hard to get out of bed. Symptoms differ from person to person, Mandelin said.

“In general flares involve increased pain and swelling in the same joints that the patient finds are usually the most troublesome anyway,” he said. “A more serious flare can also involve joints that had previously improved during the course of treatment.”

In addition to swelling and joint pain, a flare-up may also include feelings of fatigue, fever and loss of appetite.

Triggers vary

For some people the weather can cause a flare-up, for others stress can be a trigger, Mandelin said.

“Not taking medication as prescribed can cause a flare of your rheumatoid arthritis,” Myasoedova said. “A major stress physical or mental — such as surgery, infection or loss of a loved one — can trigger a flare-up. Generally, the flare is less likely if a patient is taking appropriate treatments.”

Dietary triggers are more rare.

“The frustrating thing with diet triggers is that they are personal to each patient if they happen at all, so there is no one single diet recommendation that works for everyone,” Mandelin said.

“Sometimes, rheumatoid arthritis can become more active without any apparent trigger, requiring change in medications,” Myasoedova said.

Finding relief

Work with your primary care provider or rheumatologist to create a plan of action to keep your symptoms in check, Myasoedova said. Be open about your symptoms, especially any changes.

“Keeping a diary of your flares and discussing them with your provider can be helpful. If you think you are in a flare of your rheumatoid arthritis and it is not responding to your usual treatment, contact your rheumatologist’s office to discuss your symptoms,” she said.

If possible, bank a few sick days so you can take time off from work to get relief when most needed.

“Frequent flare-ups can be a warning sign that the overall control of your disease isn’t what it should be,” Mandelin said. “Uncontrolled disease can cause more trouble than just flare-ups, so if your arthritis gets out of control often you should be asking your rheumatologist about stronger medication.”