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Dealing with Flares

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If you have inflammatory arthritis, changes are very good that you’ll have flares. They might be rare or they might be frequent, but they are just part of the package deal that no one signed up for. 

Luckily there are some tools we can use to make flares suck less.

What is a Flare?

Before we get to some coping strategies, let’s first discuss what a flare is.

What we call a flare is a period of increased inflammation, when your arthritis is more active. A flare can last for days or weeks and may resolve on its own. If it just keeps on going, then we don’t usually call it a flare, it’s just the arthritis going out of control.

If you are in pain all the time and it is significantly impacting your ability to function, you need to be working with your health care team to try to get your arthritis under better control. It will take experimentation with different medication options, not ‘lifestyle management’ – aside from learning to cope as best as you can while you wait for the medication to be figured out.

Flares vs Daily Discomfort 

When the arthritis is well-controlled, we become good at pushing past our day-to-day discomforts. It might even feel odd to call our daily experience painful. The stiffness and the slight ache in the morning as joints get used to moving again is definitely uncomfortable, but we are so used to it that it’s weird to call it pain. 

Most of the time, this ability to push past the discomfort is a good thing. As we move in the morning the stiffness and ache improve. If we waited for that to spontaneously get better before we got out of bed… Well, we’d never get out of bed.

Mild flares can grow slowly. Maybe it takes just a little longer to limber up in the morning. Maybe the ache persists longer into the day. Maybe it doesn’t go away at all, but you’re still able to push past it. And maybe that is as far as the flare goes before you’re back to your usual and you’ve forgotten all about it. 

But when a big flare comes along, you cannot ignore it. You will not be able to do everything you are used to doing. The very first tool to manage during a big flare is to lower your expectations.

Lower Your Expectations

Lowering your expectations is a simple idea but it is often so hard for us. It’s hard not to feel guilt or shame, especially at our age. People expect someone in their 70s or 80s to have arthritis, not someone in their 20s or 30s.

But we have to acknowledge and let go of that guilt and shame and even the anger and lower our expectations all the same. In the middle of a big flare, you simply cannot do everything that you are used to doing. 

Adjust your Habits

Take a moment and list out all the habits that you currently have. Now is not the time to worry about habits you want to start, just think about what you currently do that helps you feel good and be healthy. 

These are going to be things to prioritize during your flare. Someone else can do the dishes but only you can move your body or phone a friend or go to bed at a decent hour.

Some habits you won’t have to change – like brushing your teeth. But others you’ll need to adjust. 

For example, if you have a habit of going for an afternoon walk, there is a good chance that a big flare will impact your walk. Here are some examples of ways you could adjust your habit:

  • Go for a shorter walk
  • Ride a bike, go for a swim, or do yoga
  • Do some simple stretches in bed
  • Sit outside to get some fresh air
  • Phone a friend or have them over for tea or an outdoor visit

I’m using physical activity as the example here because during a flare it is the first thing to go. We don’t want to move when moving hurts. Though we need to listen to our bodies and rest, we also need to move.

Mindfulness can help

During a flare, it is natural to want to distract yourself as much as possible from the pain. And don’t get me wrong, it can be a useful skill, but there is also a good argument for keeping awareness of your sensations. 

Keep (or develop) a habit of doing periodic body scans. You can use a guided meditation, which will start at your head and work your way down (or vice versa) and there are plenty of options in apps or online. You can also do this less formally, letting your attention drift as you pay attention to different areas of your body.

If you are currently in a flare, now may not be the time to start practicing this, especially if you don’t have a strong mindfulness practice. But let me tell you a story about how mindfulness can help even in the middle of a bad flare.

This sort of body mindfulness led me to an interesting discovery during my first really bad flare. Before this one, my flares would affect only one or two joints and were over within a couple of weeks. This one affected nearly every joint and didn’t start to improve until a few months after starting medication.

I was laying on the couch one day – where I spent most of my time during that flare, as even sitting upright hurt – and I realized that my muscles were sore. I scanned through my body and massaged the sore muscles. As I thought about it, I realized that my muscles were sore because I wasn’t using them enough. I thought about which muscles were the most sore and which exercise would use those muscles. I only did a couple of each so that it didn’t cause too much joint pain, but it was enough to ease the muscle ache.

Ask for help

This is a crucial step but how much help you need and how much help you can get are so widely variable. If you live with others, hopefully, they understand that there are times when you may not be able to do as much around the house. 

You can also consider getting someone to come in to help with tasks such as house cleaning. You can hire someone or ask a friend or family member to assist.

And finally, always remember that you have the option to reduce your standards a bit. If you go an extra couple of days between washing dishes or sweeping, it won’t be the end of the world. If you’re used to doing that every day, it will feel uncomfortable, but sometimes that is just what we have to do.

Easy to prep food for arthritis flares

Another way to get help is in meal prepping. Convenience foods have a bad rap for being unhealthy but there are plenty of great options that make it easier to put together a meal. The downside is that it can be more expensive, so you may need to watch your budget more closely.

Here are some great convenience foods that can help you eat well with less effort:

  • Frozen vegetables – most people don’t think of them as convenience foods because they are so commonplace. But how much easier does it get to have veggies? Just put some in a bowl with a tiny splash of water, cover the bowl and microwave for a couple of minutes. Done.
  • Salad kits
  • Microwavable rice cups
  • Canned tuna or salmon
  • Prepped veggies – your grocery store will likely have a variety of prepped vegetables from cubed squash to stirfry mix. You can even find frozen chopped onions now! Cruise the isles before your next flare so you’ll know what is available to you locally.
  • Consider delivered meal prep kits or take out – if this is going to be a major part of your strategy, you’ll want to plan ahead of time to ensure that you know what options will fuel you and leave you feeling good (or as good as you can feel during a flare)
  • Rotisserie chicken, pre-cooked chicken strips or shredded chicken

And, of course, there are plenty of meals and snacks that you may currently eat that are easy to prep:

  • Nuts
  • Fruit
  • Sandwiches or toast
  • Cheese
  • Yogurt
  • Eggs

These are just a few ideas to get your mind churning. Take a moment and make a list of all the meals and snacks you like to eat and rate each on a scale of 1-5 how much effort it takes to prepare. You might even consider making a list of your favourite easy meals and snacks and sticking it to the fridge. 

None of this applies only to flares

The strategies discussed here are not just applicable to when you have a flare. They are helpful whenever things are busy, stressful, or you’re going through major changes such as having a new baby at home. 

Any time when you are unable to do everything that you are used to doing, you can use some of these strategies. 

Chime in!

Let me know in the comments below: Which of these strategies do you think will be the most helpful for you? What strategies do you use that I didn’t include? I’d love to hear from you!

Until next time,

-Samantha.

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