Osteoarthritis flare-up: here’s how to treat it

Just as you notice wrinkles or gray hair with age, your joints can also naturally change over time. Some people may develop osteoarthritis, a condition that affects the cushioning in your joints. Osteoarthritis can affect joints throughout your body: from your neck to your feet.

Many people never get symptoms with osteoarthritis, but some experience bouts of discomfort and stiffness, which can make everyday activities like climbing stairs or putting on shoes more challenging. These moments are called osteoarthritis flare-ups. “While they can be uncomfortable and cause soreness, there’s a lot you can do to manage and even prevent them,” says Aashini Govani, PT, DPT, a physical therapist with Hinge Health.

Here’s a closer look at what can trigger osteoarthritis flare-ups, plus tips on how to treat and prevent them, including exercises recommended by Hinge Health physical therapists. 

Symptoms of osteoarthritis flare-ups

If you develop osteoarthritis, you may notice the following:

• Joint pain or achiness

• Joint stiffness

• Joint tenderness

• Reduced flexibility and range of motion 

• Everyday movements like walking, bending, or climbing stairs feel difficult

• Swelling 

• A cracking sensation when you move the affected joint

What causes osteoarthritis flare-ups?

An osteoarthritis flare-up can happen after a busy day of activity, especially if it involves doing more than usual or engaging in tasks that are physically demanding, like carrying boxes or raking leaves. Other common causes of ‌arthritis flares include: 

• Age. As you age, cartilage changes that lead to osteoarthritis become more common. Research suggests that at least 80% of people over age 55 show signs of osteoarthritis on an X-ray, even though many don’t have symptoms. 

• Sex. Women are more likely to develop osteoarthritis than men, though it’s not clear why. 

• Repetitive motions. “Flare-ups often occur following repetitive motions, like playing sports or doing chores,” says Dr. Govani. “They can also happen if you exceed your movement sweet spot, or doing enough activity to feel challenged without pushing to your maximum effort.” Activities that involve heavy lifting or extended periods of standing can trigger a flare-up if your body isn’t ready, Dr. Govani says.

• Lack of sleep. “When your body is tired, it works harder to do everyday activities,” Dr. Govani says. “As a result, you may not move as smoothly, which can stress your joints.” Not getting enough quality sleep each night can also trigger an osteoarthritis flare, creating a pain-sleep cycle: pain hinders sleep and lack of sleep intensifies pain.  

• Weather changes. Research shows humidity can affect your joints. For some people, hot and humid weather can contribute to an osteoarthritis flare-up. For others, colder, drier climates can lead to discomfort. “Everyone’s triggers are different,” Dr. Govani says. 

How long do osteoarthritis flare-ups last?

Flares often last for a few days, but everyone’s body is different, Dr. Govani says. "Some people recover from a flare and return to their usual activities after a day or two, while others may not feel better until after a few weeks.”

The best way to manage an osteoarthritis flare-up is by moving your body, even though it can feel tempting to do the opposite. 

Movement is medicine: “Staying active and building strength in the muscles around the affected joint can help you recover from a flare-up more quickly,” says Dr. Govani.

Treatments for an osteoarthritis flare-up

If you have an osteoarthritis flare-up, there are things you can do to help relieve symptoms and allow you to keep moving and do all the activities you enjoy. Here’s what Hinge Health physical therapists recommend. 

• Try physical therapy and targeted exercises. Targeted exercises can help alleviate discomfort from an osteoarthritis flare-up. “A physical therapist can recommend movements that will help strengthen the muscles around the affected joint, so you can move more comfortably,” Dr. Govani says. They can also recommend adaptive tools, such as a key turner or grip wrench, to simplify everyday tasks. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. Inactivity can lead to more joint stiffness and pain, Dr. Govani says. You may not be able to do your regular activities or workouts, but even doing simple exercises can help you recover from a flare. Try low-impact activities such as cycling, elliptical training, rowing, tai chi, swimming, or water aerobics, as these movements put minimal stress on your joints.

• Apply heat or ice. It’s a personal preference, but most people who experience an osteoarthritis flare-up prefer heat, says Dr. Govani. Moist heat, like a warm damp towel or hot water bottle, can help relax muscles around the affected joint.

• Try over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for osteoarthritis pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. Another option is using a topical NSAID cream, such as diclofenac (Voltaren).

• Improve your sleep. One study found that those over the age of 50 who slept less than six hours a night were more likely to be diagnosed with osteoarthritis and experience joint pain than those who got at least seven hours. “When you’re well rested, you’re less likely to experience osteoarthritis symptoms, such as pain and stiffness,” Dr. Govani says.

• Address stress. While stress doesn’t directly cause osteoarthritis flares, high levels of stress hormones can amplify pain, Dr. Govani says. Mindful techniques like deep breathing may help you feel more calm and at ease. One study found that women with knee osteoarthritis who meditated twice daily for two months experienced significant improvements in knee function and reduced pain.

• Eat a healthy diet. Research shows that eating anti-inflammatory foods, such as plant-based options, can help ease pain and slow cartilage changes in your joints. 

• Consider steroid injections. If your joint pain from osteoarthritis is so bad that you can’t do physical therapy or exercise, your doctor may recommend a steroid injection. This can help relieve inflammation and pain so that you can do the movements you need to heal. 

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain associated with conditions like osteoarthritis. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

How to prevent an osteoarthritis flare-up

Although you can’t predict when a flare will happen, there are several things you can do to help prevent them.

• Do low-impact exercises regularly. “Movement strengthens the muscles around the affected joint,” says Dr. Govani. “During a flare-up, an irritated joint can benefit from strong muscles taking the pressure off it.” Exercise also boosts blood flow, which can reduce inflammation around the joint. Do warm-ups like dynamic stretches before your workout to help prepare your body for movement.

• Maintain a healthy weight. “This can alleviate pressure from weight-bearing joints like your knees, ankles, hips, and lower back,” Dr. Govani says. A study found that overweight people with knee osteoarthritis who lost 20% of their body weight experienced a 25% reduction in pain and improved function compared to those who didn’t lose as much weight. Maintaining a healthy weight also lowers the risk of type 2 diabetes, which can trigger inflammation that aggravates osteoarthritis. 

• Make posture adjustments. “There’s no perfect posture, but rounding your shoulders frequently can trigger an osteoarthritis flare in your neck or spine,” says Dr. Govani. Similarly, holding any position for too long can irritate joints. Whether you’re on your feet or sitting in a chair, try to switch positions and take breaks to stretch throughout the day to help reduce tension and relieve stiffness. 

• Use assistive devices if necessary. A brace, splint, or cane can make moving around easier. These tools can also help you stay active by reducing pressure on sore joints, says Dr. Govani. Ideally, these devices are temporary solutions. Strengthening the surrounding muscles is the key to reducing flares.

• Stay hydrated. “Drinking plenty of fluids throughout the day helps keep your joints lubricated, making them feel better,” says Dr. Govani.

PT tip: Don’t push through pain

The idea of “no pain, no gain” is outdated. While mild discomfort is usually fine, intense pain is a sign that you need to dial back, says Dr. Govani. “Focus on short, gentle movements to warm up your muscles and increase blood flow to your joints,” she says. “Even five to 10 minutes of gentle exercise can help sore joints feel better.”

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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