Symptoms of rheumatoid arthritis (RA) can start suddenly and then go away. When your symptoms have been quiet for a while and then reappear or become worse, most people refer to it as an RA flare. One description of an RA flare is a worsening of signs and symptoms that are bad enough and last long enough to require a change in treatment. Signs of an RA Flare An RA flare can include any of the common symptoms or signs of RA such as: Joint pain and tenderness Joint swelling Increased joint stiffness Increased pain that interferes with sleep Increased fatigue Fever Signs and symptoms of a flare may also involve areas of your body beyond your joints, such as inflammation (swelling and irritation) of your eyes, salivary glands, blood vessels, heart, or lungs. Causes of Flares RA is an autoimmune disease. This means your body's immune system is misfiring. Normally your immune system attacks foreign invaders like viruses or bacteria, but in RA, the attacks are against your own tissues, sending out cells that cause inflammation to your joints and other areas of your body. These attacks are what cause a flare. What triggers a flare is not as clear. Some flares seem to be caused by emotional stress or by physical stress like an infection. One known trigger is childbirth—most women with RA will experience an RA flare about four to six weeks after giving birth. But in many cases, flares occur without any known triggers. Managing RA Flares If you have a flare of RA symptoms, let your rheumatologist know—you may need to have a change in treatment. These strategies can help you manage flares: Have a flare plan in place with your rheumatologist. Your doctor may want you to add or increase a medication any time you start to have flare symptoms. Have a contingency plan for work and home. For instance, plan ahead to have reduced hours and more help when you feel a flare of symptoms starting. Get more rest. Listen to your body and decrease your activity level as needed. Don't abandon exercise. Even though you may need more rest, try to keep active. Continue your exercise programs as best you can. Maintain a good nutrition plan. If there are certain foods that seem to trigger your symptoms, avoid them. Reduce stress. Try to find some relaxing activities or practice stress reduction techniques like deep breathing or meditation. A long warm bath may be soothing. Get some emotional support. Tell your friends and loved ones how you feel. Sharing your feelings at a support group is another good option. Don't smoke. Smoking has been shown to decrease the effectiveness of RA medications. Key Takeaways Rheumatoid arthritis flares are a normal and expected part of RA. Although physical and emotional stress may trigger flares, there is no way to predict or prevent them. Since flares are common, plan ahead and be prepared. Help manage flares by working with your rheumatologist, getting more rest, staying active, and getting support at home and at work.