An osteoarthritis flare-up refers to a sudden and temporary increase in symptoms. The condition affects the joints' cartilage, which is slippery tissue at the end of bones.

In healthy joints, cartilage allows bones to move smoothly, but osteoarthritis (OA) causes the cartilage to wear away and the bones to rub together, leading to pain and stiffness.

A flare-up can be brought on by several factors, including:

  • injury
  • stress
  • changes in the weather

OA affects 27 million Americans. In this article, we list the best ways to treat and prevent flare-ups, which are marked by increased pain and stiffness.

Osteoarthritis pain in knee, flare-up with person holding knee.Share on Pinterest
Joint pain may characterize osteoarthritis flare-ups.

An OA flare-up leads to a sudden increase in symptoms. These may include:

  • joint pain
  • swelling
  • stiffness in the morning
  • a reduced range of motion in the joint
  • fatigue
  • difficulty sleeping due to pain

The exact cause of OA flare-ups is unknown. This makes them difficult to avoid completely.

Unlike flare-ups of rheumatoid arthritis, those of OA are not triggered by inflammation resulting from an immune response.

Some factors, however, can increase the likelihood of experiencing a flare-up. These factors, often referred to as triggers, include:

Injury to the joint

Injury or trauma to the joint can cause an increase in OA symptoms. Joint injuries can result from:

  • repetitive motions
  • exercising the joint too much
  • a fall or knock to the joint

Injuries cause OA flare-ups when they:

  • damage the cartilage, bone, or both
  • change the mechanics of the joint, leading to further deterioration

Further breakdown of the joint

OA is characterized by a breakdown of joint cartilage. This happens naturally with age, but an event such as an injury can accelerate the process.

When cartilage breaks down, it causes the bones of the joint to rub together, leading to pain.

Deterioration in the cartilage is also linked to the development of bone spurs. Known as osteophytes, these are small bony protrusions that can irritate the joint and worsen pain.

Emotional stress

High levels of stress lead to physical symptoms, even in healthy individuals.

In people with OA, stress can exacerbate joint pain, which in turn amplifies stress. This may lead to difficulty sleeping, which can further increase a person's sensitivity to pain.

Findings of a study from 2010 indicate that people with OA may be likely to have mood-related disorders linked to stress, such as anxiety and depression.

Environmental changes

Changes in weather can aggravate arthritic joints.

Many people notice worsened symptoms when the weather is cold or when there is a sudden drop in barometric pressure.

Other health conditions

OA may flare up after a person's health status changes. This may occur due to an infection, for example, even when the infection is being treated.

Sudden or excessive weight gain can cause symptoms to flare up because extra weight adds pressure to the joints. Excess weight can be especially problematic when OA is in the hips, knees, or spine.

An OA flare-up can be treated with medication, lifestyle changes, and home remedies. A combination of the following methods may be necessary:

Medication and medical treatment

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Medication may be prescribed to treat osteoarthritis flare-ups.

Over-the-counter (OTC) and prescription medications can relieve OA symptoms.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to reduce arthritis symptoms.

Those available OTC include:

  • aspirin
  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)

NSAIDs are a short term solution for joint pain, and if taken for long periods they can cause stomach bleeding.

If OA symptoms are more serious, a doctor may prescribe stronger medications. These include narcotics, prescription-strength NSAIDs, and corticosteroid injections.

Joint replacement surgery may be necessary to resolve symptoms, in severe cases.

Transcutaneous electrical nerve stimulation (TENS)

TENS therapy sends electrical pulses through the skin. The aim is to change the body's nerve signals and reduce pain. TENS devices are available OTC, or through a doctor or physical therapist.

This therapy cannot slow or reverse joint damage and is only intended to alleviate pain. TENS is not suitable for everyone, and anyone interested in using a device should first speak with a doctor.

Hot and cold therapy

Applying a heating pad or an ice pack can reduce pain and stiffness in the joints. Some people see the best results when they alternate between hot and cold.

Stress management

Managing stress can help to reduce pain during flare-ups and minimize their frequency.

Tips for managing stress include:

  • keeping track of events and situations that increase stress
  • trying cognitive behavioral therapy (CBT), which can help a person learn to approach stressors in a more positive manner
  • practicing stress-busting techniques, such as meditation, mindfulness, deep breathing, and progressive muscle relaxation
  • getting a massage, which can reduce physical pain and emotional stress.
  • regularly getting at least 7 hours of sleep a night

Balance rest and activity

It is important to rest after periods of activity, and resting can be beneficial during an OA flare-up. However, too much rest can prolong the pain.

Whenever possible, try to engage in light activities, such as a short stroll, a gentle swim, or light housework.

Assistive devices

Certain devices can reduce stress on the joints and make life easier for people with arthritis. Helpful products may include jar openers, adaptive cutlery, grabbing devices, and dressing aids.

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A doctor may be able to help manage flare-ups.

While it is not always necessary to see a doctor during an OA flare-up, symptoms that persist for more than a few days may need medical treatment.

A doctor may request imaging tests, possibly involving X-rays or MRI scans, to check for changes to joints, deterioration, and any further abnormalities.

They will likely recommend medications to treat pain.

If necessary, the doctor may suggest additional treatments to address triggers, such as CBT for stress.

Flare-ups are not always preventable, but some strategies can help to minimize risk.

People with OA may find it helpful to:

  • Maintain a healthful weight through dietary changes and exercise.
  • Reduce stress through meditation, mindfulness, and deep breathing exercises.
  • Get plenty of sleep each night.
  • Engage in regular exercise to strengthen bones, lubricate joints, and increase muscle mass.
  • Wear supportive braces to protect and stabilize joints.
  • Use assistive devices to reduce stress on joints.

OA is a progressive disease. During a flare-up, pain and other symptoms get much worse.

It is important to remember that flare-ups are temporary and can be treated with medications and lifestyle changes.

Preventing flare-ups is not always possible, but several management techniques can reduce their severity and recurrence.