Do you have ankylosing spondylitis (AS)? Sometimes, the pain in your back, hips, and body suddenly increases, making it difficult to get out of bed in the morning, and making it difficult to do anything. Doctors call this a 'flare-up', or an exacerbation of the disease. It's like a fire that has been extinguished and suddenly flares up again. Not everyone experiences this pain the same way. But only those who have experienced it know how difficult it can be.
What really happens during a 'flare-up'?
Simply put, a 'flare-up' is a period of time when your Ankylosing Spondylitis (AS) becomes temporarily more active. During this time, symptoms can become more severe. While some people may experience this discomfort throughout their body, others may experience increased pain in just one area, such as their back or hips.
Let's see what symptoms are commonly seen during this time.
| Symptom | Description |
|---|---|
| Severe pain | Severe pain, especially in the back, hips, and other joints. |
| Excessive fatigue/fatigue | Excessive fatigue and sleepiness even after doing nothing. |
| Difficulty moving the body | Difficulty bending and turning due to stiffness in the joints and spine. This condition is especially severe in the morning. |
| Mental changes | Frequent feelings of anger, frustration, and sometimes depression . |
| In addition, other symptoms that some people experience include: | |
| Other features | Feeling feverish, sweating, joint inflammation and warmth, and muscle spasms . |
Sometimes, before a flare-up, morning stiffness can be more severe than usual. It's like a warning sign.
Why is the disease suddenly escalating like this?
It's hard to pinpoint a single reason for this. There could be several factors at play.
- Increased inflammation: The main cause is a sudden increase in inflammation in the body, especially in the joints of the spine.
- Other infections or injuries: Another infection entering the body, or even a minor injury, can sometimes cause a flare-up.
- Not taking medication properly: This is a very important issue. If you do not take the medication prescribed by your doctor on time, or if you miss the dose, there is a high chance that this situation will occur.
- Excessive fatigue and stress: Imagine you were exhausted from a big party at home, or you lost sleep over a big project at the office. Some patients say that this condition can also be caused by stress and excessive fatigue .
- Weather changes: Some people find pain worse in cold weather.
- Change in treatment: Maybe the treatment you are currently taking is not the right fit for your body. That can also cause a flare-up.
But sometimes, depending on the nature of the disease, the difficulty can increase in this way without any particular reason.
How can you find comfort during this difficult time?
It's very difficult when a flare-up occurs, but there are a few things we can do to manage it.
- Medication: Medication may be needed to control pain.
- If you are already taking NSAID (Nonsteroidal Anti-inflammatory Drugs) painkillers, your doctor may advise you to temporarily increase the dosage.
- If you are taking a specific type of medicine called a biologic , your doctor may decide to change the dose of that medicine or switch you to a different medicine. Never change the dose of the medicine yourself.
- Rest and sleep: It is very important to give your body enough rest. Get a good night's sleep.
- Light exercise: You can reduce joint stiffness by doing things like slow, easy stretches, rather than strenuous exercise .
- Hot and cold therapy: Applying a hot water bottle or ice pack to the painful area can provide relief.
- Hot bath: Taking a hot bath can relax muscles and joints and reduce pain.
- Massage: Gentle massage can provide relief from muscle pain.
What can we do to prevent flare-ups?
Although it is not possible to completely stop flare-ups, you can try to reduce the frequency of them.
The most important thing is to talk to your rheumatologist and make a plan in advance for what to do if you have a flare-up. Ask him or her to clarify the following:
- Should I change my medication dosage during a flare-up? If so, what is the correct dosage to take?
- What is the maximum dose that can be taken per day?
- How long and how often can these medications be used?
Write these instructions down somewhere. Also, tell your doctor about all the medications you are taking (even over-the-counter painkillers).
When is it best to see a doctor?
While not every pain requires a trip to the doctor, sometimes it's essential to seek medical advice. Be sure to talk to your doctor if you have any of the following conditions:
| Status | What to do |
|---|---|
| If the pain does not subside after about 7 days of treatment according to your plan. | Call your doctor immediately and seek advice. |
| If the flare-up is much more severe than usual (e.g., unbearable back pain). | Call your doctor immediately. |
| If flare-ups occur more frequently or last longer than usual. | Inform your doctor about this at your next medical appointment. |
Take-Home Message
- Flare-ups are common in Ankylosing Spondylitis (AS), and the symptoms can vary from person to person.
- Things like overexertion, stress, and missing prescribed medications can trigger flare-ups.
- Talk to your doctor about how to manage a flare-up and make a plan in advance.
- If the pain is severe, does not improve within a few days, or flare-ups occur more frequently, do not hesitate to seek medical advice.
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