Learn Some Common Causes and Symptoms of Arthritis Flares

Triggers vary by the type of arthritis you have

Senior African American man rubbing his shoulder
Terry Vine / Getty Images

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 or the ongoing progression of your disease. It is often hard to tell.

Symptoms of a Flare

An arthritis flare is defined as an episode of increased disease activity or worsening symptoms.

People with arthritis typically recognize a flare by the sudden intensity in joint pain accompanied by other characteristic symptoms such as fever, fatigue, malaise, stiffness, or joint swelling.

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

A flare can involve a single joint or multiple joints. Typically speaking, a person with osteoarthritis will either have single joint involvement or recurrent flares with the same, multiple joints. By contrast, those with autoimmune arthritis, like rheumatoid arthritis or psoriatic arthritis, can often experience multiple joint flares concurrently.

Causes of Flares

The cause of a flare can vary by the arthritis type. Broadly speaking, osteoarthritis flares are related to conditions or events that directly affect the joint, while autoimmune arthritis flares are largely related to conditions or events that affect the immune system and cause an inflammatory response.

Among the most common triggers:

  • With osteoarthritis, overexertion and trauma are the most likely causes of a flare. Physical triggers such as repetitive motion or weight gain can increase the likelihood of a flare as can external triggers such as cold temperature or changes in barometric pressure. Stress and infection are also common causes.
  • With rheumatoid arthritis, flares can be related to any condition that causes your immune system to respond to inflammation. It may be a physical stimulus such as overexertion or an emotional one such as stress. In the same way that certain foods can cause allergy, there are food allergens that can trigger arthritis. Moreover, the drugs used to treat rheumatoid arthritis (which work by dampening the immune response) can increase the risk of infection which, in turn, increases the risk of a flare.
  • With psoriatic arthritis, the triggers for a flare are the more or less that same as those for psoriasis. They may include stress, injury to the skin, bacterial infection, certain medications, allergies, smoking, diet, weather changes, and excess alcohol intake.

Diagnosis and Treatment

To differentiate a flare from worsening of the disease, your doctor may order a battery of blood tests including the erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) test to distinguish between chronic (persistent) inflammation and acute (current) inflammation.

The treatment of a flare may require a short course of corticosteroids, such as prednisone or methylprednisone. If the flare persists, your doctor may adjust the dosages of your current medications or change your therapy altogether if it is deemed that your drugs are no longer working.

A Word From Verywell

While the symptoms of an arthritis flare can be distressing, you shouldn't leave yourself at their mercy. Beyond medications, there are a number of things you can do:

  • Adjust your activity levels accordingly, balancing periods of activity with periods of rest.
  • Schedule your daily obligations to ensure you provide yourself ample downtime.
  • Use a hot or cold pack on the affected joint. Cold packs ease inflammation. Hot packs promote blood circulation to relax muscles.
  • Lose weight to relieve some of the structural stress from your joints, particularly those of the lower body.
  • Practice stress-relieving techniques, such as meditation or yoga breathing, to reduce muscle tensions that can exacerbate symptoms and to decrease your reaction to the arthritis pain.

    Sources:

    Cross, M.; Dubouis, L.; Mangin, M. et al. "Defining Flare in Osteoarthritis of the Hip and Knee: A Systematic Literature Review—OMERACT Virtual Special Interest Group." J Rheumatol. 2017; 44(12):1920-27. DOI: 10.3899/jrheum.161107.

    Myberk, V.; Bingham, C.; Choy, E. et al. "Identifying flares in rheumatoid arthritis: reliability and construct validation of the OMERACT RA Flare Core Domain Set." RMD Open. 2016; 2:e000225. DOI: 10.1136/rmdopen-2015-000225.