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Getting your strength back after an arthritis flare or illness week (UK guide)

Written by Louis Maxwell — First Contact Practitioner, HCPC PH128483.

Clinical review status: not yet recorded

After a flare or a week ill in bed, days of much less movement can leave your muscles weaker and your stamina lower, so stairs, the kettle and the walk to the shop can feel harder even once the pain settles. Start with small, frequent movement you can manage today — standing up from a chair a few times, short walks around your home, gentle joint movements — and build up a little at a time rather than waiting to feel back to normal. Pace your day, keep eating and drinking, and ask about NHS physiotherapy: in many areas you can refer yourself to community MSK physio without seeing a GP. Get…

After a flare or a week ill in bed, days of much less movement can leave your muscles weaker and your stamina lower, so stairs, the kettle and the walk to the shop can feel harder even once the pain settles. Start with small, frequent movement you can manage today — standing up from a chair a few times, short walks around your home, gentle joint movements — and build up a little at a time rather than waiting to feel back to normal. Pace your day, keep eating and drinking, and ask about NHS physiotherapy: in many areas you can refer yourself to community MSK physio without seeing a GP. Get urgent help for a hot, swollen joint with a high temperature, a painful swollen leg, chest pain or breathlessness.

This guide is for one job: getting your strength and confidence back once the worst of a flare or illness has passed. If you are still in the middle of a flare, start with our flare-up: what to do now guide and printable flare action plan. For day-to-day energy, see energy management and pacing.

First check: is it the right time to build up?

You do not need to be pain-free to start. A good sign is that the flare or infection is settling: swelling is going down, you are eating and drinking again, and you can get to the toilet and back safely. If a hospital team, physiotherapist or your rheumatology team has already given you a recovery plan, follow that ahead of this page.

Check the urgent help list below first. A joint that is getting hotter and more swollen, a new fever, or a leg that has become painful and swollen are not signs of being out of condition. They need prompt medical advice.

Week 1: small, often and boring on purpose

  • Stand up from a firm chair a few times, several times a day, using your hands if you need to. Our sit-to-stand practice guide explains how to set up safely
  • Walk around your home every hour or so while you are awake. The NHS advises getting up and moving around regularly rather than sitting still for long periods, and being confined to bed for 3 days or more raises the risk of a blood clot (DVT)
  • Move sore joints gently through a comfortable range a few times a day — the NHS sitting exercises are a good starting point
  • Keep up meals and drinks. Small, regular snacks count if your appetite is low
  • Rest before you are exhausted, not after. A short sit-down between tasks protects tomorrow

Weeks 2 to 6: build up a little at a time

Increase one thing at a time — a few more minutes of walking, one more repeat of an exercise, or one extra job in the day. Some aching that settles by the next day is common when you restart. If pain keeps you awake, a joint swells more, or you feel wiped out the following day, go back to the last level that felt manageable and build again more slowly.

Over the following weeks, work towards the NHS physical activity guidelines. For adults aged 65 and over, these are to be active every day, even if it is just light activity, and to do activities that improve strength, balance and flexibility on at least 2 days a week. Arthritis UK (formerly Versus Arthritis) recommends a mixture of strengthening, stretching, fitness and balance activities. For osteoarthritis, NICE recommends exercise tailored to you as a core treatment.

Pacing so you do not boom and bust

The common trap after a flare is doing everything on the first good day, then paying for it for a week. Plan the day, put the most important job first, split big jobs into smaller parts, and leave some energy spare. Our pacing guide and pacing techniques for pain show how to set a baseline you can repeat on a bad day as well as a good one.

Getting physiotherapy on the NHS

The NHS says physiotherapy is free on the NHS, although there may be a waiting list. In many areas you can refer yourself to NHS community musculoskeletal (MSK) services without seeing a GP. Some GP surgeries have first contact physiotherapists who can assess bone and joint problems. If you cannot get to the surgery or hospital, a physiotherapist may be able to visit you at home, and some offer phone or video appointments.

  • Check your GP surgery website or ask reception whether you can self-refer to MSK physiotherapy
  • If you have rheumatoid arthritis or another inflammatory arthritis, ask your rheumatology team or advice line whether the flare needs a review and whether they can refer you to their physiotherapist
  • While you wait, our NHS physio waiting list guide and waiting list help page show what you can safely do in the meantime
  • If you pay privately, the NHS advises choosing a physiotherapist who is chartered (MCSP) and registered with the Health and Care Professions Council (HCPC)

If an infection, steroids or a hospital stay caused the setback

If you care for someone getting back on their feet

  • Let them do as much of each task as they safely can. Stand nearby for the tricky part rather than taking over
  • Agree a simple daily plan: a few sit-to-stands, a short walk, meals and drinks, and rest breaks
  • You can ask the local council for a free care needs assessment if daily tasks have become unsafe, and for a carer's assessment for yourself

When to get urgent help

  • Call 999 for chest pain, severe breathlessness or collapse — including leg pain and swelling with breathlessness or chest pain, which can mean a blood clot has travelled to the lungs
  • Call 999 after a fall if someone cannot get up or may have injured their head, neck, back or hip
  • Urgent GP appointment or NHS 111 for throbbing pain and swelling in one leg, usually the calf or thigh, especially after days in bed
  • Urgent same-day advice (GP, rheumatology advice line or NHS 111) for a hot, swollen, very painful joint with a high temperature or feeling unwell — see our hot swollen joint guide
  • See your GP if you are not improving after a few weeks, flares keep coming back, or everyday tasks such as washing, dressing or stairs are getting harder

Frequently asked questions

How long does it take to get my strength back after a flare?

It varies a lot, depending on how long you were less active, your type of arthritis, other health conditions and your age. Many people notice small gains within a few weeks of regular practice. Track simple things — how many times you can stand up from a chair, or how far you can walk — so you can see progress that is easy to miss day to day.

Should I rest completely until the pain has gone?

Usually not. Short rests help, but long spells of complete rest tend to make stiffness and weakness worse. Gentle movement within comfort, little and often, is usually better. Follow any specific advice from your own team, especially after surgery or a joint injection.

Is this a flare or am I getting frailer?

A flare usually means more pain, stiffness or swelling in a familiar pattern. Losing strength, appetite, weight or confidence over weeks, or new falls, is broader and worth raising with your GP. The two can happen together, and both can improve with the right support.

Sources and further reading

Educational information for people in the United Kingdom — not a diagnosis or personal medical advice. Charity no. 1218461. Pending clinical review. Everyone's situation is different, so always follow the advice of your own GP, pharmacist, physiotherapist 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

Last updated 2026-10-19. This is general information, not a substitute for personalised medical advice.

Sources and references

  1. NHS: Physiotherapy (including self-referral to MSK services)
  2. NHS: Physical activity guidelines for older adults
  3. NHS: Sitting exercises
  4. NHS: Strength exercises
  5. NHS: DVT (deep vein thrombosis)
  6. NHS: Rheumatoid arthritis treatment (physiotherapy and occupational therapy)
  7. NICE NG226: Osteoarthritis in over 16s
  8. Arthritis UK (formerly Versus Arthritis): Exercising with arthritis