“Even when things are going really well with my pain management, there will be times when my symptoms really flare up – more than just a ‘normal’ bad day. The pain team told me there’d be times like these…”

When you are living with long term pain, progress is not a smooth line upwards. It is completely normal to have ups and downs.

When we use the term ‘flare up’, we are talking about an increase in symptoms more severe than the ups and downs that are part of ‘normal’ life with persistent pain. Although sometimes flare-ups are unavoidable, if you know what tends to trigger your flare-ups, and learn to notice the early warning signs of them, you can go some way to preventing them.

Be Prepared! 

If you can’t prevent a flare up, it helps to have a plan in place to help you cope with it. Although most people think of a flare-up in terms of physical symptoms, flare-ups also often bring with them difficult emotions, such as frustration, worry and sadness. Coping with a flare-up means thinking about your physical, practical, mental and emotional needs.

Your Flare-up Plan A may include making preparations in advance so you have what you need to hand when the time comes. Some people find it helpful to have a flare-up box which means everything is in one place and is easy to find – no searching in cupboards when your pain is at its worst… As you read the following, think about what you might need in your flare-up box.

Managing Activities During a Flare-up

Most people reduce how active they are during a flare-up. Resting can be very helpful but remember that spending more than a few days in bed or lying down is likely to prolong the flare up overall. If you do need some bed rest, start to get (gently!) moving after a couple of days. Remember to pace yourself and gradually build up your activity levels.

• Medication

• It’s best to talk to your GP or pain specialist about how to use medication during a flare-up and whether there are any additional medications that it would be suitable for you to take at these times.

• Doing this IN ADVANCE of having a flare-up means you can start taking any additional medication as early as possible, and can avoid having to get to your GP during a flare-up.

• Other Sources of Pain Relief

• Heat or cold packs, TENS, massage and baths can be helpful for some people.

• Support

• Having help with your practical needs – getting food, running a bath, helping you get dressed and so on – is important. Particularly if you live alone, letting people know (ideally in advance) what you might need during a flare up (and then asking for it!) can feel difficult but can make a big difference.

• Emotional support is also important during a flare-up. Take a few moments to think about who you think you’d find most helpful to talk to at that time. Could you let them know you’d welcome their support in a flare-up?

• Some people can find it helpful to write themselves messages of support – what do you think you need to hear when you are in the middle of a flare-up? You could write these thoughts down so you can look at them when you need to. Below are Some Examples.

• Keep calm and breathe.
  This flare up will pass.
  Just deal with it moment by moment.
  Be kind to yourself.
  Don’t forget to eat.

• Distraction

• Having nothing on your mind except the pain can make it feel more overwhelming. While distraction won’t reduce your pain levels, it can help give you another focus. Distracting activities can also help with your mood – watching a favourite comedy or listening to music that lifts your spirits, for example.

• Most people find pain makes it hard to concentrate so bear this in mind when choosing distracting activities.

• As it is important to regularly change the position your body is in, and to mix up resting and moving, it is a good idea to have a few things you can do, each for a little while.

Relaxation and Breathing

Many people tend to tense their body and hold their breath when in increased pain. Doing short relaxation and mindfulness practices can be helpful. CLICK HERE for more information.

Eating Well (and Treats)

• During a flare-up, cooking can feel too much. Having food in the cupboard or freezer which is quick to prepare can make sure you eat nutritious food with minimum effort– soups and frozen meals, for example.

• We’ve also heard many people who put food treats in their flare-up boxes – a bar of chocolate or special box of biscuits. We recommend having a treat or two in your flare-up box – treating yourself with kindness is an important part of managing a flare-up. We’ve heard of all kinds of treats – magazines, a new book, a scented candle, DVD… only you can decide on what would be right for you!