How Long Does a Flare Last? 

Question: I was diagnosed with rheumatoid arthritis (RA) three months ago, so learning to recognize an arthritis flare is new to me. I realize the length of a flare can vary, but how long does a flare last for most people? Months? Years? 

Answer: People usually know a flare of an inflammatory disease like RA, psoriatic arthritis, or ankylosing spondylitis is getting under way when morning stiffness increases. That is, they wake up in the morning feeling their joints are stiffer than usual, and it takes longer until the joints loosen up sufficiently for daily activities. With bad flares, morning stiffness and fatigue may last all day and greatly interfere with people’s lives. To the question "how long does a flare last?" the answer is that they can persist for weeks or months unless there is a change in treatment. 

Usually your symptoms are reliable indicators of an arthritis flare, so it is important to keep tabs on them, as well as what you are doing to treat your arthritis. 

Changes in blood work may also indicate an increase in inflammation. For example, both the erythrocyte sedimentation (“sed”) rate and the blood level of C-reactive protein may rise. Although these test results don’t change only when there is an arthritis flare, they may provide supporting evidence of worsened disease activity. These numbers are helpful for your doctor to track improvement of the disease flare after treatment.  

It’s crucial to suppress inflammation during flares, especially so soon after your diagnosis, when initial damage to your joints can occur. How long it takes to suppress a flare depends on the medications you take. One strategy for severe flares is to control symptoms quickly with low-dose prednisone, which can improve symptoms within days, while simultaneously starting methotrexate and other medications designed to suppress disease activity within weeks or months. 

John H. Stone, MD, MPH 
Director, Clinical Rheumatology 
Massachusetts General Hospital 
Boston, Massachusetts