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Triggers and Treatments for Arthritis Flare-Ups

Medically Reviewed by Tyler Wheeler, MD on August 24, 2020

For many people with osteoarthritis (OA), some days are better than others. When your symptoms suddenly get more intense, you're having a flare-up.

You might notice more pain, swelling, and stiffness. It could be harder for you to move. Your medications may not work as well. A flare-up can last for days or weeks.

The best way to manage flare-ups is to think ahead. Figure out what's likely to trigger them for you. And work with your doctor to come up with a way to deal with them.

What Causes a Flare-Up?

The most common causes of an OA flare-up are overdoing an activity and injuring a joint. Other things that can trigger flares are:

  • An infection, like a cold or the flu
  • Growths on the ends of your bones called bone spurs
  • Repetitive movements
  • Stress
  • Weight gain
  • Cold weather
  • Changes in barometric pressure (pressure in the atmosphere linked to weather changes)

Over time, you can learn what causes your flare-ups and spot the signs that one is on the way. Early treatment helps you manage them. Before a flare, you might notice dull pain in your joints, or daytime sleepiness over several days.

Treating and Managing Flare-Ups

Talk to your doctor about how to handle flare-ups, and let them know if they happen a lot. They may need to change your treatment plan.

Some flare-ups get better after you rest and take over-the-counter pain meds for a couple of days. Call your doctor if they last longer than that, or if your symptoms are intense.

Medication changes. You might need to adjust your medication temporarily, or add a new one. Medicines that can help with flares include nonsteroidal anti-inflammatory drugs (NSAIDs), either prescription or over-the-counter. You may take them as a pill or put them on your skin. Acetaminophen helps some people. Your doctor may also inject steroids into your joints.

Rest. One of the best ways to deal with a flare is to take it easy. Take a sick day if you need to. Ask family members to help out with chores. But try not to stop moving completely. Do a few gentle stretches to keep yourself from getting stiff.

Hot and cold therapies. Moist heat around your joints boosts blood flow and relaxes muscles. A warm paraffin wax dip may make your hands or feet feel better. A special machine heats the wax, which is the same type used in candles.

If too much exercise causes flare-ups for you, use an ice pack right after your workout to ease pain. A cold compress may help at other times, too. Cold constricts your blood vessels, which decreases blood flow. That leads to less pain.

Limit the use of either of these methods to two to four times a day, for no more than 15 minutes at a time.

Kinesio taping. We don't have a lot of research on it, but one study found this flexible tape could help with OA pain and stiffness. Your doctor or physical therapist puts the tape around your joints to take pressure off, while still giving you a full range of motion. You can use the tape for days or weeks. Your therapist or doctor can show you how to put it on at home.

Acupuncture. We need more studies about how well acupuncture works for osteoarthritis. But some people get relief from it. An acupuncturist puts extra-thin needles into certain points on your body. You may feel discomfort when the needles are deep enough. Other than that, it doesn’t often hurt.

Capsaicin cream. This lotion made with chili pepper extract may help with mild knee pain. It can’t go deep enough to help your hips. Wash your hands well after you apply it to make sure it doesn’t get into your eyes.

Aid devices. A cane or brace can provide support and pain relief when you have a flare-up in your knees or hips. Your doctor will help you select a brace and make sure it fits. Finger and wrist splints and similar devices can help with arthritis in your hands. An occupational therapist can recommend the right wearable support device for you.

Education and support groups. They can help you learn to manage flare-ups, as well as life with osteoarthritis in general. Cognitive behavioral therapy and counseling may also help, especially if you have lots of stress.

Prevention

Along with following the treatment plan your doctor prescribes, some lifestyle changes can help prevent flare-ups.

Movement. Exercise makes the muscles near your joints stronger, helps them work better, prevents stiffness, and eases pain. Find an activity you enjoy and that feels good. Walking, stationary biking, resistance training, and balance exercises are good options. Water activities are easy on the joints and increase your range of motion. A physical or occupational therapist can help you create a fitness routine you can stick to

Stress relief. Mind-body practices like tai chi or gentle yoga can help you move and relax at the same time. Meditation and other relaxation techniques can also relieve stress.

Weight loss. If you're overweight, weight loss eases pressure on your knees and hips. The more you lose, the more your symptoms will improve. To start, set a goal of losing 5% of your body weight.

Show Sources

SOURCES:

CDC: “Arthritis Types.”

Arthritis Foundation: “Arthritis Pain Relief and Shoe Inserts,” “What Triggers an Arthritis Flare?” “Weather and Arthritis Pain,” “Tips for Managing an Arthritis Flare.”

Arthritis & Rheumatology: “2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.”

Therapeutic Advances in Musculoskeletal Disease: “The effectiveness of Kinesio Taping for pain management in knee osteoarthritis: a randomized, double-blind, controlled clinical trial.”

Australian Family Physician: “Taping for knee osteoarthritis.”

Mayo Clinic: “Rheumatoid arthritis,” “Septic arthritis,” “Osteoarthritis,” “Tai chi: A gentle way to fight stress,” “Cognitive behavioral therapy,” “Acupuncture,” “Capsaicin (Topical Route).”

American Society for Surgery of the Hand: “Paraffin Wax Bath.”

Hospital for Special Surgery: “Conservative Management of Osteoarthritis.”

National Institute for Health and Care Excellence: “Osteoarthritis: care and management.”

National Heart, Lung, and Blood Institute: “Calculate Your Body Mass Index.”

National Center for Complementary and Integrative Health: “Acupuncture: In Depth.”

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