You’re in a Flare. Here’s What to Know and What to Do Next.
Cristina Chandler, APRN-CNP
May 27, 2026
What Are the Signs That It’s an Autoimmune Flare?
Living with an autoimmune condition means learning to read your body like a language only you fully understand. Flares, those unexpected periods when symptom activity intensifies, are one of the most challenging parts of life with an autoimmune condition(s). Whether you have multiple sclerosis, rheumatoid arthritis, or one of the other conditions we treat at AndHealth, this guide is here to help you recognize what’s happening, take care of yourself, and know when to reach out to your care team.
A flare is a temporary worsening of your symptoms, often tied to increased inflammation or immune activity. While every person’s experience is unique, here are the most common flare symptoms by condition.
| Condition | Common Flare Symptoms | |
| Multiple Sclerosis (MS) | Sudden worsening of existing symptoms (vision changes, weakness, numbness or tingling), extreme fatigue, balance and coordination problems, cognitive fog, bladder or bowel changes. Your provider can help distinguish whether you may be in a new relapse, or whether prior symptoms are temporarily worsening due to heat, infection or fatigue. | |
| Ankylosing Spondylitis (AS) | Severe low back and spine pain, prolonged morning stiffness (often lasting more than an hour), hip and sacroiliac joint pain, deep fatigue, eye inflammation | |
| Rheumatoid Arthritis (RA) | Warm, swollen, and tender joints (especially hands, wrists, and feet), morning stiffness lasting more than one hour, fatigue, low-grade fever, decreased grip strength | |
| Psoriatic Arthritis (PsA) | Joint swelling and pain, worsening skin lesions, swollen fingers or toes, fatigue, tendon or ligament pain at attachment points, nail changes | |
| Psoriasis (PsO) | New or spreading plaques, intense itching or burning sensation, thicker and more scaly skin patches, skin cracking or bleeding | |
| Atopic Dermatitis (AD) | Intense itching (often worse at night), red and inflamed skin patches, oozing or crusting skin, skin thickening with repeated scratching, disrupted sleep | |
| Hidradenitis Suppurativa (HS) | New painful nodules or abscesses, increased swelling beneath the skin, drainage from existing lesions, worsening pain in the armpits, groin, buttocks, or under the breasts. Increased chronic drainage can occur with higher Hurley Staged HS. |
Are There Early Warning Signs Before a Flare?
Many patients report picking up on subtle signals one to two weeks before a full flare takes hold. Paying attention to these prodromal signs can help you get ahead of it.
Research on patient-reported experiences of flares found that for example, patients with RA often noticed increased fatigue, worsening pain, and a general sense that “something is off” before their flare was clinically measurable.¹ Other patients described feeling emotionally and physically “slowed down” in the period leading up to a full flare.²
Common early warning signs across autoimmune conditions include:
- Unusual fatigue not explained by activity level or sleep quality
- Increased muscle aching or joint stiffness, especially in the morning
- New or worsening skin sensitivity (for skin-related conditions)
- Sleep disruptions that feel different from your norm
- Heightened stress response or anxiety – research consistently shows that psychological stress can alter immune balance and precede flare activity³
- Low-grade feeling of illness sometimes described as feeling “pre-sick”
Starting a simple symptom journal, even just noting how you feel each morning on a 1–10 scale, can help you and your care team identify patterns over time.
6 Low-Cost Self Care Tips To Help During a Flare
Self-care during a flare doesn’t need to be complicated or confusing. Here are evidence-informed approaches that can help calm inflammation and support your body:
#1: Rest intentionally. Your body is working hard. Protecting your sleep and reducing unnecessary physical demands is not laziness; it’s medicine.
#2: Apply heat or cold. Warm compresses or heating pads can ease joint stiffness and muscle tension. Cold packs may help reduce acute swelling. Use whichever provides relief and follow your care team’s guidance.
#3: Focus on anti-inflammatory foods. A diet rich in omega-3 fatty acids (found in fatty fish, walnuts, and flaxseed), colorful vegetables, and whole grains has been shown to provide support in reducing inflammation.
#4: Gentle movement when possible. For many autoimmune conditions, rest doesn’t mean complete inactivity. Short, gentle walks or light stretching can support circulation and mood without stressing inflamed tissues. Always listen to your body and pause if symptoms worsen.
#5: Manage stress actively. A well-established body of research shows that psychological stress can trigger and worsen autoimmune flares by disrupting the balance between pro- and anti-inflammatory immune signals.³ Simple stress-reduction practices such as deep breathing, guided meditation, or even spending time in nature may help calm your nervous system.
#6: Stay hydrated and prioritize sleep. Both dehydration and poor sleep are associated with increased inflammation. Set a consistent sleep schedule and limit caffeine, especially in the afternoons and evenings during a flare.
How to Tell Friends and Family You Need Rest and Support During a Flare
Communicating your needs during a flare can feel vulnerable, especially when your condition is invisible to others. Here are some ways to open that conversation:
- Be direct but simple: “I’m in a flare right now. My condition is more active and I need to take things easy for a few days or weeks. I might need to cancel plans or ask for help.”
- Use an analogy: “Think of it like having the flu, but it comes from my immune system, not a virus. I need rest and low stimulation.”
- Tell them what you need specifically: Rest and quiet time, a meal dropped off, someone to cover a responsibility, or simply understanding if you cancel plans without much notice.
- Let them know it’s temporary: “I’ll reach out when I’m feeling better. I just need to focus on recovery right now.”
You don’t owe anyone a detailed medical explanation. Clarity and kindness to yourself and others go a long way.
When Should I Call My Doctor About a RA, AS, PsA, PsO, HS, AD or MS Flare?
Mild flares can often be managed with self-care and your current treatment plan. But there are times when reaching out to your care team is the right call. Contact your provider promptly if you experience:
- A high fever alongside your usual symptoms, especially if you are on immunosuppressive medication such as a biologic of DMARD – please contact us right away
- Symptoms that are new or significantly different from your usual flare pattern
- Rapid worsening over a short period of time (hours to days)
- Joint swelling that is severe or spreading to new areas
- Skin symptoms that are infected — signs include increased warmth, spreading redness, pus, or fever (particularly important for HS and AD)
- Neurological changes such as sudden vision loss, significant new weakness, or difficulty with speech or balance (particularly important for MS)
- Symptoms that don’t begin improving after 2–3 weeks of your usual flare management
When in doubt, call. A brief check-in with your care team is always better than waiting too long. If you are a multiple sclerosis patient, please contact your care team sooner than later, as earlier treatment can help you manage a possible relapse.
How Can I Keep My Spirits Up During an Autoimmune Flare?
Flares are not just physical; they take a real emotional toll. Fatigue, pain, and feeling limited can affect your mood and sense of self. Research on MS found that fatigue during a relapse was independently associated with depression, highlighting why emotional well-being deserves as much attention as physical symptoms.⁵
A few approaches that patients and researchers have found helpful:
- Connect with people who understand. Whether it’s a trusted friend, a family member, or an online community of others living with your condition, feeling seen matters.
- Focus on small wins. Getting dressed, eating well, or simply resting without guilt are real accomplishments during a flare.
- Protect one thing that brings you joy: a podcast you love, a TV series, a book, a gentle creative outlet. Pleasure and rest are not the same as wasted time.
- Practice self-compassion. Flares are not failures. They are part of living with a condition your body did not choose.
- Consider speaking with a therapist or counselor even for a few sessions during an acute period. Cognitive behavioral approaches have shown benefit for chronic illness coping.
Words of Wisdom From People Like You About Life with Autoimmune
How Can AndHealth Help Me Through a Flare?
At AndHealth, we specialize in exactly these moments. Our telehealth model means you don’t have to leave home (or the couch!) to connect with a specialist in rheumatology, dermatology, or neurology who understands what you’re going through.
Your AndHealth care team can:
- Assess whether your current treatment plan needs adjustment based on your flare severity
- Prescribe short-term therapies to help reduce inflammation or manage pain
- Monitor your labs and disease activity remotely so you don’t fall through the cracks
- Connect you with care coordinators who can help you navigate insurance, medications, and follow-up
- Provide the ongoing, relationship-based care that helps you recognize patterns and prevent future flares from escalating
Flares are not something you should manage alone. You have a team, and we’re here whenever you need us.
About the Author
Cristina Chandler, APRN-CNP, is an integrative medicine nurse practitioner with expertise in chronic and autoimmune conditions such as rheumatoid arthritis, psoriasis, and multiple sclerosis. Prior to AndHealth, she spent time in medical and ICU units.
She holds a Master of Science in Nursing from The University of Cincinnati, a Bachelor of Science in Nursing from Mt. Carmel College of Nursing in Columbus Ohio, and completed additional coursework in integrative medicine through George Washington University.
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