Anyone remember 'The Yuk'....? (Flare-Ups revisited)

What's changed since 2013?

Flare-ups are periods when symptoms of inflammatory arthritis—such as pain, swelling, stiffness, and fatigue—worsen beyond the usual day-to-day variation. These episodes can last from a few days to several weeks and may significantly disrupt daily life.

I’ve been reflecting on one of the original 2013 PsAZZ News articles on "Flare-Ups" which came about as a result of our peer group meetings and email 'topics of conversation' to try and find our common themes and triggers. Back then we discussed what flare-ups were to us, the impact they can have and shared some tips and management strategies. We also coined our own phrase for that feeling when you know you are sliding into flare-up - a kind of all over, flu-like feeling... which we collectively decided to call 'The Yuk'! I wondered how, since then, research and clinical understanding has advanced understanding - especially regarding triggers, management and interventions (aka treatments).

Here’s an updated overview reflecting what is now known about flare-ups in inflammatory arthritis as of 2025.

Since 2013, research has identified a broader range of known triggers for flare-ups, including:

• Infections (such as colds or urinary tract infections)

• Physical or emotional stress

• Changes in medication or missed doses

• Hormonal changes

• Weather changes (evidence is mixed but we wrote about this!)

• Dietary factors (for some individuals)

Not all flares are the same. The importance of personalised trigger identification is now emphasized, with people encouraged to track their symptoms and potential triggers using apps or diaries (see the ‘Resources Page’ for a free pdf download to help get you started)

Some flare-ups can be mild and short-lived, while others are severe and prolonged. This distinction is important for tailoring our self-management approaches and decisions to seek treatment and support. Recognition and management of flares is important.

Sometimes self-management strategies, such as rest, gentle exercise, and stress reduction are enough. It’s been increasingly recognised that things like Mindfulness, cognitive behavioural therapy, creative or physical therapy can be helpful.

Other times we may need medication adjustments that could help prevent longer-term joint damage and reduce the impact on our quality of life for example, temporary increases in anti-inflammatory drugs or corticosteroids can be used during flares (seek medical supervision if needed).  Some people may find that their biologic medications have reduced the frequency and severity of flares. If you experience frequent or severe flares, it’s recommended you consult your rheumatology team for the latest management strategies and support.

Since 2013, there has been a greater shift towards patient information and shared decision-making. People are encouraged to develop their own flare management plan with their healthcare team, including when to seek medical advice and how to adjust medications safely.

Practical Tips for Managing Flares:

• Track your symptoms and triggers to identify patterns.

• Have a flare plan: Know which medications to adjust and when to contact your healthcare provider.

• Prioritise rest, but also include gentle movement as tolerated.

• Use heat or cold packs for symptom relief.

• Seek support from healthcare professionals, family, peer groups or patient organisations during difficult flares.

So whilst there is no simple solution, it is great that the understanding of flare-ups in inflammatory arthritis has deepened and that there is now a greater focus on individualised care, earlier diagnosis and treatments, and in helping empower people to manage their condition proactively.