Managing a flare-up

From time to time you may experience a flare-up. This is when the symptoms of arthritis temporarily worsen. This could include an increase in pain, swelling, stiffness and reduced mobility. You may also notice an increase in fatigue, trouble sleeping, anxiety, and stress. Setbacks or flare-ups are often caused by doing too much, overdoing it, and pressure from others. The good news is that these flare-ups are usually temporary. If the symptoms persist, discuss with your doctor.

You might not always be able to prevent a flare-up, but you can prepare for them and manage them well.

Your flare-up care plan might include:

• Planning ahead: have a ‘setback plan’ ready with things that help when symptoms spike
• Being kind to yourself: this is not your fault. You’re doing your best
• Prioritising: focus on what truly needs to get done. Let the rest wait
• Pace yourself: break tasks into smaller steps and take breaks before you need them
• Saying “no” when you need to, even to people you care about
• Asking for help: it’s a sign of strength, not weakness
• Rest and sleep: give your body time to heal
• Relaxation techniques: breathing exercises, meditation, or whatever calms your mind
• Hot or cold packs: use them to ease pain and stiffness
• Gentle movement: stretching, walking, or any low-impact activity that feels right
• Assistive devices: don’t hesitate to use tools or supports to protect your joints

Illness can trigger arthritis flare-ups. Have you ever come down with a cold or the flu and noticed your joints got more painful? Maybe you had COVID-19, recovered, and then your arthritis flared up. You’re not imagining it. This happens to many people with arthritis, especially autoimmune types.

Here’s why

When you’re sick, your immune system jumps into action. That immune response causes inflammation, which is usually a helpful part of fighting off viruses and bacteria. But if you have autoimmune arthritis, that same response can go too far and make your arthritis symptoms worse.

There’s also something called molecular mimicry. That’s when a virus or bacteria looks a bit too much like your own cells. Your immune system can get confused and accidentally start attacking healthy parts of your body, causing a flare-up.

If you're on medications like prednisone or biologics (e.g. Amgevita), you're already working to manage inflammation, but those same medicines can lower your immune defences, making you more vulnerable to infections. At the same time, missing doses or stopping medication without advice can also trigger a flare. It’s a balancing act, and your health team can help you get it right.

Staying well and reducing your risk of catching colds, flu, COVID-19, allergies, physical and emotional stress and all other infections will help you to reduce the chance of having a flare-up.

The pandemic helped normalise some great habits to reduce your chances of getting sick, like staying home when unwell, wearing masks, and getting vaccinated. These measures can help protect you and your whānau, especially during cold and flu season.

It's also helpful to learn about your type of arthritis, as this may help you better manage a flare-up. Ask your health team more questions about managing flares for your type of arthritis.

You're not alone

Flare-ups can feel discouraging, but they don’t define your journey. You’re part of a community of people who understand what you’re going through, and there’s support and resources available.

Whether you reach out to our Arthritis Assist team, check in with your doctor, or connect with others online, you don’t have to go through this alone.