Pam, the word flare means a lot of different things to a lot of people. To answer your question, the disease takes two different courses.
Some people have incidents of pain and symptoms which disappear after a period of treatment.
These persons will have period where they feel normal and the disease is in remission. Although they are not cured, and the symptoms can and do come back only to disappear again. The second course is where the symptoms and pain of the disease are permanent and slowly, over time, get worse. These people always have pain and symptoms, but for a period of time the pain goes off the scale. To answer your question, the disease takes two different courses.