Triggers for Rheumatoid Arthritis Flares

From everydayhealth.com

People with rheumatoid arthritis (RA) often cycle between times when their symptoms are relatively well controlled and when pain, stiffness, swelling, and fatigue suddenly worsen. These episodes, known as flares, can last for days or weeks and may interfere with daily life.

While flares can seemingly come out of nowhere, certain factors may increase the likelihood of symptoms worsening. Identifying your personal triggers may help you avoid them, or at least reduce their frequency, severity, or duration.

Common Triggers to Look Out For

The exact cause of an RA flare isn't always clear. Over time, many people with RA notice that certain circumstances tend to precede a flare. Although triggers differ from one person to the next, experts have identified many common culprits.

Environmental Triggers

“One of the most common questions I get from patients with rheumatoid arthritis is whether certain environmental factors can trigger their symptoms,” says Priyanka Dongare, MD, a fellow in Stony Brook Medicine’s Division of Rheumatology in New York. “While environmental triggers don’t cause RA flares in every patient, many people notice patterns.” These triggers include:

• Weather Changes “Cold weather and sudden weather changes are probably the most frequently reported triggers,” says Dr. Dongare. But the weather may not have as much of an impact as patients may think. A meta-analysis found only that weather’s impact on RA symptoms appears to be minimal.
• Air Pollution Higher levels of air pollution have been linked to an increased risk of RA flares. One study found that exposure to pollutants including PM2.5, PM10, nitrogen dioxide, and ozone was associated with greater disease activity and higher levels of inflammation.
• Occupational Exposures Dust, fumes, and chemical irritants may aggravate symptoms in some people with RA. But most research has examined these exposures as risk factors for developing RA rather than triggers for flares.
• Cigarette Smoke and Secondhand Smoke Tobacco smoke causes whole-body inflammation, one of the main triggers for arthritis. “Multiple studies have demonstrated that smoking not only increases the risk of developing RA, particularly seropositive RA, but can also worsen disease activity and reduce response to treatment,” says Dr. Dongare. 

Physiological Triggers

Changes in the body, some of which you can manage through lifestyle modifications, can affect inflammation and increase your risk of a flare.

• Sleep Deprivation “Poor sleep is one of the most common triggers I see in clinical practice,” says Dr. Dongare. Research has shown that inadequate or disrupted sleep can increase inflammatory cytokines such as IL-6 and TNF-alpha, which are key drivers of RA inflammation. “Patients often say that after several nights of poor sleep, they experience increased pain, stiffness, and fatigue.”
• Physical Overexertion There’s a fine line between exercise and overdoing it. While regular movement is recommended for people with RA, pushing your body too hard can temporarily increase joint pain, stiffness, and fatigue. Repetitive motions, heavy lifting, or unusually strenuous activity may aggravate already sensitive joints, making flare symptoms feel worse.
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• Hormonal Shifts Hormones help regulate immune function. Sharp drops in oestrogen, such as after childbirth, around menstruation, and during menopause, may increase disease activity and trigger flares.

• Inconsistent Medication Skipping doses, delaying refills, or stopping medication because you think you feel fine can increase the risk of a flare. Disease-modifying antirheumatic drugs (DMARDs) and biologics help keep the immune system's inflammatory activity under control, and can worsen symptoms if not taken as prescribed.
• Added Sugars and Ultra-Processed Foods Diets that include these foods may promote inflammation and worsen RA symptoms over time. These foods have been linked to immune dysregulation and increased inflammatory signalling, which may contribute to greater disease activity.

Emotional Triggers

The state of your mental health can also affect your RA symptoms. 

• Stress “While stress doesn't directly cause RA, it can amplify inflammation and make symptoms feel significantly worse,” says Dongare. One long-term study found that those with greater perceived stress had worse pain, greater fatigue, and lower physical function.
• Grief Research suggests that intense grief is associated with higher levels of inflammation, and experts note that the emotional strain of losing a loved one may increase disease activity and flares.
• Anxiety A systematic review found that about 1 in 5 people with RA experience clinically significant anxiety symptoms. Research has linked anxiety to greater pain, fatigue, and disease burden.
• Depression Depression and RA have a bidirectional relationship. One review found depression is associated with higher disease activity and worse treatment outcomes in inflammatory arthritis, suggesting that depressive symptoms can make flares more difficult to manage.

Track Your Triggers

Because RA affects everyone differently, tracking your triggers and symptoms can help you identify patterns that may otherwise go unnoticed. Dongare suggests keeping a symptom diary or using a smartphone app to track these variables:

• Pain levels
• Stiffness
• Fatigue
• Sleep quality
• Stress
• Diet
• Exercise
• Environmental concerns

“Tracking can also help rheumatologists distinguish between inflammatory disease activity and other contributors to pain such as osteoarthritis, fibromyalgia, sleep disorders, or mood disorders,” says Dongare.

Tracking is a tool, not a diagnosis. She cautions against assuming that every flare has a clear cause, since RA symptoms can naturally fluctuate. If you consistently notice the same pattern, though, you should discuss it with your rheumatologist.

How to Avoid Your Trigger(s)

While you can't prevent every RA flare, addressing common triggers may help reduce their frequency and severity. The key, says Dongare, is to focus on factors you can control.

• Prioritize sleep. Poor sleep can worsen inflammation, pain, and fatigue, so maintaining good sleep habits may help keep symptoms in check. 
• Manage stress. "Stress management should be part of every patient’s treatment plan,” says Dongare. Meditation, counselling, exercise, and strong social support systems can help reduce the physical toll of chronic stress.
• Stay physically active. “Many patients worry that exercise will worsen their arthritis, but the evidence consistently shows the opposite,” she says.
• Follow a healthy eating pattern. Dongare says maintaining a healthy weight and following a Mediterranean-style diet may support overall health and help reduce systemic inflammation.
• Quit smoking. It’s not good for any part of your body — joints or otherwise.
• Take medications as prescribed. Skipping doses or stopping treatment can increase the risk of disease activity and flares.

“Avoiding triggers can help manage symptoms, but controlling the underlying inflammation with appropriate medical treatment remains the foundation of RA care,” she says. Keep up with regular rheumatology appointments and talk with your healthcare provider before making changes to your treatment plan.

Questions to Ask Your Doctor

If you notice possible RA flare triggers, share them with your healthcare professional. They can interpret symptoms, adjust treatment if needed, and keep your disease under control.

• What symptoms or patterns should I track to better identify my RA flares?
• Could my current medications or dosing schedule be adjusted to better prevent flares?
• Are there environmental or lifestyle triggers I should be most cautious about?
• How can I safely modify my diet, activity level, or daily routine without making my symptoms worse?
• Should I adjust or pre-plan treatment around known triggers like stress, illness, or travel?
• When should I contact you if I think I’m having a flare?

The Takeaway

• RA flares are periods of worsening pain, stiffness, swelling, and fatigue. While they can seem unpredictable, research suggests they’re often linked to environmental, physical, and emotional triggers that vary by person.
• Common triggers include weather changes, air pollution, smoking, workplace irritants, poor sleep, overexertion, hormonal shifts, missed medications, diet, and stress-related factors like anxiety or grief.
• Because triggers differ widely, tracking symptoms alongside daily habits can help identify personal patterns. Working with a healthcare provider can help confirm flare patterns and guide more effective treatment.

 https://www.everydayhealth.com/rheumatic-conditions/triggers-for-rheumatoid-arthritis-flares/

Causes of Hands and Fingers Locking Up

From verywellhealth.com

Along with ways to relieve stiff, immobile joints 

Hands locking up can be a symptom of various medical conditions, or occur as a side effect of anxiety. Common causes of hands locking up include rheumatoid arthritis, osteoarthritis, carpal tunnel syndrome, Dupuytren's contracture, and trigger finger. These conditions can also cause pain, swelling, and difficulty with daily tasks.

This article discusses hands locking up—potential causes, related symptoms, what to do about it, and when to seek medical attention.

Pekic / Getty Images

Why Are My Hands Locking Up?

Hands locking up can occur with several different medical conditions or be related to anxiety. Sometimes, hand cramps can occur from low levels of magnesium or calcium.

Here are some common causes of hands locking up.

Rheumatoid Arthritis

Rheumatoid arthritis is a condition that occurs when the body mistakenly identifies its own structures as foreign and launches an attack. This condition affects joints throughout the body and can cause symmetrical symptoms as it develops, meaning it may affect both hands at the same time.

Other symptoms of rheumatoid arthritis include:

             Joint pain

• Swelling in and around joints
• Stiffness
• Fever
• Weight loss
• Decreased energy
• Weakness

Osteoarthritis

Osteoarthritis is a condition that occurs when cartilage that provides padding between bones in a joint begins to break down. Over time, the bones can rub against each other, causing significant pain. Joints in the hand are often affected by osteoarthritis, causing them to lock up.

Osteoarthritis is not a condition that affects the whole body all at once, but it can occur in more than one joint at a time. If this is the cause of hands locking up, it often affects a specific joint in a specific finger.

Other symptoms of osteoarthritis can include:

• Joint swelling
• Decreased mobility in the affected joint
• Nodules (bumps) grow on affected finger joints

Anxiety

Anxiety and anxiety disorders can cause a variety of physical symptoms, including feeling like the hands are locking up. This can occur during a panic attack, along with other symptoms, such as:

• Chest pain or tightness
• Restlessness
• Fatigue
• Mood swings
• Difficulty paying attention
• Headaches
• Body aches and/or pains
• Difficulty sleeping or sleeping too much
• Excessive worrying
• Upset stomach
• Sweating
• Trembling hands

Dupuytren's Contracture

Dupuytren's contracture (also called Dupuytren's disease) is a hereditary condition that causes hands to lock up. This condition causes the fascia in the palm of the hand to progressively thicken and shorten.

The condition begins with nodules that form in the palm. Over time, the fingers can be drawn in toward the palm and become stuck in a bent position. Early on, nodules from Dupuytren's disease can be tender to the touch. However, this pain typically goes away with time.

Carpal Tunnel Syndrome

Carpal tunnel syndrome develops from compression of the median nerve in the wrist. In addition to hands locking up, this condition often causes pain, and numbness/tingling in the area of the hand that is supplied by this nerve—the thumb, index finger, middle finger, and half of the ring finger.

Trigger Finger

Trigger finger is a condition that affects the flexor tendons that bend the fingers. These tendons travel through tendon sheaths—tunnels that allow the tendons to glide smoothly as the fingers move. Tendon sheaths are held in place by structures called pulleys.

Trigger finger occurs when the tendon, sheath, or pulley becomes inflamed, causing the tendon to "catch" as the affected finger bends and straightens.

In severe cases, inflammation can cause the finger to lock up—either in a bent or straight position.

Other symptoms of trigger finger can include:

• Pain with use of the hand
• Tenderness in the palm at the base of the affected finger
• Swelling
• Decreased range of motion

Hand Locking and Related Symptoms

Depending on the underlying cause, locking of structures within the hand can occur with other symptoms, such as pain, swelling, decreased range of motion, and difficulty performing daily tasks.

What to Do About Hands Locking Up

Treatment for hands locking up depends on the underlying cause. However, gentle range of motion exercises can often be helpful. If exercises cause pain or make the locking up worse, stop them and consult a healthcare provider.

Follow these steps for tendon gliding exercises:

1. Begin with your fingers straight.
2. Bend the large knuckles, keeping the smaller knuckles straight.
3. Straighten your fingers.
4. Bend your large knuckles and middle knuckles until your fingertips touch your palm. Keep the smallest knuckles straight.
5. Straighten your fingers.
6. Bend the middle and smallest knuckles, keeping the large knuckles straight.
7. Straighten your fingers.
8. Make a full fist.
9. Straighten your fingers.
10. Repeat this sequence 10 times.

Additional treatments for locking hands can include moist heat or ice, splinting, stretching, strengthening exercises, and activity modification, depending on the underlying cause.

Getting a Referral for Hand and Finger Symptoms

It's important to identify the cause of fingers locking up to determine the best treatment. Consult your healthcare provider to discuss your symptoms. Blood tests and X-rays are often used to help diagnose conditions that can cause this symptom.

Your healthcare provider might also refer you to a specialist, such as a rheumatologist or orthopaedic surgeon, to assist with diagnosing and treating your condition. Rehabilitation with a certified hand therapist (CHT) is another common treatment for conditions that cause the hands to lock up. Find a hand therapy specialist using this online search link provided by the Hand Therapy Certification Commission.

Summary

Hands locking up can be a symptom of a variety of conditions, such as arthritis, carpal tunnel syndrome, Dupuytren's contracture, and trigger finger. It can also occur as a side effect of anxiety. Other symptoms can occur along with locking hands, such as pain, swelling, decreased range of motion, and difficulty performing daily tasks.

Blood tests and X-rays are often used to help diagnose the underlying cause of hands locking up. Treatment frequently includes range of motion exercises and activity modification. In severe cases, surgery might be required.

https://www.verywellhealth.com/hands-locking-up-8404569

How to Manage Anxiety When Living With Psoriatic Arthritis

From verywellhealth.com

Psoriatic arthritis (PsA) is a progressive, inflammatory condition that affects the joints and entheses (the tissues that connect tendons and ligaments to your bones). PsA is caused by an over-reactive immune system. It is associated with psoriasis and can be similar to rheumatoid arthritis.

About 1 in 3 people with PsA also have anxiety. This can be explained, at least in part, by the pain and sleep disruptions caused by PsA.If your anxiety is affecting your quality of life, reach out to your healthcare provider to talk about treatments that can help.

Here's a closer look at how anxiety is related to PsA, along with 12 tips to help manage it.

Elva Etienne / Getty Images

How Is Anxiety Related to PsA?

Anxiety is characterized by feelings of worry or fear. It's common for people with chronic illnesses to have anxiety; often, they worry about their symptoms getting worse. Anxiety becomes a vicious cycle for people with PsA because poor mental health can be associated with higher perceptions of pain and more stress, which can trigger painful PsA flares. It is important to make sure mental health is addressed alongside physical health when treating PsA.

12 Tips to Deal With Anxiety

These tips and tricks can help people with PsA manage their anxiety and improve their quality of life.

#1 Develop a Pain Management Plan

Pain is a significant issue for people living with PsA. But knowing you and your healthcare team have a plan in place to deal with it can help keep you from stressing about it. Treating PsA usually involves a combination of medication, physical activity, dietary changes, mental health support, and other therapies. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first line of treatment for pain, but if they don't work for you, your healthcare provider may recommend other medications, such as prescription-strength NSAIDs or a corticosteroid drug. 

#2 Practice Mindfulness and Relaxation Techniques

Techniques like meditation, deep breathing, and guided imagery can help with both anxiety and pain. Mindfulness-based stress reduction (MSBR) is a noted and effective form of meditation for arthritis. It involves being fully present in the moment and recognizing thoughts and feelings in a non-judgmental way.

#3 Make Sure You Get Quality Sleep

Sleep problems are common in those with PsA. And not getting enough sleep can cause anxiety or make it worse. Sleep medications, practicing good sleep habits, and relaxation techniques may help, but it’s also important to address any ongoing pain issues that could be contributing to your insomnia.

#4 Consider a Mental Health Specialist

A mental health specialist, such as a therapist, can teach you tools and techniques to manage your anxiety while providing emotional support and referring you for a medication evaluation, if necessary. Taking care of your mental health will not only improve your day-to-day life, it can also help ease your pain and other PsA symptoms.

#5 Seek Social Interaction

The combination of anxiety and physical pain from PsA can make you feel like staying home and not interacting with others. But isolating yourself can make your anxiety worse. Have a lunch date with a friend, schedule a weekly phone call, join a support group—anything to foster a sense of connection with others.

#6 Try Aromatherapy and Other Alternative Therapies

Alternative and complementary therapies for PsA have not been well-studied, so before you try any, talk with your healthcare provider first. That said, you may get some relief from both anxiety and pain by trying acupuncture, massage, or aromatherapy with essential oils. Scents used to treat anxiety and stress include rose, sweet orange, clary sage, and lavender.

#7 Exercise on a Regular Basis

Staying active offers many benefits for people living with PsA. For one thing, people with arthritis notice their joints stiffen up and muscles become weaker when they're inactive. And, of course, exercise is proven to help boost mood, and it can provide a social outlet, too. If you’re interested in starting a regular exercise program, talk with your healthcare provider about what activities are safe and most appropriate for you.

#8 Keep a Journal

Journaling has been found to have benefits for both physical and emotional health. Regularly writing down your thoughts and feelings can help reduce anxiety while also lowering blood pressure and improving immune system function.

#9 Avoid Unhealthy Coping Behaviours

Living with anxiety and chronic pain can be incredibly hard, but unhealthy coping behaviours will ultimately make things worse. These include isolating yourself, avoiding check-ups or not adhering to your treatment plan, abusing drugs or alcohol, and other risky behaviours. If you’re having a hard time coping, reach out to your healthcare provider or a trusted loved one for help. You don’t have to do this alone.

#10 Limit Alcohol and Caffeine

Alcohol has the potential to worsen PsA symptoms and inflammation, and heavy drinking is also linked to anxiety. Too much caffeine can also trigger anxiety. As with anything, moderation is important for both caffeine and alcohol.  

#11 Contemplate Getting a Pet

There are many ways a furry friend can help ease PsA-related anxiety. For example, pets help provide a distraction from pain, provide comfort and companionship, and can reduce feelings of isolation.

#12 Eat Nutritious Foods

While diet cannot cure PsA, certain foods can help improve your mood while reducing inflammation. These foods include fatty fish, nuts, olive oil, lean protein, and colourful vegetables. If you need some guidance, a dietitian can help put together a meal plan that best suits your needs.

Summary

PsA is a chronic condition that doesn’t just affect you physically, but also emotionally. Anxiety is common, but there are many ways to manage it, including exercise, seeking counselling or a support group, developing a pain management plan, and more.

A Word From Verywell

It's important not to overlook the mental health effects of a chronic illness like PsA. If you're struggling with anxiety, tell your healthcare provider. They can go over coping tools with you, and if necessary, connect you with a mental health professional.

FREQUENTLY ASKED QUESTIONS

• Does psoriatic arthritis affect you emotionally?

  Yes. One in 3 people living with PsA were found to have at least mild anxiety, and 1 in 5 reported at least mild depression.

• Does stress trigger psoriatic arthritis flare-ups?

  It can. Your body's stress response can cause your muscles to tense, increasing pain, and it can also trigger inflammation, which contributes to joint damage.

• Do people who live with psoriatic arthritis have a greater risk of having panic attacks?

  People living with PsA have a significant risk of having anxiety, which can potentially lead to panic attacks. Not everyone with anxiety will develop panic attacks, though. The good news is that both PsA and anxiety can be managed with proper treatment.

https://www.verywellhealth.com/psa-and-anxiety-5218914