Inflammatory arthritis

During a flare-up, you may find that you require more rest than usual, and you may want to take time off work if this is possible for you. Trying to push through fatigue and pain are likely to make these symptoms worse so taking a break can be a good idea to allow your body to recover. However, staying completely immobile can be counterproductive. While intense exercise is not recommended, light stretching, swimming or gentle strolls can help relieve pain and stiffness. You may also want to use your splints if you have them.

Heat - in the form of a hot shower or bath, or a hot water bottle - can help with joints that feel stiff and achy. In contrast, cold packs can help soothe hot and swollen joints. Alternating between hot and cold immersion - also known as contrast bathing/hydrotherapy - can also be beneficial.

Your GP is likely to have prescribed you painkillers to help control your joint pain - such as ibuprofen, naproxen or celecoxib. During a flare-up, you may need to take these regularly throughout the day (without exceeding the maximum daily dose detailed in your prescription).

Taking non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen with food or medication like lansoprazole or omeprazole can help protect your stomach from irritation. If you have been prescribed NSAID gel, apply this over the affected joints as per instructions. If you have not been prescribed painkillers, your GP can arrange this for you.

Your GP can prescribe a short course of steroids for you to help tackle your flare-up, either as tablets or injections. While long-term steroids can have serious side effects, using them as a short course during a flare-up can dramatically improve your symptoms. Your GP is welcome to contact the rheumatology service directly if they have any questions about steroid prescriptions.

Ask us for a Fatigue Management Pack. This pack has been created by the Rheumatology occupational therapists and contains useful resources for coping with fatigue.

The Arthritis UK helpline is free to call from the UK. They can provide you with not just information about your condition but also emotional support and help coping with symptoms such as fatigue and pain.

The National Rheumatoid Arthritis Association (NRAS) and the National Ankylosing Spondylitis Society (NASS) also have their own helplines - see resources below.

Your GP may want to test you for other conditions that may be contributing to your fatigue, such as anaemia or vitamin deficiencies.

Due to low staffing numbers, our review appointments are currently running behind schedule. This means that you are unfortunately unlikely to be reviewed by a consultant or specialist nurse at the time stated in your latest clinic letter. 

We understand it can be worrying if you have not received your appointment letter when expected. Please be reassured that you will automatically be allocated the earliest available appointment, and a letter will be sent to you as soon as this is arranged. Please note that unfortunately our secretaries are not able to bring your review appointment forward if you contact the service. We sincerely apologise if your review appointment is running late. 

If you start experiencing recurrent and prolonged flare-ups while waiting for an appointment, or if the pain, swelling or stiffness in your joints gradually gets worse, please get in touch with the rheumatology advice line. 

To manage your inflammatory arthritis, your consultant may prescribe you an injectable medication known as a biologic. These drugs are supplied by private companies and not by NHS pharmacies. On average, it may take up to 6-8 weeks for you to receive this medication once you have had your pre-screening done. It will be delivered to your home and a nurse employed by the company will come and show you how to administer the injection. 

Your consultant is likely to ask you to keep taking your current medication until you receive the biologic. This should be stated in the letter from the clinic at which the biologic was prescribed. If you are struggling with your symptoms while waiting for the new medication, your GP may be able to prescribe you a short course of steroids to help control your joints. Please contact your GP directly about this. 

We know waiting for new medication can feel frustrating, especially if your symptoms are difficult to manage. As biologics are supplied by private companies, unfortunately our secretarial team cannot speed up delivery. Thank you for your understanding!