For many people with arthritis, a flare-up occurs when symptoms — sometimes suddenly — get more intense. The flare-up might entail more pain, swelling, and stiffness. It can have an effect on your daily activities, making it harder for you to move.
Prevention is the best medicine against these flare-ups, which can last for days or weeks, explains orthopedic surgeon Alexander van der Ven, M.D.,  with Miami Orthopedics & Sports Medicine Institute .
“We spend most of our time with patients discussing what they can do to minimize the triggers of flare-ups,” says Dr. Van der Ven.
The best way to manage flare-ups is to avoid sedentary living by staying active, keeping up with physical therapy sessions if required, maintaining a healthy weight with proper dieting which includes non-inflammatory food choices, he said.
The COVID-19 pandemic has contributed to increasing cases of arthritis flare-ups, he points out.
“We’re not seeing the kind of the weekend warrior injuries that we used to because people aren’t participating in those types of events,” said Dr. van der Ven, who oversees the joint replacement surgery program at Doctor’s Hospital. “But, on the other hand, people are becoming much more sedentary now. They’re not maintaining their bodies, and this is putting them at risk for these flare-ups. So, my sports medicine colleagues are seeing a little bit of a decrease in their demand, and physicians who see more patients with arthritis are seeing an increase in flare-ups.”
Here’s more from Dr. van der Ven on arthritis flare-ups.
Question: What happens to arthritis patients when they experience flare ups?
Dr. van der Ven: “Arthritis is typically not a static disease. It is an episodic, ever-changing, dynamic and progressive disease. It is characterized by the eventual breakdown of the joint. It’s kind of the accumulation of episodic events. Flare-ups are when we basically see an increased amount of irritation to the joint, which is caused by both swelling and thickening of the joint or stiffness of the joint. Most people feel some pain and so these flare-ups are often what brings people to the doctor. A lot of people know they have arthritis, but it’s the flare-ups which are the things that can disable patients. And so that’s usually when someone will seek medical help.”
Question: Usually, how long do these episodes last?
Dr. van der Ven: “What we see is anywhere between two weeks to two to three months.
Question: What are the most common reasons for arthritis flare-ups?
Dr. van der Ven: “It can be an injury, like a small injury… or a large injury. Sometimes it’s a misstep. Sometimes, there can be inflammatory triggers in someone’s life based on their diet and life stresses.”
Question: What can arthritis patients do to avoid or minimize flare-ups?
Dr. van der Ven: “The mainstay of treatment is the prevention of flare-ups. The most important factor is going to be maintaining your weight. The reason for that is we know that increased weight also produces more inflammatory triggers, or cytokines, in the body. So, we know that people who keep their weight under control will have less inflammation in their body.
“And diet is so important, obviously. Certain foods are going to trigger inflammation. Avoid foods that have a high inflammatory component, such as a lot of animal products, which seem to cause more inflammation in the body. After weight and inflammation, the third factor is going to be injury prevention. For example, you don’t want to twist your knee the wrong way, or have a misstep. Injury prevention is done through physical fitness, whether it’s visits to a physical therapist or a personal trainer. The most important thing with fitness is to cross-train — not doing the same exercise over and over again. Try a variety of lower-impact stabilization exercises.”
Question: What are the ways to treat these flare-ups?
Dr. van der Ven: “Treatment is going to be either over-the-counter non-steroidal, anti-inflammatories (NSAIDs) – and only if it is medically safe for you to take these. There’s a lot of people who cannot take them so you should check with your doctor, of course. We also have Miami Orthopedics & Sports Medicine Institute’s arthritis clinic  which basically dedicated to treating these types of conditions. Sometimes, these flare-ups might require things like a brace or temporary immobilization. Sometimes, drainage of fluids or an injection of the joint is necessary, or other more powerful types of medications.”