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Every day with rheumatoid arthritis (RA) can be tough, but it is even more challenging when you are going through a flare-up.

Over the last 20 years, I’ve managed to find a few things that help during these periods of more severe symptoms. From lifestyle changes to how I eat or move, these strategies have been life changing for me.

Some of these I use on a day-to-day basis to manage pain, but I really lean into each of these during those rough flare-ups that anyone with RA is familiar with.

The simplest, most useful thing to do during an RA flare is to start the morning with soothing heat.

If I immediately plug in a moist heating pad or microwaveable heating pad and put that on my problem joints, it soothes everything and lessens the painful aching. I try to do about 20 to 30 minutes of heat first thing in the morning.

I love coffee, but if I increase my green tea drinking during a flare, it makes my body feel so much better.

Green tea has many health benefits in general, but it has been a helpful tool for me over the last 15 years or so. For me, it seems to help with inflammation, fatigue, and overall mood during a flare. Research backs this up.

Every day, I make a big smoothie jam-packed with anti-inflammatory goodies. During a flare, I will make two smoothies per day — one for breakfast, and then one later in the day for a snack.

I usually do an almond milk base so it is dairy-free, then pack it with lemon, lemon rinds, bananas, pineapple, collagen, superfood greens, and some plant-based protein. (During a flare, I follow this recipe.)

When I am in the middle of an arthritic flare, the worst thing I can do is stay sedentary.

When I was a little kid with RA, I didn’t understand this concept. I would always sit on the couch during the flare, and it would make me so stiff and even more restless.

Now, I know the importance of staying active despite the pain.

I keep movements gentle during a flare, starting the morning with some gentle stretching, then get outside if the weather is good for a nice, slow walk. I always feel better when I’m done.

Another go-to exercise is Pilates. This has been the most beneficial, gentle strength training exercise I have done over the years. I feel great after I finish a Pilates class, even during a flare.

The key is to keep things gentle and low impact.

Most of us with RA have learned to manage our diet all the time to keep the condition more manageable.

When I am going through a flare, I really simplify to avoid any additional inflammation. For me, this means keeping my diet dairy-free, gluten-free, and full of fruits and veggies. Also, eating whole foods with antioxidant properties has been shown to reduce inflammation.

During a flare, my go-to dinner is always rice, roasted asparagus, and salmon with lemon on top. I will eat this every night!

I avoid added sugar completely during a flare because it always increases my joint pain.

Stress is one of my top RA triggers. Anytime I have a stressful week, I almost always have a little flare at the end.

During a flare, I try to do all the little things I love that also eliminate stress. Some of my favorite stress-relieving activities are sitting outside in nature, watching movies with my daughter, sitting on the porch swing listening to the sounds outside, reading in the quiet each morning, and maybe even going for a massage.

Anything that eliminates stress for you is important to do during a flare.

I never realized the importance of foam rolling for joint pain until I had knee surgery last year.

Before then, I had foam rolled occasionally or during physical therapy treatments, but not all the time. This is now something I do twice a day to help joint pain.

During a flare, I will even increase the frequency to three times a day, and do more specific foam rolling for my joints.

You can foam roll almost any muscle in your body. I focus on my arms, all the muscles around the knees, and my upper back. You should talk with your doctor or physical therapist to learn the best foam rolling moves for your problem areas.

The last tip I rely on for getting through an RA flare is my transcutaneous electrical nerve stimulation (TENS) machine.

At the end of the day, I will hook it up to my knee and do a 20-minute session. This helps dulls the pain and allows me to sleep better.

I use a TENS machine all the time, but during a flare I make sure to use it longer each night. It has made a huge difference for my pain!

Alexis Rochester is an investigative chemist, blogger, and founder of Chemistry Cachet. She shares science-based skin care, cleaning, gardening, and health tips. She was diagnosed with RA at age 10, so she has a passion for pain management tips and research, along with sharing her journey through this disease. She lives in Texas with her daughter, husband, and bulldog. You can find her posting pictures and fun stories daily on Instagram. Also look for Chemistry Cachet on Facebook, Pinterest, Twitter, and LinkedIn.