Lupus flare ups can be difficult to manage, but there are steps you can take to help reduce symptoms and get through a flare. In the opening paragraphs below, we’ll provide a quick overview of what lupus is, what causes flares, and general tips for managing flares when they occur.
What is Lupus?
Lupus is an autoimmune disease where the immune system attacks healthy cells and tissues, causing widespread inflammation and pain. There are several types of lupus, with systemic lupus erythematosus (SLE) being the most common. With SLE, nearly any part of the body can be affected including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.
What Causes a Lupus Flare Up?
A lupus flare refers to a period when lupus symptoms suddenly worsen or new symptoms emerge. Flares can range from mild to severe. Some potential triggers for lupus flares include:
- Stress
- Exposure to sunlight
- Pregnancy
- Hormonal changes
- Infections
- Medication changes
- Poor diet
- Fatigue
It’s not always possible to pinpoint what causes a flare, but minimizing exposure to known triggers can help reduce flare frequency and severity.
General Tips for Managing a Lupus Flare
When a lupus flare occurs, here are some general tips to help manage symptoms:
- Get extra rest and avoid overexertion.
- Use hot or cold compresses to ease pain and swelling.
- Take over-the-counter pain relievers as needed.
- Reduce stress and practice relaxation techniques.
- Eat an anti-inflammatory diet high in fruits, vegetables, and omega-3s.
- Stay hydrated and limit sunlight exposure.
- Seek emergency care if you have severe symptoms like chest pain, trouble breathing, or confusion.
While those tips can help in the moment, the rest of this article will provide more specific ways to fight back against a lupus flare based on your symptoms and the parts of the body involved.
Managing Joint Pain and Swelling Flares
Joint pain, swelling, and stiffness are some of the most common lupus flare symptoms. Here are some tips to reduce joint flare ups:
- Apply cold or hot compresses to painful joints for 15-20 minutes at a time.
- Wrap joints with an elastic bandage to provide compression and support.
- Get plenty of rest and avoid activities that aggravate joint pain.
- Take over-the-counter NSAIDs like ibuprofen to relieve pain and swelling.
- Follow a low-inflammation diet with lots of antioxidant-rich fruits and veggies.
- Do light range-of-motion exercises to maintain flexibility.
- Consider using assistive devices like crutches, canes, or splints to reduce joint strain.
- Explore supplements like fish oil, turmeric, and ginger to reduce inflammation.
- See a rheumatologist for steroid injections or prescription anti-inflammatory medications if OTC options insufficient.
- Discuss pain management options like physical therapy or acupuncture with your doctor.
Learning your limits and not overdoing activity when joints are inflamed can go a long way in managing pain during flares. Let pain be your guide, and don’t push yourself to do activities that exacerbate joint swelling.
Coping with Skin Rashes and Lesions
Skin issues like rashes, lesions, and mouth sores are common lupus symptoms that tend to flare periodically. Here are some tips for managing lupus-related skin problems:
- Avoid direct sunlight exposure which can worsen skin lesions – use sunscreen and protective clothing/hats.
- Apply cold compresses and topical creams like hydrocortisone to itchy rashes to reduce inflammation.
- Keep skin moisturized to reduce risk of cracks and lesions, but avoid very hot baths.
- Bandage any open sores and consider using antibiotic ointment to prevent infection.
- Manage mouth sores with saltwater rinses, anesthetic gels, soft foods, and avoidance of hot, spicy, or acidic foods.
- Ask your doctor about prescription steroid creams or antimalarial drugs for severe rashes.
- See a dermatologist if skin symptoms don’t improve with typical lupus treatments.
Be very gentle with your skin during flares and avoid picking at rashes or lesions to prevent infection. Keeping skin protected and moisturized can help reduce irritation.
Controlling Fatigue and Low Energy
Extreme fatigue and weakness are often debilitating symptoms of a lupus flare. Try these tips to boost your energy levels:
- Get adequate rest and take naps as needed to restore energy.
- Reduce activities and delegate tasks to others during flare ups.
- Exercise moderately when possible to increase stamina – try low-impact activities like walking, swimming or cycling.
- Eat energizing foods like lean proteins, nuts, beans, veggies, and whole grains.
- Reduce stress and get support from family and friends when energy is low.
- Ask your doctor about prescription stimulants if fatigue interferes with daily activities.
- Consider supplements like iron, B12, vitamin D, ginseng, and coQ10.
- Use assistive devices and arrange accommodations at school or work during flares.
Listen to your body, rest when needed, and don’t overexert yourself when energy levels are depleted. Prioritize necessary tasks and ask for help to avoid fatigue worsening your flare.
When to See Your Doctor
During a flare, call your doctor right away if you experience:
- Fever over 100 F
- Severe headache or confusion
- Vision problems or eye pain
- Chest pain or trouble breathing
- Dizziness or fainting
- Leg swelling or pain
- Difficulty moving limbs or numbness
- Blood in urine or stool
- Rapid weight gain or loss
Prompt medical care is needed for potentially serious issues like infections, blood clots, organ damage or stroke. For mild to moderate flares, make an appointment so your doctor can evaluate and adjust your treatment plan.
Medications for Managing Flares
Prescription medications can help reduce inflammation and pain during lupus flares. Common medications include:
| Medication | Uses | Side Effects |
|---|---|---|
| NSAIDs (ibuprofen, naproxen) | Reduce fever, pain, and inflammation | Stomach upset, bleeding, kidney damage |
| Corticosteroids | Strongly reduce inflammation and immunity | Bone loss, high blood sugar, mood changes |
| Antimalarials | Reduce skin rashes, fatigue, joint pain | Nausea, diarrhea, eye issues |
| Immunosuppressants | Reduce inflammation and immune system activity | Infections, nausea, liver damage, cancer |
| Biologics | Target specific parts of the immune system | Infections, injection reactions, headaches |
Stronger immune-suppressing drugs may be used for severe flares. Talk to your doctor about potential medication side effects and stay current on important health screening tests.
Lifestyle Changes to Reduce Flares
Making certain lifestyle adjustments can help minimize lupus flares in the long-run:
- Correct any vitamin deficiencies – especially vitamin D which can reduce flares.
- Quit smoking – smoking worsens lupus inflammation.
- Reduce stress – try meditation, yoga, or counseling to cope with stressors.
- Exercise regularly – low-impact activity helps reduce joint pain and fatigue.
- Get enough rest – aim for 8-9 hours per night and naps during flares.
- Eat a healthy diet – emphasize anti-inflammatory foods like produce, fish, nuts and olive oil.
- Avoid sun exposure – use sunscreen and protective clothing to prevent flares.
- Use assistive devices – tools like knee braces, grab bars, shower chairs and mobility aids can help conserve energy.
Making lifestyle changes can be challenging, so focus on one or two areas at a time. Even small steps towards better health can reduce your lupus symptoms over time.
Alternative and Natural Remedies for Lupus
Some people with lupus find relief from alternative remedies used alongside traditional treatment. Options may include:
- Fish oil – anti-inflammatory omega-3s may reduce joint swelling and pain.
- Probiotics – promote gut health and immune regulation.
- Acupuncture – may ease joint pain and fatigue.
- Massage – improves circulation and relaxes tense muscles.
- Chiropractic – spinal manipulation can relieve pain.
- Yoga/Tai Chi – combines meditation, deep breathing, and gentle movement.
- Turmeric – curcumin has antioxidant and anti-inflammatory effects.
- Ginger – may reduce nausea, pain, and inflammation.
Talk to your healthcare providers before trying alternative therapies to make sure they are safe and appropriate for your condition. Complementary remedies should not replace standard lupus treatment.
Emotional Support for Coping with Flares
In addition to physical symptoms, lupus flares can take a psychological toll. Seeking emotional support and practicing self-care can help you cope. Consider these tips:
- Join a lupus support group to connect with others facing the same challenges.
- Enlist family and friends to provide meals, rides, childcare or other assistance on bad days.
- Talk to a therapist or counselor for encouragement, coping strategies and problem-solving skills.
- Express your feelings creatively through journaling, art, or music therapy.
- Learn relaxation techniques like deep breathing, guided imagery, and positive visualization.
- Focus on what you can control and accept what you cannot change.
- Be patient, compassionate and forgiving with yourself on difficult days.
Managing the emotional side of lupus flares is just as important as managing the physical symptoms. Support from others and being kind to yourself can help you get through.
When to Go to the Emergency Room
Most lupus flares can be managed at home under a doctor’s supervision. But if you have any of the following severe symptoms, go to the emergency room or call 911 immediately:
- Chest pain or pressure
- Difficulty breathing
- Severe headache or dizziness
- Confusion or altered mental state
- Sudden blurry vision or vision loss
- Seizure
- Racing heartbeat or palpitations
- Fever over 104 F
- Severe abdominal pain
- Heavy bleeding or bruising
- Blood in urine or stool
- Sudden swelling in legs or feet
These symptoms may indicate a potentially life-threatening complication requiring emergency treatment. Call 911 or go to the ER right away if you have any concerning or severe symptoms, especially involving your heart, lungs or brain.
When to See Your Rheumatologist
It’s important to have regular follow-up care with your rheumatologist when living with lupus, even when your condition is stable. But be sure to call your doctor right away if you experience:
- Persistent fever over 100 F
- Sudden worsening of joint pain or swelling
- Increasing rashes, lesions or ulcers on skin
- Abnormal bruising or bleeding
- Mouth sores that prevent eating or drinking
- Increased fatigue, weakness or dizziness
- Chest pain with deep breathing
- Shortness of breath
- Headaches that won’t go away
- Vision changes or eye pain
- Confusion or memory loss
- New or worsening kidney problems like increased urination, foamy urine, or swelling
Prompt medical evaluation helps prevent complications and permanent organ damage. Your rheumatologist can assess your symptoms, adjust medications if needed, and provide guidance for managing the flare.
Conclusion
Lupus flares can be frustrating and difficult to cope with. The best strategy is to minimize known triggers, use medications as directed, and follow your rheumatologist’s advice for managing symptoms. Have a flare management plan in place so you can respond quickly at the first signs of a flare brewing. With the right treatments and lifestyle adjustments, many people with lupus can enjoy long periods of low disease activity without severe flares.
