A flare-up, often referred to as a “flare,” is a sudden, severe onset of symptoms. As example, you've been managing well, your symptoms have lessened and, having momentarily forgotten the pain and dryness, you've been living 'full out' as you used to. Then, suddenly, those angry symptoms are back!
Joint pain is one of the most common symptoms of Sjögren's disease. Multiple joints are painful, usually episodically with periods of joint pain, known as “flares”, followed by periods of little or no joint pain. Tenderness and swelling of the joints, when present, are indicative of inflammatory arthritis.
Both heat and cool packs can help relieve muscle and joint pain associated with Sjögren's. Use heat for joint stiffness and to relax muscles. And use cold packs to help reduce inflammation/swelling on sore joints and muscles.
A flare can last for hours, days, weeks, or months.
Dry mouth.
There may be times when your symptoms get worse (flare-ups) and times when they're better (remission). It's not known exactly why this happens, but it's thought that certain things, such as overdoing it and not resting enough, may trigger your symptoms or make them worse.
Nipocalimab is the first and only investigational therapy granted U.S. FDA breakthrough therapy designation for the treatment of adults living with moderate-to-severe Sjögren's disease [news release]. Johnson & Johnson. 2024 Nov 11.
The main chronic complications of the disease derive from prolonged periods of hydration problems affecting the main mucous membranes. This leads to many symptoms that become chronic, including itchy eyes, a dry mouth, dry cough, or tiredness and chronic pain.
Tips for Managing an Arthritis Flare
Fried foods, such as french fries and fried chicken, are high in fat and can be difficult to digest, making them problematic food for people with Sjogren's syndrome. Studies in animals showed that high-fat foods will cause worsening the symptoms like dry eyes and dry mouth by causing changes in the gut microbiota.
It has been reported that more than 400 drugs can exacerbate the dryness symptoms of Sjögren's syndrome, including antihypertensives, diuretics, antidepressants, antiparkinson drugs, antipsychotics, antihistamines, centrally acting analgesics, and anticholinergics [6], [13], [14], [15].
Clinical History
Dryness of the eyes (xerophthalmia) and mouth (xerostomia) almost always occurs in patients with Sjögren syndrome, though symptom severity ranges from very mild to debilitating.
Some people with Sjogren's syndrome also have one or more of the following:
Doctors typically use steroids to treat flare-ups, when symptoms such as joint pain and rashes come on suddenly. Steroids such as prednisone or methylprednisolone are taken by mouth, and your doctor determines the dosage based on the severity of your symptoms.
CNS or Central Nervous System Complications of Sjögren's Disease. Patients with Sjögren's disease may have “myelitis,” which is inflammation of the spinal cord. Myelitis can cause weakness, numbness, and difficulty with urination and/or defecation.
Many of the autoimmune diseases that overlap with Sjögren's can cause the same symptoms. For example, overlapping diseases like lupus and rheumatoid arthritis can also cause fatigue or joint pain — symptoms that are common in Sjögren's. These similarities can make it challenging to diagnose overlapping diseases.
It is useful to identify how a flare up affects you personally. The earlier you can identify the signs the earlier you can take action to minimise its impact upon yourself. Common early warning signs are increased stiffness, poor quality of sleep, trouble concentrating or increased irritability.
Go slowly.
Exercise with slow and easy movements. If you feel pain, take a break. Sharp pain and pain that's worse than the usual joint pain might mean something is wrong. Slow down if you see swelling or redness in your joints.
In this test, the second through fourth metacarpophalangeal joints (see image, lower left) or the metatarsophalangeal joints (see image, lower right) are squeezed together to test for tenderness. A positive result raises the question of an inflammatory arthritis such as rheumatoid arthritis.
You might think of dry eyes or a parched mouth, but there are other subtle signs of Sjogren's disease (formerly syndrome) you may be ignoring. A hoarse voice. Itchy eyes. Wanting to crawl back into bed in the morning because you're still tired.
A flare-up, often referred to as a “flare,” is a sudden, severe onset of symptoms. As example, you've been managing well, your symptoms have lessened and, having momentarily forgotten the pain and dryness, you've been living 'full out' as you used to. Then, suddenly, those angry symptoms are back!
Sjögren syndrome is a chronic systemic rheumatic disease that is characterized by excessive dryness of the eyes, mouth, and other mucous membranes. White blood cells damage glands that make moisture, and sometimes other organs can be damaged. Dry mouth and dry eyes are the hallmark symptoms of this syndrome.
Nuts, leafy greens, fatty fish, avocados, olive oil, whole grains, and foods prepared with turmeric, garlic, or ginger have proven to benefit some individuals. To alleviate symptoms, some patients avoid red meat, alcohol, smoking, processed or fried foods, and refined grains as well as safflower, corn, and canola oils.
Nipocalimab is the only investigational treatment to be granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) for SjD (November 2024). It also received Fast Track Designation by the U.S. FDA earlier this year in April 2025.
Immunosuppressant drugs: These are stronger than Plaquenil and actually decrease (or suppress) immune system activity rather than just calm it down. These medicines are called immunosuppressants. They include methotrexate, mycophenolate mofetil, azathioprine, and cyclophosphamide.