Rheumatoid arthritis is an autoimmune condition that causes joint pain, inflammation, stiffness, and fatigue. Women are three times as likely as men to suffer from the disease. Even though RA is a long-term condition, short-term bouts, or flares, of acute pain with inflammation and swelling can occur.

During a flare, your arthritis is at a high level of activity. White blood cells enter into the joint causing cartilage damage and the synovial lining to grow into areas where it shouldn’t be. Eventually, your joints—and even your organs—can be permanently damaged.

Currently doctors aren’t quite sure why flares occur. Some suspected causes include stress, certain foods, an infection, and even the weather. Flare triggers differ from person to person, and so do the remedies. Here are three ways to cope when your arthritis flares up.

Plan in Advance
It’s better to have a plan in place than to figure out how to cope when you’re in the middle of a flare. From the time you’re diagnosed, you should consult with your doctor about how to alter your medication during these painful periods. Learn about safe ways to increase your current medication, or whether other medications would be more effective during a flare.

One such drug is etanercept (Enbrel ®). In a study reported in the British Journal of Medicine 88 patients were treated with this drug. In the year prior to etanercept treatment 80 patients experienced a total of 214 flares. Eight had no flares. During the first year of receiving etanercept only 50 patients had flares and the number of flares decreased to 83. Thirty-eight patients had no flares.

Knowing how to alter your meds shouldn’t be the only part of your plan, however. You’ll need to alert your family about the need to pitch in more when you’re having a flare. Talk to your supervisor or manager about needing time off from work, or taking work home. Also, if stress usually triggers your flares, figure out ways to reduce it during these periods.

Get Hot or Cold Relief
Heat or cold treatments can reduce acute pain and swelling during a flare. According to the University of Washington Orthopaedic & Sports Medicine (UW Medicine), cold packs numb the sore area, and heat treatments can relax your muscles. Heat is also soothing. However, hot treatments can worsen inflammation, so choose your remedy with care.

Dry heat treatments include a heating pad, heat lamp, or electric blanket. Wet heat treatments can be a soak in a tub, hot tub, or Jacuzzi, and paraffin baths. For cold treatments use ice packs or bags of veggies wrapped in towels to protect your skin. You can combine hot and cold treatments, such as contrast showers: stand under hot water for five minutes then switch to cold water for the same amount of time, and end with another warm shower.

Caution: UW Medicine recommends not using excessive heat or cold, and checking the area afterwards to ensure there’s no swelling or discoloration. If you have any circulatory problems, diabetes, broken or irritated skin, avoid hot and cold treatments.

Eliminate Trigger Foods
Many autoimmune disorders are connected to food allergies, and oftentimes, individuals experience flare-ups after eating certain foods.

As time goes on, you’ll figure out whether a particular food sends your arthritis into overdrive. Some common foods that trigger flares include dairy and wheat products, eggs, meat, citrus fruits, tomatoes, peanuts, coffee, and alcohol.