Expert Blogs | Pain Management
5 Ways to Manage Pain Flare-Ups

If you live with chronic pain, one of the most important things you can do for yourself is to learn how to manage pain flare-ups. A pain flare-up is a substantial increase in the intensity of an underlying chronic pain problem. While the change in pain level can be dramatic, it is not a new pain, but rather a significant exacerbation of a pain problem that already exists.

Still, the sudden spike in pain can be so unsettling that you may worry that there is a new injury or problem, leading you to shift your attention from calming the flare-up to seeking a new diagnosis and new treatment for this “new pain” (which isn’t really a new pain at all). All of this misplaced effort allows pain to run amok.

A pain flare-up is not to be confused with the term breakthrough pain, which originally came about to describe increases in cancer pain that were not adequately controlled by pain medications and needed an extra boost. Breakthrough pain eventually became a popular term for the pharmaceutical industry to promote the daily use of added pain painkillers during the day to try to bring down routine fluctuations in pain levels.

Pain flare-ups can be attributed to a whole host of causes, including these common culprits:

  • Physical Activity – A certain movement or task can set off a pain crisis. For example, something as simple as bending the wrong way or sitting too long in the car can be a trigger.
  • Stress – Whether it be emotional or physical stress, going into fight-or-flight mode seems to make us more sensitive to pain. We have a tendency to carry stress in our bodies right where we hurt the most.
  • Poor Sleep – Studies have shown that pain intensity can correlate with the quality of our sleep. Something as simple as staying up an extra hour later than normal can leave you feeling more pain sensitive and uncomfortable the next day.
  • Overdoing It – Trying to get too many things done in a day or participating in an activity for longer than what you can typically handle is a common cause of flare-ups.
  • Eating the wrong foods – Foods that cause inflammation, fluid retention, dehydration, or trigger headaches can play a role in aggravating an existing pain problem.
  • A Virus – Having the flu or a cold can leave muscles and joints feeling achy and can easily make a chronic pain problem feel that much worse.
  • ??? – It is worth pointing out that sometimes pain flare-ups occur from no particular cause; they just happen.

Whatever the trigger, it may be helpful to think of a flare-up as a situation where something has gone awry in the communication between the nervous system and the musculoskeletal system. The processing of information in the brain and the nerves that connect with your body are telling your muscles to react and tense up. Having a robust flare-up management game plan is an integral part to successfully managing chronic pain.

Here are my tips to developing a winning flare-up management tool kit!

  • Pacing – Learning how to slow down and pace activities can be a critical part of living well with a chronic pain problem. If overdoing it causes you to crash for the next few days, then pacing will actually help you get more done in the long-run. Consider breaking up tasks into smaller jobs as opposed to trying to do them all at once.
  • Avoid Shutting Down – Sure, rest is an important part of recharging, but too much avoidance of activity can actually make the pain worse. Find the right balance between moving too much and aggravating the flare-up-up versus doing too little and causing the body to get tighter, stiffer, and sorer.
  • Don’t Panic – A bad pain flare-up can set off all kinds of alarms. But this mindset will only serve to make you tenser and hurt even more. Learn strategies to calm the nervous system and use them when you start to feel control slipping away.
  • Move – It may seem counter-intuitive, but the right movement strategies can be your best friend when it comes to managing a flare-up. Learn stretches to release tight muscles groups, or consider gentle yoga poses to connect the mind with the body in a calming way. And even doing some cardio or a nice walk can improve your mood and outlook enough to reduce the pain.
  • Pamper Yourself – This might be a good time to book a massage, check in with the chiropractor, or see an acupuncturist, if these practices have a proven track record with your particular condition. It helps to have an outside support team

Creating a successful flare-up-up tool kit will be well worth your time and energy, but it might mean thinking outside the box to get there.

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Peter Abaci, MD

Peter Abaci, MD

Board-certified anesthesiologist and pain specialist

Peter Abaci, MD, is one of the world’s leading experts on pain and integrative medicine. He is the medical director and co-founder of the renowned Bay Area Pain and Wellness Center and the author of Conquer Your Chronic Pain: A Life-Changing Drug-Free Approach for Relief, Recovery, and Restoration and Take Charge of Your Chronic Pain: The Latest Research, Cutting-Edge Tools, and Alternative Treatments for Feeling Better.

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