Frequently asked questions

The symptoms of inflammatory arthritis vary greatly. A "flare" is when your symptoms are at their worst. Here are a few examples of what a flare might cause.

• Increase of swelling/stiffness in the joints.
• Worsening of pain in joints.
• Increased tiredness.
• Night sweats.
• Fever.
• Weight loss

Flares are unpredictable and can last for hours days or weeks. They can have triggers such as infections or stress, but sometimes  here might not be any reason.

More information about flares

Rest the affected joint. In most cases cold packs or ice can ease the symptoms. In some cases, hot packs are more soothing, however, if your joints are already warm and swollen this might increase the pain. 

Use maximum doses of pain relief (such as paracetamol) and anti inflammatory if prescribed. If there is no benefit from this then speak to your GP or pharmacist about a possible change. 

If you have a TENS then use this. 

If your symptoms do not improve within five days, contact the rheumatology advice on 01592 648065 or contact your GP.

More information about managing your flares

Find more specific information on blood tests for each drug.

Sulfasalazine: reduce your dose to what is was the previous week and remain on this dose for an extra week before trying to ncrease the dose again.

Methotrexate: try splitting your dose so you still take all the tablets within a 24 hour period. Alternatively, you could ask your GP to give you anti nausea tablets or you could contact us to discuss the possibility of changing from tablets to a Methotrexate injection.

Leflunomide: Ask your GP to reduce to dose to 10mg daily. If you are already taking 10mg daily please contact our Rheumatology advice line on 01592 648065

If you are self injecting your medication, make sure the injection site is rotated and use a moisturising cream to relief itchiness. If you had an infusion (drip) in hospital please inform us.

If you are taking tablets and have developed a rash, see you GP first to discuss whether this could be due to your medication. If your GP advices you to stop your medication, please inform us on the advice line on 01592 2648065

Leflunomide: ask your GP to reduce your dose to 10 mg daily. If the diarrhoea persists or you are taking any other type of medication then please inform us to discuss alternative treatment.

For a simple infection (e.g. treated with oral antibiotics and improving) you do not usually need to stop your arthritis medication unless you are treated with biologic drugs.

For moreserious infection - requiring hospitalisation/intravenous antibiotics - the following drugs should be temporarily discontinued until you recover from the infection:

• all biologic drugs
• Methotrexate
•  Leflunomide, 
• Azathioprine
• Mycophenolate
• Cyclosporin
• Tacrolimus

If infections develop frequently, please inform us so we can amend your medication. You must not take Methotrexate and Trimethoprim together.

Fatigue is unfortunately a very normal symptom of arthritis. Make sure you only carry out tasks which need to be done and take frequent breaks when carrying out these physical tasks. Ask members of your family to help!

More information about fatigue

You only need to take action if you have had skin contact with someone with shingles or chickenpox or someone in your household has it. If you develop a rash which is either chickenpox or shingles then see your GP and contact our Rheumatology Advice Line for advice about your medications.

In most cases, having arthritis does not mean you will not be able to have children. However, it is best to consult your doctor before getting pregnant as your condition may affect your pregnancy and your pregnancy may affect your arthritis. 

Often you will need to change your treatment plan while you are pregnant. Some of the drugs used on rheumatology can be harmful to a foetus, please discuss your drugs with a health care professional before you plan to conceive.

Find out more about arthritis, pregnancy and conception.

You do not need to continue taking folic acid if you have stopped taking Methotrexate.

Yes you can as long as there is no other medical reason.

If you are taking biologic medication then you are not able to have the shingles vaccine.

If you are taking any of the DMARDS Methotrexate, Sulfasalazine and Hydrochloroquine you can have the vaccine.

If you are on high dose steroids and or Leflunomide please ask the Rheumatology department for advice.

If you are taking any of the DMARDs Methotrexate, Sulfasalazine, Leflunomide and

Hydroxychloroquine then you can continue taking them.

If you are taking a biologic medication always stop your medication prior to surgery and for time after. Please contact the advice like for more guidance.

Read up to date advice

If you have been in contact with someone who has a positive covid test please do not attend the hospital for 10 days for any face to face appointments, procedures or medications. Please ring the appointments department who will rearrange your appointment for a different time.