WHEN SHOULD I WORRY ABOUT...

What Makes Arthritis Flare Up?

March 11, 2021 - Katie McCallum

When you're suffering from a painful condition like arthritis, you're almost always looking for ways to keep your symptoms at bay.

We've all heard the old wives' tale that when an achey joint is acting up it's a sign that bad weather is on the way...but can it really be true that something like a change in weather can trigger your pain?

"It's true — the symptoms of arthritis can recede and flare up. It's also true that a change in weather can sometimes trigger a flare-up, which is often magnified when a certain type of arthritis is not being well-managed," says Dr. Syed Alam, rheumatologist at Houston Methodist.

"While you can't control the weather, the good news is that you can avoid other triggers of arthritic flare-ups — as long as you know what type of arthritis you have in the first place," adds Dr. Alam.

Arthritis is a broad term for pain, tenderness or swelling in a particular joint (or joints), and the three most common types of arthritis are:

  • Rheumatoid arthritis – when your immune system attacks the structure of your joint
  • Osteoarthritis – wear and tear damage that breaks down the cushion in your joint
  • Gout – when sharp crystals form and deposit in a joint

"When it comes to flare-ups of these types of arthritis, the triggers themselves aren't actually the source of your pain. They're just things that aggravate the underlying issues of the arthritis," explains Dr. Alam.

What causes rheumatoid arthritis to flare up?

Rheumatoid arthritis is one of the more sinister forms of arthritis. Not only can the damage to your joints lead to swelling, stiffness and pain, there's no way to undo it — aka, it's permanent.

With rheumatoid arthritis, there's likely always some low level of inflammation affecting your joints, but it can also flare up in response to stress or, believe or not, the weather — specifically, rain.

"When you're stressed, either mentally or physically, your body is less equipped to handle the inflammation caused by your condition," explains Dr. Alam. "Since it leads to swelling and stiffness, more inflammation means more intense pain."

As for why a change in weather might trigger a flare up of rheumatoid arthritis, it's all about joints under pressure.

"Changes in weather, such as rain, are often accompanied by changes in air pressure, and this change is thought to affect the pressure within your joints — making any underlying swelling feel more painful," explains Dr. Alam.

While you can't control the weather, you can take steps to reduce your stress levels. And when a flare up hits, you can use a cold compress to reduce the inflammation that's causing some of your pain.

What causes osteoarthritis to flare up?

Osteoarthritis is the most common type of arthritis. It's the "wear and tear" type of damage that affects the cartilage in your joints — which becomes more common with age.

"Like rheumatoid arthritis, osteoarthritis causes joint pain that can tend to flare up from time to time," says Dr. Alam. "Unfortunately, it's still not completely clear what triggers osteoarthritis to flare up, although we suspect that a primary contributor is overuse of the affected joint, either due to repetitive action or prolonged activity without sufficient rest."

To prevent osteoarthritis flare-ups, take care to ensure you don't overwork an arthritic joint.

And if you do experience a flare-up, you can help relieve your symptoms by using a warming pad or warm compress, taking over-the-counter pain relievers or just giving the joint some rest.

What causes gout to flare up?

Gout is a complex form of arthritis that can flare up suddenly and severely. It occurs as a result of having high levels of uric acid, which makes it easier for urate crystals to form. These sharp crystals can deposit in your joints, causing inflammation, swelling and pain.

"The most common trigger of gout is eating purine-rich foods, since high levels of purines can increase the amount of uric acid in your bloodstream," explains Dr. Alam.

Gout-sufferers can help avoid flare-ups by avoiding foods rich in purines, including:

  • Red meat
  • Liver
  • Certain types of seafood, including tuna, scallops and trout
  • Alcohol, particularly beer
  • Fruit juices and other beverages that contain fructose

"Similar to rheumatoid arthritis, a flare-up of gout can be alleviated by using a cold compress on the affected joint, which helps reduce the inflammation that's causing your pain, swelling and stiffness," says Dr. Alam.

When to see a doctor about a flare-up

If you're experiencing joint pain that flares up from time to time, Dr. Alam recommends being evaluated.

"For many people, arthritis starts as a flare-up, and it's important to seek a diagnosis. Remember, you need to know the specific type of arthritis you're suffering from to be able to prevent or alleviate future flare-ups," says Dr. Alam.

For instance, you won't know whether to use ice or heat to relieve your joint pain unless you know if it's rheumatoid arthritis or gout as opposed to osteoarthritis.

"In addition, and particularly for rheumatoid arthritis, seeking a diagnosis early on gives you a better chance of avoiding the permanent joint damage this condition can cause," explains Dr. Alam.

And even if you've been diagnosed, there are still times you may need to see your doctor about a flare-up.

"It's very important to call your doctor if you're experiencing pain in a new joint or if your flare-up is severe, since this could be a sign of arthritic infection," warns Dr. Alam.

If you're experiencing a mild flare-up in a joint you're used to experiencing pain, your doctor may be able to help you manage that pain by prescribing medications over the phone — but only if he or she is already familiar with you and your condition.

Lastly, Dr. Alam recommends approaching supplements with skepticism.

"There are supplements claiming to fix just about everything these days, but there are a lot of 'placebo effects' when it comes to pain," warns Dr. Alam. "Supplements aren't treatments, and it's important to realize that some types of arthritis can do serious damage to your joints in the meantime."

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