From the Guidelines
If you're experiencing a flare-up of a past injury, I recommend starting with the RICE protocol: Rest the affected area, apply Ice for 15-20 minutes every 2-3 hours, use Compression with an elastic bandage, and Elevate the area above heart level when possible. This approach is based on the general principles of managing acute injuries and flare-ups, as there is no specific evidence provided that directly links to the cause of flare-ups in past injuries. However, the most recent and highest quality study provided is from 1, which discusses the management of atopic dermatitis and mentions that several risk factors can induce flare-ups, including dry skin, excessive sweating, changes in temperature or humidity, irritants, allergens, infections, and stress. Although this study is not directly related to the question, it provides some insight into the potential causes of flare-ups.
Causes of Flare-ups
Flare-ups can occur due to various reasons, including:
- Injured tissues healing with scar tissue that is less elastic and more vulnerable to re-injury 2
- Inflammation pathways being more easily triggered in previously injured areas, explaining why old injuries sometimes become painful during weather changes or increased activity
- Other potential causes such as changes in temperature or humidity, irritants, allergens, infections, and stress 1
Management of Flare-ups
In addition to the RICE protocol, it is recommended to:
- Take over-the-counter pain relievers like ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours or acetaminophen (Tylenol) 500-1000mg every 6 hours as needed for pain and inflammation
- Limit activities that aggravate the injury for 48-72 hours
- Gentle stretching and movement within pain-free ranges can help prevent stiffness
- If the flare-up is severe, persists beyond 7-10 days, includes new symptoms like numbness or weakness, or if you develop fever, redness, or significant swelling, seek medical attention promptly
It is essential to note that the evidence provided does not directly address the cause of flare-ups in past injuries. However, the management strategies recommended are based on general principles of managing acute injuries and flare-ups. Further research is needed to determine the specific causes of flare-ups in past injuries and to develop targeted management strategies.
From the Research
Causes of Flare-up of a Past Injury
- A flare-up of a past injury can be caused by various factors, including overuse or strenuous activity, which can lead to re-injury of the affected muscle [(3, 4)].
- Insufficient rehabilitation or incomplete recovery from the initial injury can also contribute to a flare-up [(5, 6)].
- Failure to follow proper treatment protocols, such as the RICE principle (rest, ice, compression, and elevation), can impede the healing process and increase the risk of re-injury [(7, 6)].
Risk Factors for Flare-up
- The severity of the initial injury can impact the likelihood of a flare-up, with more severe injuries being more prone to recurrence [(5, 6)].
- The type of activity or sport being performed can also influence the risk of flare-up, with high-impact or high-intensity activities being more likely to cause re-injury [(3, 4)].
- Individual factors, such as age, fitness level, and overall health, can also play a role in the risk of flare-up 6.
Prevention and Management
- Proper rehabilitation and recovery techniques, including gradual return to activity and strengthening exercises, can help prevent flare-ups [(5, 6)].
- Adherence to treatment protocols, such as the RICE principle, and regular follow-up with a healthcare professional can also help manage and prevent flare-ups [(7, 6)].
- Education on proper injury prevention and management techniques can also help reduce the risk of flare-up [(3, 4)].