This page gives patients with arthritis advice on how to manage a flare (worsening of symptoms).

What is a flare?

You may experience your arthritis being increasingly painful; with joint swelling and stiffness despite being on treatment. It will often settle on its own and an increase in your usual medication is not needed. This is known as a flare.

During a flare you may generally feel unwell and more tired than usual. These symptoms can last anything from days to a couple of weeks.

Possible causes

Often there is no obvious cause for a flare but they can be linked to stress, infection and vaccinations.

How to manage a flare?

Most flares can be successfully managed with self-help methods, which you can start yourself before contacting the Rheumatology Advice Line (contact details at the end of this page).


Your local pharmacist or GP will be able to provide advice about suitable pain relief and anti-inflammatory treatments.

Regular pain relief such as paracetamol or co-codamol taken at regular intervals can help manage the pain.

Non-steroidal anti-inflammatory (NSAIDs), such as ibuprofen or naproxen, can also be taken to help reduce the inflammation. If you are over 65 years, have a history of kidney impairment, previous peptic ulcers, heart disease or asthma, and if in the past NSAIDs have aggravated your asthma then before taking NSAIDs you should ask your GP for advice. Anti-inflammatory gels can be applied directly to an affected joint, but should be used with caution if already taking oral NSAIDs.

Do not exceed the recommended dosage on the packaging and always read the leaflet. If you are not sure if you are able to take a specific pain relief please discuss it with a pharmacist or your GP.

Self help

If your current pain relief is not effective when taken regularly for up to a week after the start of a flare, you should speak to your pharmacist or GP about an alternative.

Heat packs, such as a hot water bottle or warm water such as a bath can help with pain. It is not advisable to apply heat to already warm to the touch inflamed joints. Ice packs or a bag of frozen peas can be useful to treat pain and help to reduce any swelling. Do not apply ice or heat directly to your skin. Wrapping an ice pack in a towel will avoid damage and irritation to the skin. Ice and heat treatments can be applied for up to 15 minutes at a time. Please ask for a copy of the leaflet GHPI0659 Ice and heat treatment.

Raising your affected limb above your heart height (elevation) or changing your position by using cushions in a chair (positional technique) can help to reduce swelling. Elevation and positional techniques may also help with a flare. Elevation may help with swelling experienced in specific joints such as the knees or feet. Supporting joints with pillows can make them more comfortable, such as a pillow behind your back or neck.

By using splints provided by the hand therapists and in soles from podiatry this may help to rest affected joints.

If you have not been seen by the hand therapists or a physiotherapist and feel you could benefit from their advice on joint protection or beneficial exercises and splints you can self-refer. Please enter the following website address into your browser where you will find the self-referral forms in the section ‘How can I see a physiotherapist’.


Alternately you can leave a message on the following numbers:


Cheltenham General Hospital

Tel: 0300 422 3040

Monday to Friday, 8:00am to 5:00pm

Gloucestershire Royal Hospital

Tel: 0300 422 8527

Monday to Friday, 7:30am to 5:30pm

Occupational Therapy

Cheltenham General Hospital

Tel: 0300 422 3040

Monday to Friday, 8:00am to 5:00pm

Gloucestershire Royal Hospital

Tel: 0300 422 8586

Monday to Friday, 7:30am to 5:30pm

Similarly if you have not been seen by podiatry and have continuing foot pain that may benefit from further advice, you can find self-referral forms online at:



Tel: 0300 421 8800

Monday to Friday, 9:00am to 4:00pm

Rest and exercise

Gentle exercise until a flare has passed is known to be helpful in relieving some pain as it releases natural pain relief called endorphins into the body. It can also help with your mood, sleep and general well-being. By keeping moving during a flare you will reduce stiffness in your joints. Spending long periods in bed or sitting down can increase stiffness.

Exercise can help ease arthritis pain but knowing which is best for you can be difficult. Often an increase in pain is telling you that you have done too much. To avoid this it is important to pace yourself by doing a steady amount of activity every day.

Some people get caught in the trap of yo-yoing, for example, doing lots on one day and then feeling unable to do anything for the next few days.

Take regular breaks and plan your week. Spreading activities throughout the week, changing the way you do things and asking for help can make things easier. An increase in pain does not mean you have damaged yourself, just that you may have done too much.


For further advice please speak to either our physiotherapists or hand therapists.

What if my symptoms continue?

If the flare continues for over a week and has not responded to any of the self-help treatments, or you are having regular flare ups, we advise you to call the Rheumatology Advice Line. Please leave a message and we will call you back within 48 hours.

Contact information

Rheumatology Advice Line

The advice line is open from Monday to Friday, 10:00am to 1:45pm

There is no longer an answerphone service, the calls will be answered and an appointment made for a call back from the nurse. Please be aware this is not an emergency line

Tel: 0300 422 6412

When we call back we are likely to ask:

  • How long have you had the symptoms and what part of the body is affected?
  • What self-help treatments have you tried?
  • Any obvious cause for the flare - have you been unwell?
  • Have you had any bloods done recently?
  • Current medications and previous steroid use whether this is oral, intra muscular Depo-Medrone or joint injections.

If your problem requires urgent attention outside of the Rheumatology Advice Line hours then please contact your GP or NHS 111 for advice.

NHS 111

Tel: 111

Further information

Versus Arthritis

Tel: 0300 790 0400


National Rheumatoid Arthritis Society

Tel: 0800 298 7650


Live better to feel better: Gloucestershire self-management


Tel: 0300 421 1623


The Pain Tool Kit


Pain Concern

Tel: 0300 123 0789




Printable version of this page

Managing a flare GHPI1549_01_22 Department: Rheumatology Review due: January 2025 PDF, 200.2 KB, 5 pages
Reference number GHPI1549_01_22
Department Rheumatology
Review due January 2025