Are Flares just a part of PsA?

I am fairly new to PsA, having been diagnosed almost a year ago. I am on Methatrexate, Humira, and low dose steroid. I have been doing really well for the last 7-8 weeks. The Humira finally kicked in after about 4 months and seemed to be really helping. Last Thursday, out of the blue, flare. Everything hurt - elbows, shoulder, knees, wrist. You get the picture. Seems like I flare up about every 2 months or so. My reumy puts me on steroid taper to try and break the flare. Is this the only treatment option when this happens? Trying to wait it out this time. I hate the way the steroids at high doses make me feel. Also is this normal and to be expected even when on Humira? I have just been approved for Remicade, but have been holding off because of it's side effects, going to an infusion, getting relief from Humira most of the time. Is there any way to stop the flares? Would I have them with the Remicade too? Are they just a part of PsA? I can't seem to identify and specific triggers to these flares. Thanks for any thoughts and guidance.

I've wondered why some people have flares. My flares, if you can call them that, aren't much to speak of. Here and there I'll get some stiffness in my fingers or pain in the tops of my feet, and my legs get itchy from the little bit of psoriasis that I still have. But the worst PsA symptoms--stiffness, fatigue, weakness and generalized pain have been gone for the almost 7 months I've been on Enbrel. I feel very fortunate about that because it seems it takes longer for a lot of people to get results or they need to switch biologics until something works.

I've wondered about a few things. Do you think some batches of the med aren't handled properly before or during shipment that they lose effectiveness? I've also wondered if the injection doesn't go into fat, is it less effective? I have thin legs, for instance, and was injecting into my upper thigh. It would always hurt and bleed. My nurse daughter told me when the injection is supposed to be in fat, there's an important reason for that....she explained it and said at the hospital they always give those types of injections into the stomach fat--not the thighs or arms. Our body chemistries probably have lots to do with how biologics work, too. I have noticed, and this was even before I went on Enbrel, that too many sweets/sugar would cause a flare. I can only imagine how very frustrating this must be when you're doing everything right! I was thinking, too, maybe because it took 4 months for Humira to work, your immune system is really fighting the Humira, and msybe it'll win if you give it a little more time. I know those extreme flares must be horrible, but hopefully they'll come less and less often and you'll feel confident the Humira is working well! Keeping my fingers crossed for you! Good luck--and I hope you're feeling better!

Thanks for sharing Grandma J, and the good wishes. I'm going to hang tough. I just wondered if the flares really truly went away, or just a part of life with PsA regardless of meds you are on. I was feeling really frustrated this morning when walking was such a chore. I'm going to keep at it and hope things calm down soon. Have a great day!

I think it depends on the person. Some people go into remission for years with the meds, some experience a reduction in the severity of flares but no real remission.

I've had times where walking, or writing, or really any moving because of my hip (very bad days, only a few), were almost impossible. With the meds, I'm having way less of those times. I'm also stronger- I've learned exercises in PT that have strengthened the muscles supporting my hip so the SI joint isn't hanging out all alone with no support (I was a super skinny person until prednisone) and my hands are stronger and more dextrous from the OT exercises. Also, I've got sort of a groove to get into depending on what hurts- major SI joint pain means big moist heat heating pad + maybe extra Tylenol + certain stretches + I don't get much school work done that day. It starts to get sort of simple after a while. It's hard to deal with big flares, though- go easy on yourself, even with exercise (meaning do strategic exercise instead of like, starting out with competitive weight lifting or something), and get some scented bath salts, for heaven's sake. :)