Flare Ups 5 Feb 2018

What is a Flare Up?

People with long term conditions such as pain or fibromyalgia have good and bad days. This is normal. A flare up is when the condition or pain is significantly worse than usual, much worse than on a typical ‘bad day' and where it becomes increasingly difficult to do your normal activities. Flare ups can last a couple of days to a few weeks!

They are a normal part of life with long term conditions, but with good day to day self management these flare ups will become less frequent and less intrusive. We could describe a flare up as "a bend in the road..not the end of the road". It usually settles but it is important to recognise that managing a flare up is very different from managing long term pain on a day to day basis!

So you need a plan... (2 plans in fact! One for managing a flare up and one for early intervention!)

Early Warning Signs or Flare Up?

For a plan to work you need to be able to;

1) Recognise when it is creeping up on you and so you need to know your 'early warning signs'

2) Recognise when a flare up is happening and know what to do when it does!

Early Warning Signs

Freethink: What are your personal early warning signs that lead to a flare-up?

Some examples below:

  • restless
  • overdoing it
  • lower mood
  • fatigue
  • an unexpected event
  • increase in stress
  • irritability
  • sleep deteriorating
  • putting off things
  • overconfidence
  • panicky

Learning your early signs and having an early intervention plan can help you to head off or prevent a flare up! This is the time you want to focus on all your "safety" stuff (relaxation, breathing, pleasurable activities). NOTE- Its usually the time when these things get missed or dropped!!!

Managing a Flare Up

Once you are in the flare-up 'pit', if you have a plan you can find your way out of the pit easier and quicker.

Some of the common things that we know are helpful when you are dealing with a flare-up are:

  • Rest (only for a maximum of 2 days)
  • Then start gently moving again (or stiffness and muscle tension will set in)
  • Pain medication (increase and/or take medication more regularly for a short time if needed. Always follow medical advice and stay within prescription guidelines.)
  • Heat (e.g. Hot water bottle, bath)
  • TENS machine
  • Relaxation including breathing exercises
  • Be kind to yourself
  • Stay calm, that's hard to do when the pain significantly increases
  • Positive self talk and increase "safety" messages like

    "It will get better, it did before", "it's just a bend in the road" "my back is strong" "I am relaxed, muscle tension won't help me"

Look at the threat vs safety article on this website for more on this.

Flare up Box

Some people have said they found it helpful to keep a little flare up box somewhere safe with all the things in it they need if they were experiencing a flare up. (Relaxation CD, TENS machine, favourite film, a book, photos, quotes). That makes everything easy to find if when you need at and also people reported that just knowing it is there "just in case" reduced the their stress a little.

Learning from flare ups

An important factor that we gain from the experience of being in the flare up pit is learning. We can learn valuable skills through difficult experiences, if we then recognise this we can use our learning to have a positive effect on how we deal with things in the future.

Key Points

Flare-ups will happen due to the nature of long-term pain

There are warning signs that we maybe heading for a flare-up, if we recognise these we maybe able to stop it.

It is important to have a flare-up plan so we know how to deal with one should it arise. This will alter not only the impact the flare-up has but also how long it lasts.

Dealing with negative thoughts

Long term health conditions such as long term pain produce a whole range of feelings, often negative.

Feelings or emotions tend to produce certain types of thinking. Negative emotions such as frustration, anger, helplessness tend to produce negative thoughts such as:

"There's nothing that will help me..."

"I'm never going to get any better..."

"I should be able to cope with this..."

"It's hopeless..."

These negative thoughts can create extra pressure if you think "I should be able to cope". You can push yourself to do more than you should, which will make your pain worse.

Negative thinking stops positive action.

Negative thinking stops you taking control and often ends up making you feel worse.

What can you do with negative thinking?


  • the negative thoughts i.e-"I can't cope"
  • Reassure:

  • "Some things I can't do, but others I can"
  • "If I pace myself I can manage"
  • "I can cope better if I don't get too tense"
  • Think positive:

  • "I know I can cope, if I plan properly"
  • Positive thinking puts you in control of your situation.
  • Bowen Therapy for Flare Ups

    Bowen Therapy can be used during a flare up to help calm down the central nervous system, reduce muscle tension and aid relaxation. It can be used as part of your first aid measures when a flare up occurs.