Managing flare ups

Managing Flare-ups

Persistent pain is not the same all the time, some days or weeks can be worse than others. This is sometimes known as a “flare-up” or a “set back”.

Even if you have mastered lots of pain management skills, situations can still flare-up your pain. Although this is not something to worry about, it can be a nuisance and very frustrating and can make you feel that you have little control over your pain.

First reactions to flare-ups are often that the exercises or over-doing it may have caused the flare-up or that the pain problem must be getting worse. Thinking like this can lead to feeling hopeless and will make it more difficult to cope. If you accept that flare-ups will happen from time to time, then you can plan for them.

There are some simple things you can do that will make a difference to:

• How often you have a flare-up
• How long it lasts
• How severe it is at the time

The three main aspects to managing flare-ups are:

1. Identifying the triggers
2. Prevention
3. Managing flare-ups

1) Identifying the triggers

Common causes of flare-up include daily stresses and hassles building up, being more active and not pacing. Sometimes a particular activity will lead to a flare-up, for example, gardening or carrying heavy shopping bags. It may be that you can get help with this activity or change the way you do it to stop this happening. Changing what you do could be as easy as breaking the activity down into short sessions with breaks using pacing.

It can sometimes be difficult to figure out the trigger so keeping a record of your activities can be helpful for this detective work as you may notice that your flare-ups happen at certain times. Keeping a record of your exercise and activity will help you spot times when things are going wrong. Bear in mind that being unwell with flu or other illnesses can make you tired and your pain worse so you should cut back your activity at these times.

Sometimes we won’t know what has caused our flare up. Don’t spend too long thinking about. Focus your energy on doing things to help you manage it!

2) Prevention

Once you have identified triggers, the ideal way to manage them is to work out how you can prevent these occurring in the future.

Using pacing and working out your baselines for activities and situations will prevent you from becoming overactive – a common trigger for flare-ups. Also, try to make time for relaxation regularly by building it in to your daily routine. Even a few minutes in the morning and evening can make a real difference to general tension levels and pain.

Finally, by following recommendations for taking your pain medication appropriately you may be less likely to “flare-up”.

3) Managing flare-ups

Ease the pain

Try to think of things that help your pain. Think of this as your self-help toolbox. This could be as simple as a heat pad, Tens machine or a warm bath. Think about what has worked for you before.

Relaxation

Your muscles may tense up during a flare-up, and this will increase your pain. Relaxation is likely to help and there are lots of ways to do this.

Distraction

Being able to focus your attention away from the pain can help you put it to the back of your mind. Watching a good programme on TV, reading or using a computer can all be useful ways of doing this. Using your imagination to create a scene in which you feel peaceful, in control and happy can help you to feel calmer and more in control of your pain.

Cut back on activities-“Dial Down!”

Reduce your activities slightly but do not stop them altogether. Set priorities so that the most important things get done first. If you do have to spend some time in bed make sure this is kept to a minimum. Gradually return to your usual level of activity using pacing as you may have lost some of your fitness. Don’t be afraid to ask for help from your family and friends or work colleagues. They may be able to help you reduce your activity for short periods.

Adequate medication

During a flare up you may feel that you need to take some extra medication. It is useful to have a plan for the amount and type of medication that you will take during a flare up and for how long- work with your healthcare professional to have a safe plan.

Thoughts and feelings

It is natural to feel frustrated and fed up during a flare up but try to be aware of unhelpful thoughts which can creep in and lead to anxiety or low mood. Deal with the thoughts by changing them to make them realistic and helpful. Think of some positive statements to help you cope, for example reminding yourself that the flare up will pass and you will get through it.

Alternative treatments

Some people living with persistent pain try other treatments such as herbal remedies, acupuncture or massage. For some, these are helpful additions to other pain management strategies.

It is important to know that some herbal remedies and treatments can interact with other medication. Therefore, if you are looking at trying alternative treatments it is best to keep your health care professionals informed. 

It is also useful to think about the expense and the longer-term effectiveness of any of these treatments.

Reconnecting to life- What’s important to you

Hopefully the information that you have read in this section has allowed you to begin to think about how working with your pain, becoming more accepting of it and allowing it to be there can allow you to continue engaging in the activities that really matter to you, which will hopefully allow you to live a meaningful, more enjoyable life.

More on identifying what’s important to you

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