Osteoarthritis (OA) primarily affects cartilage, the tissues that protect bones and form joints. OA is a degenerative disease. This means that damage done to the joints can’t be reversed. An OA flare-up, or “flare,” refers to a sudden influx of symptoms. Flares can be brought on by many factors.
When an OA flare-up is manageable with medications and lifestyle changes, it’s considered an acute, or temporary, condition. If your symptoms continue to worsen, you might be experiencing worsening joint damage and not a flare-up.
Symptoms of an OA flare-up
An injury to the affected joint or joints may cause an OA flare-up. A flare-up can also occur when the joint breaks down further over time.
Symptoms of an OA flare-up may include:
- increased joint pain
- swelling of the affected area
- reduced range of motion at the location of the joint
- fatigue from increased pain
Causes of OA flare-ups
The precise cause of a flare-up is not known. An Injury or trauma to the affected joint may cause an OA flare-up. This is different from rheumatoid arthritis (RA). In RA, changes in the immune system cause flare-ups that produce inflammation or swelling. OA causes inflammation of the affected joints, but a flare-up isn’t caused by inflammation like in RA.
Cartilage provides shock absorption during movements. A breakdown of cartilage leaves your joints more vulnerable to flare-ups because the bones rub together.
Osteophytes, also known as bone spurs, may cause OA flare-ups. Bone spurs are small pieces of bones that grow on broken-down joints. Sometimes bone pieces, as well as cartilage, can come loose and cause more pain.
Flare-ups may also be brought on by:
- exercise-related injuries
- repetitive movements
- cold weather
- a drop in barometric pressure
- weight gain
Working with your doctor
You don’t necessarily need to see your doctor every time you have a flare-up. If pain and other symptoms last longer than a few days, you may want to make an appointment. Your doctor should address symptoms that seem to progress, like worsening flexibility.
It may also be helpful to track your OA flares for future reference. A journal or an app can help you and your doctor track the progression of your OA.
Your doctor may recommend an X-ray or MRI to look for changes in your joints. This can also help them identify bone spurs or other potential causes of your OA flare-ups.
Joint replacement surgery may resolve recurring flare-ups and significant pain.
Treating an OA flare-up
Treating an OA flare-up may require a combination of over-the-counter (OTC) or prescription medications and home remedies. Talk to your doctor about the options below.
OTC pain medications are often the first course of action for OA flare-ups. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common OTC drugs used for arthritis-related pain. These include ibuprofen (Advil, Motrin), aspirin, and naproxen (Aleve). While NSAIDs are effective against joint pain and inflammation during a flare-up, they carry the risk of stomach bleeding if you take them too long. NSAIDs also may interact with prescription medications, and they can increase blood pressure.
Acetaminophen (Tylenol) is another OTC pain relief option. However, acetaminophen products don’t treat inflammation. This medication can affect the liver if you take it too long or in large doses.
Transcutaneous electrical nerve stimulation (TENS) is another OTC option. A TENS device runs on batteries and it comes with adhesive pads that you place on the site of pain. The device then delivers electric pulses to alter certain nerves that signal pain. TENS isn’t a medication, but some devices are available over the counter. More complex devices are also sold through physical therapists and medical supply stores at a higher cost. While TENS can offer pain relief during a flare-up, it can’t minimize OA damage.
Sometimes OTC medications may not offer enough relief in the case of a severe OA flare-up. Prescription options may include:
- prescription-strength NSAIDs
- tramadol (Ultram)
Prescription pain pills can carry similar risks as their OTC counterparts. Also, the downside to narcotics for pain relief is that they can cause dizziness, which may increase your risk for falls. Prescription pain relievers can also become addictive. You shouldn’t use them long-term. Corticosteroids reduce inflammation, but they can cause irritability and weight gain in some people.
Some possible home remedies for OA flare-ups include:
- heat therapy to ease stiffness
- cold compresses and ice for pain relief
- massage therapy, though be sure your therapist is familiar with OA
- breathing exercises to reduce stress
- lots of rest between activities
It’s important to note that home remedies for OA flare-ups can help reduce pain, inflammation, and swelling, but they may not be as effective for severe symptoms as medications.
The damage of OA can worsen during flare-ups. OA flares themselves are temporary and don’t signal a worsening of your condition.
Long-term management of OA is still key to preventing future flare-ups and joint damage. OA can lead to disability without proper care and lifestyle changes.
Though it’s difficult to predict the onset of a flare-up, managing your OA can decrease the risk of occurrence. Joint replacement surgery may be necessary in severe cases to prevent disability and improve quality of life.
Preventing OA flare-ups
While joint damage is irreversible, there are preventive measures you can take to minimize your risk of flare-ups. Pain medications can make daily movements more comfortable, but they don’t prevent future symptoms. This is where lifestyle measures can prove helpful. Talk to your doctor about:
- losing weight: Losing weight can reduce OA flare-ups because extra weight places more pressure on the joints. That extra pressure can wear joints down even further and cause discomfort. Weight loss may be especially helpful if you have OA in the spine, knees, and hips.
- wearing braces: Knee braces, for example, can help protect the joints while also letting you perform daily activities with more ease.
- staying active: Regular exercise can help lubricate joints and strengthen bones, all while increasing muscle mass around joints to help protect from injuries.
- using assistive devices: Devices, such as grabbers, can help make movements easier while also avoiding unnecessary stress on your joints.