In Pain

Lupus is a chronic autoimmune disease where the immune system attacks healthy tissue. This causes inflammation throughout the body, which can lead to organ damage.

People with lupus often experience periods of remission, when their condition improves. But they can also experience periods where symptoms worsen. People with lupus and their doctors refer to these periods of worsening symptoms as lupus flare-ups.

What Are Lupus Flare-Ups?

Lupus flare-ups happen when the disease is at its most active. These flare-ups, or relapses, are unpredictable. Some people may experience flare-ups every few years. Others may have them with greater frequency.

Lupus flare-ups can occur at any time, and last anywhere from several days to a few weeks or more. They can vary in severity, ranging from mild to life-threatening.

Bouts of remission, when people with lupus don’t have any symptoms, are common following a flare-up. Unfortunately, we don’t know why this cycle of flare-up and remission occurs or why it is so unpredictable.

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How to Recognize Lupus Flare-Ups

Because lupus mimics so many diseases (such as fibromyalgia, rheumatoid arthritis, infection, and thyroid disease), it’s difficult to diagnose. As a result, it can be difficult to determine when you’re experiencing a flare-up.

Common symptoms of lupus flare-ups

During a flare-up, you may experience one or more of the following:

  • Extreme fatigue
  • Skin rashes
  • Fever
  • Joint pain or swelling
  • Chest pain
  • Hair loss
  • Weight fluctuation
  • Loss of appetite
  • Swelling of the hands or legs
  • Headaches
  • Light sensitivity
  • Sores/ulcers in the nose or mouth

Symptoms vary from person to person, as well as from flare-up to flare-up. One flare-up might result in joint pain, while the next might cause hair loss. A flare-up might be a mild rash one time and a severe rash in the next.

This variability is one of the many reasons why open communication with your doctor is so important. They can work with you to identify warning signs of oncoming flares based on bloodwork, physical exams, and your own symptom history.

It’s also a good idea to track your flare-ups so that you know what to look out for. The Lupus Foundation of America has a downloadable Lupus Flare Plan worksheet you can use as a guide.

What Causes Lupus Flare-Ups?

It’s unclear what causes lupus itself. Researchers believe it’s a combination of genetic and environmental factors. Those same environmental factors also cause lupus flare-ups.

Knowing what can cause flare-ups can make them easier to manage. And maybe even avoid them altogether. Some possible causes of lupus flare-ups include:

  • Stress
  • Exposure to any form of
    light
  • Cigarette smoke
  • Exhaustion
  • Injury or other physical stress (e.g. surgery, accidents)
  • Infections, colds, viruses
  • Alcohol

Other stressors that might not be as easily avoided are:

  • Certain medications (such as those that increase light sensitivity)
  • Menstruation

Check with your healthcare provider before beginning or discontinuing any medication or supplement. And be sure all doctors, nurses, or surgeons know you have lupus. This will help them when prescribing or giving medication.

Knowing what factors can lead to a lupus flare-up can help you better understand how to avoid them, or when to seek treatment when a flare-up occurs.

Treatment for Lupus Flare-Ups

Flare-ups are a sign that one or more of your organs may be inflamed. That’s why it’s critical to seek medical help as soon as possible. Prompt treatment of lupus flare-ups can reduce the potential of organ damage.

Lupus flare-ups can negatively impact your quality of life. Flare-ups can affect your ability to work, perform daily tasks, take part in your favorite activities, and more.

There is no cure for lupus, but treatments are available for managing its symptoms.

Treatment options for lupus flare-ups

Treatments for a lupus flare-up may include:

  • Corticosteroids
  • Anti-malarial drugs
  • Immunosuppressants
  • Biologics, a special kind of disease-modifying antirheumatic drug (DMARD)

It may be necessary to combine treatments to control lupus flare-ups and lessen the risk of organ damage. Your treatment plan may change depending on the severity and frequency of your flare-ups. It may also change as you move into remission.

Getting the right medical care can ensure a normal lifespan and vastly improve your quality of life.

When Flare-Ups Happen

Getting through a lupus flare-up can be challenging and frustrating. But there are things you can do to help make them more bearable.

  • Get plenty of rest. Fatigue is a trigger for lupus flare-ups. Pushing yourself too hard when what you really need is rest could aggravate your symptoms and make the flare-up last longer. Listen to what your body says it needs.
  • Prioritize your activities. When flare-ups will happen, it may be necessary to work around them. Do the important, urgent, or most enjoyable things now and save the rest for when your flare-up subsides.
  • Ask for help. You’ll be surprised at how willing people are to lend a helping hand if you ask. During a flare-up, delegate as many activities, projects, chores, or errands as you can to friends and family willing to help out.
  • Learn everything you can about lupus. This will help you better understand what triggers flare-ups, what do to when one happens, and how to manage them. Write down questions so you can discuss them with your doctor at your next visit. Your doctor can also direct you to trustworthy resources for more information.
  • Start a conversation. Talk to those close to you about lupus and share how they can best support you during a flare-up. It can be difficult for others to tell when you’re having a good day and when you’re struggling. People can’t help if they don’t know you’re struggling or what you need.
  • Reach out to others with lupus. You can find support groups online or in your community. Other people with lupus are a great support because they know what you’re going through. When you’re battling a lupus flare-up, it can be comforting to know that you’re not alone.

For more information or to make an appointment, contact the UPMC Lupus Center of Excellence at 412-586-3550.

Sources

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Lupus Foundation of America. Does Everyone With Lupus Go Into Remission? Link

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Lupus Foundation of America. What Happens If I Leave My Lupus Untreated? Link

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Quality of Life Research. Patient-Reported Flare Frequency is Associated with Diminished Quality of Life and Family Role Functioning in Systemic Lupus Erythematosus. Lupus Foundation of America. Link

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National Institute of Arthritis and Musculoskeletal and Skin Diseases. Systemic Lupus Erythematosus (Lupus). Link

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About Rheumatology

Chronic diseases of joints and other connective tissues can cause major problems in your everyday life. The UPMC Division of Rheumatology and Clinical Immunology can help ease or correct those problems. We diagnose and treat conditions of the joints, skin, and muscles that can cause pain, swelling, and stiffness. We design individual treatment plans based on your specific problems. We have specialized centers for rheumatoid arthritis, myositis, scleroderma, systemic lupus, and vasculitis.