Arthritis Flare Ups: Why Flares Happen and How Long They Last

If you have arthritis and your symptoms suddenly get worse, you could be experiencing an arthritis flare up. Symptoms, causes, and treatment of a flare up depend on what type of arthritis you have.

arthritis flare up in hand

Some arthritis flares can be manageable, especially if you can recognize your triggers, such as certain foods.

© MoyoStudio | Getty Images

Arthritis is more than one disease. The three most common types are rheumatoid arthritis, osteoarthritis, and gout. All types of arthritis cause joint pain, swelling, and tenderness. Symptoms of arthritis tend to come and go. When they get suddenly worse, it is called an arthritis flare up. Sometimes the cause of a flare up is known. These causes are called triggers. Different types of arthritis can have different triggers. [1]

 Types of Arthritis Flares: Osteoarthritis | Rheumatoid Arthritis | Psoriatic Arthritis | Gout

According to the Arthritis Foundation, an arthritis flare is a period of increased disease activity that makes your symptoms worse. If you are taking medications to control your arthritis, they may not work as well during a flare. [2]

Inflammatory Arthritis Versus Osteoarthritis

Knowing the type of arthritis, you have is the key to recognizing and managing a flare up. [1,2] Osteoarthritis is the most common type of arthritis. It is caused by wear and tear of the cartilage linings of your joints. Since wear and tear takes time, this type occurs mostly in older people. It may be more common in a joint that you injured at some time. It causes pain, stiffness, and swelling, but not inflammation. [3]

Inflammatory arthritis may be caused by a disorder of your immune system. Your immune system is your body’s defense system against foreign invaders like germs. If you have an immune system disease called an autoimmune disease, your immune system attacks normal body tissues, including your joints. The symptom of the attack is inflammation of tissue in around your joints. [3]

Autoimmune inflammatory arthritis affects many joints all over your body at the same time. This is also called inflammatory polyarthritis. This type of arthritis is a long-term disease that is often diagnosed in young adults. Both rheumatoid arthritis and psoriatic arthritis are common types. Inflammation adds symptoms of redness and a feeling of warmth to affected joints along with pain and swelling.  [3]

Gout is also an inflammatory type of arthritis, but it is not caused by autoimmune disease. It is caused by your body producing too much of a substance called uric acid, or your kidneys not removing enough uric acid from your blood. Normally you make uric acid to break down proteins that you eat. Too much uric acid in your blood acid can leak into your joints and form sharp crystals. When this happens, you have a gout attack with symptoms that include severe pain, warmth, redness, swelling, and stiffness. [1,2,4]

Osteoarthritis Flare Up

An osteoarthritis flare up is usually caused by overusing or injuring an affected joint. This can happen with repeated movements or activity not interrupted by rest. [1,2] It can be hard to tell a flare up from worsening of the arthritis that occurs over time. Symptoms may include increased pain, swelling, and stiffness. Less common flare triggers include cold weather and gaining weight. [2] If you have a fare up, try warm heat to relieve pain and swelling, along with rest and an over-the-counter pain reliever. [1]

Rheumatoid Arthritis Flare Up

Because rheumatoid arthritis always causes a low level of inflammation, flares are common and sometimes occur without a trigger. [1,5] Symptoms of a flare may include increased pain, swelling, and stiffness. Because rheumatoid arthritis also affects the rest of your body, you may also have fever, fatigue, and weight loss. [6]

rheumatoid arthritis vs normal jointsA common cause of a flare is decreasing your anti-inflammatory medication or missing a dose. [2] Other triggers include physical or mental stress, changes in the weather, exertion, lack of sleep, or an infection like the flu, an upper respiratory infection, or urinary tract infection. [1,2,5,6]

A rheumatoid arthritis flare may last hours, days, or weeks. A flare that lasts more than a week should be reported to your doctor. Your doctor may need to add on a mechation like a steroid, or change your current medications. To manage a flare, you should alternate rest with some gentle activity to keep your joints moving. Take your usual anti-inflammatory medicines as prescribed. [6] A cold compress over a sore joint may reduce pain and swelling. [1]

Psoriatic Arthritis Flare

Psoriatic arthritis is inflammation that can affect both your joints and your skin. Many people may notice a flare of psoriasis before they get increased joint symptoms. Triggers for a flare may include stress, an injury to the skin, a medication reaction, allergic reaction, a change in diet, drinking alcohol, or smoking, as well as changes in the weather. Bacterial infections, especially a strep throat, are another common trigger. [2] Like other inflammatory arthritis flares symptoms can include swelling, pain, fever, and fatigue. Home care is similar as rheumatoid arthritis. [6]

Gout Flare Up

Gout symptoms almost always come as a sudden flare up. The most common trigger is eating too much of a protein food that is high in purines. Purines are molecules in proteins. Foods that trigger gout attacks include shellfish and other seafood, beer, red meat, liver, and foods that contain the sugar fructose. You may be able to avoid a got flare up by avoiding high-purine foods. [1,2]

Gout flare ups occur suddenly, usually at night. The pain, redness, swelling, and stiffness of a gout attack may often affect your big toe. It can also affect the joints of your arms or legs. Injuring a joint, like stubbing your toe, can trigger an attack. [4]

A gout attack usually peaks at about 12 hours and gradually gets better. To manage a gout attack, rest your joint. You should also call your doctor, because there are medications especially used to treat a gout attack. You can take an over-the-counter nonsteroidal anti-inflammatory medication (NSAID) and use a cold compress on the effected joint. [1,4]

How Long Does an Arthritis Flare Last?

The length and severity of an arthritis flare is unpredictable and differs from person to person. Different people may also have different triggers for their flares. The best advice is to listen to your body and become aware of your flare triggers. [5] It may help to keep a flare diary and work with your doctor to developing a flare management plan. Avoid treating a flare a supplement, unless you talk to your doctor first. [1] If you are having frequent flares or a severe flare that is not responding to your usual home care, call your doctor. Sometime a flare needs medical treatment to prevent permanent joint damage. [1,2,5]

Sources

  1. Houston Methodist Hospitals, What Makes Arthritis Flare Up? Rheumatoid Arthritis, Osteoarthritis & Gout: What Causes Arthritis Flare-Ups | Houston Methodist On Health
  2. Arthritis Foundation, What Triggers an Arthritis Flare? What Triggers an Arthritis Flare? | Arthritis Foundation
  3. Hospital for Special Surgery, Inflammatory Arthritis, Inflammatory Arthritis: Rheumatoid & Reactive, Gout & More (hss.edu)
  4. Mayo Clinic, Gout, Gout – Symptoms and causes – Mayo Clinic
  5. Arthritis Foundation, Understanding Rheumatoid Arthritis Flares, Understanding Rheumatoid Arthritis Flares | Arthritis Foundation
  6. Oxford University Hospitals, FAQ about managing a flare – Rheumatology (ouh.nhs.uk)

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Chris Iliades, MD

Chris Iliades has an MD degree and 15 years of experience as a freelance writer. Based in Boothbay Harbor, Maine, his byline has appeared regularly on many health and medicine … Read More

View all posts by Chris Iliades, MD

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