Quick answer: An arthritis flare-up is a temporary spike in pain, stiffness, swelling or fatigue. In the first 24–72 hours: protect hot joints, keep gentle movement, use cold for swelling or heat for stiffness, follow any flare plan from your rheumatology team, and rest before you crash. Contact your GP, rheumatology advice line or NHS 111 if you have fever, a single very hot red joint, or symptoms that keep worsening.
Flares can hit even when you have been managing well. They are common in inflammatory arthritis and can also happen with osteoarthritis after overuse, illness or poor sleep. This page is a practical UK first-aid plan — educational, not a diagnosis.
How to recognise a flare
- Joint pain clearly worse than your baseline
- Morning stiffness lasting much longer than usual
- Swelling, warmth or redness in one or more joints
- Crushing fatigue or “flu-like” unwellness with inflammatory disease
- Tasks you normally manage suddenly feel out of reach
Write down what changed and when. That note helps your GP or rheumatology nurse decide whether this is a short flare or a signal to review treatment. Download our printable flare action plan so the next spike is less chaotic.
First 24–48 hours
- Modify, do not freeze. Protect angry joints, but keep gentle range-of-motion so stiffness does not lock you in. Full bed rest often makes the next day worse.
- Cold for hot swelling; heat for stiff, non-swollen joints. Ice pack wrapped in a cloth for about 15 minutes; warm bath or wheat bag for stiffness. Never put ice or heat directly on skin.
- Follow your flare plan if your rheumatology team gave you one (for example a short steroid course or temporary pain-relief change). Do not exceed labelled or prescribed doses — ask a pharmacist if unsure.
- Prioritise sleep and pacing. Use pillows to support painful joints. Drop non-essential tasks. See pacing and energy management to avoid boom-and-bust recovery.
Days 3–7: active recovery
- Short gentle stretches or walks on flat ground — often around half your usual load
- Joint protection for kitchen, dressing and transfers
- Steady meals and fluids; ease alcohol and ultra-processed snacks if they worsen sleep or pain
- Tell work early if you need temporary adjustments — see arthritis at work UK and sick pay and fit notes
When the flare eases, rebuild activity slowly via the exercise hub and walking with arthritis rather than jumping straight back to a “catch-up” day.
When to contact a clinician
- Flare lasts longer than your usual pattern (many teams say seek review if it is still escalating after about a week)
- Fever, feeling systemically unwell, or a single joint that is extremely hot, red and swollen (infection must be ruled out)
- You cannot manage basic personal care or take medicines safely
- Flares are becoming more frequent — treatment may need review
- Chest pain, sudden breathlessness, new rash with feeling very unwell, or eye pain — seek urgent care
Use NHS 111 for urgent advice, or 999 / A&E if you feel severely unwell. Pair self-management with our longer flare-up guide and pain relief guide.
Reducing the next flare
- Keep taking disease-modifying or biologic medicines as prescribed unless your team says otherwise — stopping them is a common flare trigger
- Track stress, sleep debt, infections and overexertion
- Build rest before you crash; protect sleep
- Ask about OT, physio or a written flare plan at your next review
Frequently asked questions
Is every bad day a flare?
Not always. Weather, sleep and overdoing chores can worsen pain without a true inflammatory flare. Still treat the day kindly and escalate if red-flag signs appear.
Should I stop all exercise?
Usually no. Swap intensity for gentle movement unless a clinician has told you to rest a specific joint.
Can diet stop flares?
No diet cures arthritis. A balanced pattern may support energy and recovery, but medication and pacing remain central. See our diet guides for food-first ideas, not miracle claims.
Sources and further reading
- Arthritis UK: Managing arthritis flare ups
- NHS: Rheumatoid arthritis
- NHS: Osteoarthritis
- NICE NG226: Osteoarthritis in over 16s
- NHS: Sleep and tiredness
Educational information for people in the United Kingdom — not personal legal, benefits or medical advice. Charity no. 1218461. Reviewed by Louis Maxwell, HCPC PH128483. Everyone's situation is different, so always follow the advice of your own GP, pharmacist or rheumatology team. If you feel very unwell, call 999 or go to A&E. For urgent advice, contact NHS 111.
Continue with related help
- Flare-up guide — fuller self-management overview
- Flare action plan — printable 72-hour checklist
- Arthritis pain relief — pacing with pain self-management
- Pacing & energy — avoid boom-and-bust recovery
- Joint protection — easier everyday tasks in a flare
- Exercise hub — gentle movement as you recover
- Walking with arthritis — rebuild slowly
- Newly diagnosed — first weeks after a diagnosis
- Benefits & PIP hub — if flares affect daily living or work