Fatigue is definitely the biggest impact as you get into a vicious circle, in too much pain to exercise but the less you exercise the worse it gets. I am never 100% clear whether I should or shouldn’t do physical activities (e.g. running) if I am having a flare up in my hips for example as I am not sure if this can cause permanent damager. My mood and the weather also affect my flares. If I am worried about anything I ways get flare ups.