Managing a flare up

Inflammatory arthritis activity can vary and there will be times when it is manageable and other times when you may experience flare-ups.

A flare-up of your inflammatory arthritis may include symptoms such as worsening of joint pain, swelling, stiffness, fatigue and general “unwell” feeling.

Flare-ups are unpredictable and can start suddenly or after an illness such as a chest or urinary infection or a stressful period (physical or mental). Triggers may not always be identifiable.

You must seek urgent medical attention if you have a joint that becomes red, hot, swollen, and painful and a fever, as this may suggest that the joint is infected.

If you are experiencing frequent flare-ups, we may need to review your Rheumatology medication to better control your joint disease.

What should I do if I am having a flare-up?

Pace yourself and your activities. Short rests in between activities may be required but keep your joints moving to help prevent stiffness and maintain your muscle tone. Plan your day to account for your increased tiredness.

Gentle exercises – this will help to reduce the stiffness and help keeping you mobile.

Cold therapy – cold packs, ice or a bag of frozen peas wrapped in a towel can relieve the inflamed joint. Apply cold therapy to 15 minutes. Avoid direct contact on the skin to prevent any ice burns, by using a towel. If you have Raynaud’s disease it would not be appropriate to use cold therapy.

Heat therapy – hot shower or bath, hot water bottle, damp towel heated in a microwave, an electric heath pad or a wheat bag can be soothing and help relief a painful joint and stiffness. Apply heat therapy up to 15 minutes. Protect your skin from direct dry heat by using a towel.

Take pain medication – regular prescribed painkillers, such as Paracetamol. Never take more than the maximum recommended dose in a 24-hour period. You can ask your GP for stronger pain relief if necessary.

If you can and are not allergic to, take regular prescribed anti-inflammatories. Anti-inflammatory gels can be helpful if you only have a couple of joints affected. Never take more than the maximum recommended dose in a 24-hour period. If you are unsure if you can or cannot take anti-inflammatories, please contact your GP or the Rheumatology department before start taking it.

If your symptoms deteriorate or do not improve in5 to 7 days contact us for further advice.
- WVT Rheumatology Telephone Advice Line: 01432 36 4020
- WVT Rheumatology Patient Email: rheumatology.patient@nhs.net

Useful links:

NRAS – Managing flares

https://nras.org.uk/resource/managing-flares/#:~:text=Whether%20it's%20relatively%20short%2Dlived,feel%20increasingly%20low%20in%20mood

NRAS – Managing your Rheumatoid Arthritis

https://nras.org.uk/information-support/information/managing-your-ra/

NRAS – New2RA

https://nras.org.uk/product/new2ra/

NRAS SMILE-RA – Free self-management module programme for patients with Rheumatoid Arthritis

https://nras.org.uk/smile/

NRAS – Rheumabuddy app to support patients with Rheumatoid Arthritis with self-management

https://nras.org.uk/resource/rheumabuddy/

NRAS – Fatigue