Axial Spondyloarthritis Flares: What Triggers Them and Tips to Cope
If you have axial spondyloarthritis (AxSpA) or ankylosing spondylitis (AS), you know how painful a flare can be.
What exactly is an AxSpA flare? What can you do to take care of yourself when you have one?
What causes AxSpA flare-ups?
Doctors face a large challenge when it comes to diagnosing an AxSpA flare. Currently, there is no clear definition of what an AxSpA flare is.
This makes it very difficult for doctors to make sure that a patient gets the correct treatment. Doctors know that a flare is usually when a patient’s symptoms get worse in a short time.1
AxSpA can have many different symptoms. Because of this, doctors do not know what symptom needs to be worse for a flare diagnosis. Questions surrounding this include:
- Should there be multiple symptoms that increase?
- Should there be blood tests that show changes?
- Does there have to be a change that can be seen on x-rays, CTs or MRIs?
- How long should symptoms stay worse to define a flare?1
Doctors are currently researching the best definition of an AxSpA flare. In recent research, the main symptoms that seem to define an AxSpA flare are pain, immobility, fatigue, and emotional symptoms.1
Should I tell my doctor about flare pain?
If you are experiencing pain from an AxSpA flare, you should let your medical team know. They may have to adjust, change, or add medications to your routine.
Make sure you are taking your medications exactly as your medical team prescribes them. Taking more medication than prescribed can lead to dangerous side effects or complications. If you do not take enough, you may not get the relief you need.
If you feel like your dose is not strong enough or is too strong, you should tell your doctor so they can change your dose.2
What might help ease the pain?
Some patients find that heat or cold can help with their pain, including:
- Long, hot baths
- Moist heating pads
- Electric blankets
- Hot water bottles
- Ice packs (if you prefer cold)
Some people find relief in alternating heat and cold. Avoiding high-impact exercises like running during a flare may help prevent pain.2
How do I cope with joint stiffness and flare immobility?
Some patients notice that gentle stretching can help with immobility. It can be helpful to do your stretching after a hot bath or shower.
You should talk to your medical team about the best stretches for your needs. You may want to ask your doctor if yoga or tai chi would be appropriate or beneficial for your condition. If yoga is an option, you may want to consider a hot yoga class to get the doubled benefit of the heat and stretching.2,3
Coping with flare fatigue
Fatigue, or tiredness, is a real symptom of an AxSpA flare. Many people find that they must take frequent naps. If you are employed, consider talking to your employer about your condition and how fatigue impacts your work. They may be able to help you come up with a plan to take time off, work from home, or create a flexible schedule.3
Fatigue may also cause a feeling of loneliness. Make sure to reach out to your friends and family and let them know you are going through a flare of your symptoms. It is okay to reach out for help and ask people to check in on you.3
The emotional impact of an AxSpA flare
Many patients with AxSpA will experience emotional symptoms. These can include anxiety and depression. Make sure you let your health care team know you are experiencing emotional symptoms - they may recommend medications to help you.
You may also want to ask your care team about support groups. This will allow you to talk to other people who are experiencing the same symptoms as you. They also might be able to recommend a therapist who specializes in patients with AxSpA or similar conditions.2-4
Your care team should be able to support you
Part of having AxSpA is knowing that flares can and probably will happen. Many people find that it helps to be prepared for the symptoms that may occur.2
Some patients make playlists of their favorite music or have go-to “feel-good” movies that they watch when their emotional symptoms flare. Other people make plans with their friends and family for how they want to be supported.
Having a plan for an AxSpA flare can help reduce the burden of dealing with a flare when it happens.
You should talk to your health care team if you have any questions on how to handle your AxSpA flare. Your health care team knows your health and disease better than anyone (except you.) They should be able to help you find resources for your needs.
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