What Causes Arthritis Flare-Ups & How to Treat Them

If you have arthritis, you will likely have experienced a flare-up of symptoms at one time or another, often with no apparent cause. Depending on the type of arthritis you have, it may be related to a specific trigger like overexertion or a change in treatment, or it may just be due to the ongoing progression of your disease. It is often hard to tell.

This article will describe how to recognize an arthritis flare, what could possibly cause it, and how it's treated.

Symptoms of an Arthritis Flare-Up

An arthritis flare is defined as an episode of increased disease activity or worsening symptoms, which may involve:

• A sudden increase in joint pain
• Fever
• Fatigue
• Malaise
• Stiffness
• Joint swelling

During a flare, fatigue can become so profound that you'll feel unrefreshed even after a good night's rest.

Causes of Arthritis Flare-Ups

Many flares follow changes or reductions in treatment and may signal that the new treatment isn't effective. Watch for a flare any time you change your treatment regimen.

Other causes of flares can vary by the arthritis type. Broadly speaking, many osteoarthritis flares are related to conditions or events that directly affect the joint. Autoimmune arthritis flares are largely related to conditions or events that affect the immune system and cause an inflammatory response.

Osteoarthritis

Osteoarthritis (OA) is the most common arthritis type. It's often called "wear and tear" arthritis.

OA flares are often caused by overexertion and trauma. Physical triggers such as repetitive motion or weight gain can increase the likelihood of a flare, as can external triggers such as cold temperatures or changes in barometric pressure.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune, inflammatory form of arthritis. In autoimmune disease, your immune system attacks healthy tissues in your body.

RA flares can be related to anything that causes your immune system to increase inflammation (which is part of the healing process). It may be a physical cause (e.g., overexertion, infection) or an emotional one (such as stress).

The drugs used to treat RA dampen the immune response and increase your infection risk. Food allergens can trigger flares, as well.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is autoimmune and inflammatory. It involves joint pain and skin plaques (psoriasis).

PsA flare triggers are more or less the same as those for psoriasis. They may include:

• Stress
• Injury to the skin
• Bacterial infection
• Certain medications
• Allergies
• Smoking
• Diet
• Weather changes
• Excess alcohol intake

How Are Arthritis Flare-Ups Diagnosed?

Sometimes, it's hard to tell whether you're having a flare or your disease is progressing. To differentiate between those, your healthcare provider may order a battery of blood tests, including:

• Erythrocyte sedimentation rate (ESR or sed rate)
• C-reactive protein (CRP) test

These tests can help your provider distinguish between the chronic (ongoing) inflammation of worsening disease and acute (short-term) inflammation of a flare.

Imaging can also be used, including ultrasound, magnetic resonance imaging (MRI), and bone scans (scintigraphy).

Treatment of a Flare

You don't just have to suffer through a flare. Your healthcare provider can help you with additional treatments to help quiet down your symptoms.

Medications

Treating a flare may require a short course of corticosteroids, such as prednisone or methylprednisone. These medications are powerful anti-inflammatories.

Your healthcare provider may also suggest non-steroidal anti-inflammatory drugs (NSAIDs), either prescription or over-the-counter (OTC).

If the flare persists, your provider may adjust the dosages of your current medications or, if they suspect your drugs are no longer working, change your medications altogether.

Heat and Cold

Cold eases inflammation and heat helps muscles relax by improving blood circulation. You can use heat and cold therapeutically with:

• Hot or cold packs on sore joints
• Hot baths or showers
• Electric blankets or mattress pads to help you relax in bed

Some people prefer heat over ice or vice versa. Others alternate them or use different methods at different times. Experiment and see what works best for you.

Rest

When it comes to rest, think both of your painful joints and your whole body. For your joints:

• Avoid activities that stress them.
• Alternate activity with rest.
• Consider a brace, splint, or wrap for extra support.

For your whole body:

• Try to get extra rest and sleep in general.
• Adjust your activity levels, balancing periods of activity with periods of rest.
• Include sufficient downtime in your daily schedule.

Topical Medications

Topical medications are used on the skin. Many kinds are available for arthritis pain and they come in creams, gels, roll-ons, and patches. You can buy many over the counter, and prescription forms are available, as well.

Talk to your healthcare provider about which topical products are right for you.

Acupuncture

Research suggests that acupuncture may help relieve RA and PsA symptoms. It appears to cause:

• A release of brain chemicals that lessen pain sensations
• A release of hormones believed to control inflammation
• Altered immune function to alleviate inflammation

Acupuncture hasn't been shown to be very effective for OA.

Emotional Coping

Your mental health is important during flares, too. You can try several things to help:

• Find a support group online or in your community where you can learn and receive support from people who understand what you're going through.
• Consider cognitive behavioral therapy, which can help you cope with stress, your illness, and the limitations it places on your life.
• If depression is a problem for you, talk to your healthcare provider about treatments.

Lifestyle Management

Some changes to your day-to-day routines can help you get through times of heightened disability from your arthritis.

• See if you can work from home during flares.
• Use mobility aids such as canes, walkers, wheelchairs, and motorized carts at grocery stores.
• Keep simple, healthy meals on hand so you don't neglect your health when it's hard to cook.
• Consider delivery or curbside pick-up options for shopping.

If possible, have family or friends help with daily tasks that become difficult for you when symptoms are worse.

Prevention

During the better times, you can take steps to prevent arthritis flares:

• Lose weight to relieve some of the structural stress from your joints, particularly those of the lower body.
• Consider switching to an anti-inflammatory diet.
• Practice stress-relieving techniques, such as meditation or yoga breathing to reduce muscle tension that can exacerbate symptoms and decrease your reaction to the arthritis pain.
• Stick to your treatment regimen as prescribed.
  

Your healthcare provider may also have suggestions for flare prevention.