The term arthritis encompasses a group of conditions characterised by inflammation of one or more joints. The conditions can be broadly categorised into two types: degenerative (wear-and-tear-based) and inflammatory (autoimmune-based). The most common of these are osteoarthritis and rheumatoid arthritis, respectively. Arthritis needs to be properly diagnosed by a doctor, but you can find out more about the different types of arthritis here.
A flare is, put simply, an increase in the frequency or severity of symptoms. Most chronic (long-term) conditions flare from time to time, even with the best care. The nature and presentation of a flare will depend on the condition itself. As osteoarthritis and rheumatoid arthritis have different origins, flares will present differently and have different causes. This article examines the primary triggers for each type of flare and provides some tips for managing flares when they occur.
Osteoarthritis
Osteoarthritis is degenerative in nature. It is caused by the wearing away of the cartilage and the overgrowth of bone in the joints.
An osteoarthritis flare is characterised by an increase in pain and swelling of the affected joint(s). This may be accompanied by increased stiffness and a reduced ability to use the joint. Osteoarthritis is a mechanical condition, and the causes of flares are predominantly external, i.e. not originating within the body.
Common causes of osteoarthritis flares
- Overuse of the joint
- Injury to the joint or surrounding areas
- Weight gain, especially on load-bearing joints such as knees and hips
- Cold weather
- Stress
Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disorder. It is caused by a fault in the immune system, causing healthy tissue to be attacked as if it were diseased. This can produce inflammation in the joints and lead to permanent damage over time.
A rheumatoid arthritis flare can resemble an osteoarthritis flare, but the underlying causes are likely to be very different. Increased pain, swelling, redness and stiffness of the joint are all common signs of a rheumatoid arthritis flare, but extreme fatigue and flu-like symptoms may also be reported. As rheumatoid arthritis is autoimmune in nature, the causes of flares mostly come from within the body.
Common causes of rheumatoid arthritis flares
- Illness or infection
- Stress
- Interruption to, or changing medication
- Lack of sleep
- Overexertion
Unfortunately, rheumatoid arthritis can sometimes flare up without any clear cause. That is the unpredictable nature of autoimmune disorders.
How to manage an arthritis flare-up
The advice for coping with arthritis flares is similar, regardless of the specific variety of arthritis. The first priority is to reduce the pain and swelling. Heat or cold packs applied to the affected joint(s) may provide relief. Painkillers are another, obvious, line of defence. For a mild flare-up, over-the-counter medications may be enough. For more severe flares, prescription anti-inflammatory medicines or opioid medicines such as codeine might be required.
It's important to note that codeine, whilst it may be effective at relieving pain in the short term (such as for a flare-up), is not effective at relieving inflammation in the joints, which is commonly attributed to arthritis. For this reason, it is advisable to consult your doctor about long-term pain management.
Medicated creams and gels, such as Deep Heat, Joint Ace, and Flexiseq, can be purchased over the counter from pharmacies to help manage joint pain.
Certain alternative therapies, such as acupuncture and meditation, are effective in reducing pain and increasing tolerance in some people. The scientific research is limited, but promising, so it may be worth trying these options in addition to your normal treatment.
It may be tempting to rest completely during a flare, but prolonged periods of inactivity can actually exacerbate the condition. Instead, try to balance rest and relaxation with gentle exercise to keep the joints mobile.
An arthritis flare is a temporary state in a chronic condition. It is essential to be aware that symptoms should subside again. If an arthritis flare continues for more than a few days, particularly in the case of rheumatoid arthritis, consult a medical professional.
