Patient's perspective - Managing chronic pain flare-ups

patient having a pain flare-up

When it comes to managing and living well with my chronic pain, I find that one of the hardest hurdles to tackle are flare-ups. When you’re living with chronic pain or illness it’s inevitable that you will experience flare-ups, times where your symptoms worsen and it becomes more challenging to do the things we want. For many of us it isn’t just the pain itself that increases either, symptoms such as fatigue and brain fog (feeling confused or disorganised and struggling to focus) can also prove to be more challenging.

In the past when I’ve found myself in a flare-up my instinct has been to just stop everything I’m doing, effectively cancelling my whole life and spending my time in bed. It’s only natural that pressing the pause button is where our minds can go, but as I have learnt over the years, sometimes complete rest can be just as harmful as not resting at all.

In the Leva Clinic Pain Management Programme we cover managing flare-ups, and a big part of that is encouraging you to create your own flare-up plan so today I’m going to share what my flare-up plan looks like. Everyone’s plan should be individually moulded to fit what works for you and your life, we all have different goals and priorities so creating your own unique plan can help to get the most out of it. The benefit of creating one ahead of time is that when a flare-up hits you don’t need to use precious energy to remember what helps you, it gives you the ability to simply just refer to your plan and start putting things in place. I often used to find that despite knowing what helps me when I’m in increased pain, when that pain actually hits I struggle to remember everything, so having a plan takes that stress away.

A large part of my flare-up plan actually focuses on what my triggers are and the signs that I’m heading into a flare-up. In the past I’ve only focused on what to do afterwards, rather than putting energy into trying to avoid flare-ups in the first place. For example, I know that a busy few days in a row is likely to trigger a period of increased pain and fatigue for me, so I work on managing my diary to allow time to rest in-between busier days. I also know that muscle fatigue is typically a sign that I’m heading into a flare-up too, so when I experience this I can begin to put my plan in place before my other signs and symptoms turn up. Avoiding a flare-up isn’t just about cancelling your plans though, as I believed previously. It can often mean just doing things a little differently or scheduling in more time for breaks, I always make sure that my flare-up plan doesn’t mean I have to miss out on the things I love doing most.

A big change in my plan over the past couple of years has been medication. I’ve gone from taking opioids all the time, to now only including it in my plan. Whilst pain medication isn’t helpful for me on a day to day basis, when my pain and symptoms are at their worst medication can support me to keep moving and still take part in some daily tasks. It can often mean the difference between a day in bed and a day where I can at least sit up for most of the day. Medication will play a different role in everyone’s lives so think about when it helps you most, we also cover this in the programme.

Another new addition to my flare-up plan is making sure that whilst I’m resting, I’m not avoiding movement and activity completely. Typically in the past I would avoid going up and down stairs altogether when I was in a flare-up, but I know now that avoiding them was leaving me in more pain from my joints stiffening up. I also make sure that I have a list of low energy activities I can do such as reading or crocheting so that I don’t have to hit pause on my whole life. I find this really helps my mental health too, which can often take a hit during a flare-up.

I also have a little box full of things like heat patches and microwaveable heat packs, ibuprofen cream and joint supports if needed, all things that can help reduce my pain depending on what kind of flare-up I’m in.

I think the most important thing about your flare-up plan is that it is unique and individual to you. You know your body best and what helps one person might not work for another so spend some time thinking about what helps you most and what your triggers and signs are to help you build an effective flare-up plan for yourself.

You can learn more about managing flare-ups, including how to create your own flare-up plan, in module 6 of the Leva Clinic Pain Management Programme.